Anterior Cruciate Ligament (ACL) Injury or Tear
What You Need to Know
- ACL injuries are more common among girls than boys.
- 由于生长板的位置，儿童前交叉韧带损伤的治疗需要特别考虑.
- ACL injuries are classified by grades 1, 2, and 3.
- Depending on the grade of ACL injury, the patient’s age, and level of athleticism, non-operative or surgical treatments may be recommended.
What is the anterior cruciate ligament?
The knee is a hinge joint held together by four ligaments. 韧带是膝盖上的一种结构，它将骨头连接在一起，并帮助控制关节的运动. 膝盖两侧各有一个韧带(副韧带)，膝盖深处有两个韧带. 膝盖内部相互交叉的两条韧带被称为前交叉韧带(ACL)和后交叉韧带(PCL)。. 两根韧带一边连接到大腿骨的末端(股骨)，另一边连接到胫骨的顶部(胫骨)。. [Figure 1].
During activity, 前交叉韧带控制胫骨相对于股骨能推荐十大正规网赌平台“滑动”多远:它的作用本质上是防止过度推荐十大正规网赌平台移动. 而某种程度的运动或滑动是正常的，并且是膝关节功能所必需的, 过多的运动可能会损害膝盖的其他结构，这可能会导致一些患者的长期问题.
How is the ACL injured? What are the symptoms?
前交叉韧带可能以多种不同的方式受伤或撕裂. 最常见的机制是在体育活动中突然的旋转或切割动作, which is commonly seen in football, basketball and soccer. 韧带也可能因工伤或车祸而撕裂.
在受伤的时候，有时可以感觉到或听到“啪”的一声. 受伤时所经历的疼痛程度有些不同，但可能相当严重. Typically, the person is unable to continue play or activity, 给人的印象是发生了重大伤害. 在受伤的最初几个小时内，膝关节会立即出现肿胀，但如果立即将膝关节冰冻或用夹板固定，肿胀的程度可以得到限制.
What are the symptoms of an ACL injury or tear?
- A “pop” in the knee at the time of injury
- Swelling of the knee
- 腿部无法承受重量(尽管有些人很少或没有疼痛)
- Instability of the knee
ACL Surgery | Michelle's Story
在前交叉韧带撕裂后，米歇尔决定回到她积极的生活方式. 在运动医学整形外科医生Andrew Cosgarea的指导下，她前往约翰霍普金斯大学进行前交叉韧带重建, M.D.
How is an ACL injury diagnosed?
前交叉韧带撕裂可以由医生通过病史和体格检查来诊断. On physical examination, 医生可以特别评估当前的活动量并确定前交叉韧带是否撕裂. Additionally, 对膝关节内的其他结构也进行评估, 因为前交叉韧带撕裂通常与膝关节内其他结构的损伤有关, such as the cartilage and collateral ligaments.
X-rays are taken to evaluate for the presence of any fractures. In many patients, an MRI scan of the knee may be ordered. 如果病史和检查不确定，扫描可以澄清ACL撕裂的问题. 如果有必要对特定患者的最佳治疗方案做出决定，该扫描也可用于评估膝关节软骨或半月板组织.
What are the different types of ACL injury or tears?
前交叉韧带损伤通常分为1、2或3级.
Grade 1
一级损伤包括轻度损伤的前交叉韧带.g.，前交叉韧带轻度拉伸，但仍为膝关节提供足够的稳定性.
Grade 2
2级前交叉韧带损伤是罕见的，描述的是前交叉韧带拉伸和部分撕裂.
Grade 3
三级前交叉韧带撕裂发生在前交叉韧带完全撕裂成两半，不再为膝关节提供任何稳定性时.
Tibial Spine Avulsion ACL Injury
青少年也可能有所谓的胫骨撕脱韧带损伤. With this type of injury, the ACL itself is not torn, 但是连接胫骨的韧带(小腿骨)被扯掉了. 这取决于韧带的骨连接被扯掉了多远, 如果不固定，损伤会导致膝盖无力或不稳定.
ACL Tears in Female Athletes: Q&A with a Sports Medicine Expert
Sports injury prevention isn't a one-stop shop, especially for injuries like ACL tears, 哪些疾病在女性中比男性常见4到8倍. 发现帮助女性预防这种常见伤害的方法.
What is the treatment for an ACL injury or tear?
Treatment options are based on the patient’s symptoms, examination, the growth remaining in his or her growth plates, type of injury to the ligament, and the type of sports and activity goals.
Nonsurgical
非手术治疗最适合1级损伤. This would include immobilization or bracing, physical therapy, 逐渐恢复正常的活动和运动.
Surgical
对于三级或完全的前交叉韧带撕裂，建议进行手术治疗. Surgical options may vary based on the type of ACL injury, whether the patient has open or closed growth plates, and the type.
Seminar 常见的运动和活动相关伤害:从疼痛到断裂的考虑
