One of the most common ways people hurt their knees in Iran is by injuring their ACL (anterior cruciate ligament). This is one of the bands of tissue that holds the bones together within your knee. It also helps to keep your knee stable. You can stretch or tear your ACL if you make a sudden movement or quick, sharp turn when you’re running or jumping. It’s often painful, and can make it hard to walk or put pressure on the injured leg.
One of the most common knee injuries in Iran is an anterior cruciate ligament sprain or tear.
If you have injured your anterior cruciate ligament, you may require ACL repair surgery to regain full function of your knee. This will depend on several factors, such as the severity of your injury and your activity level.
Three bones meet to form your knee joint: your thighbone (femur), shinbone (tibia), and kneecap (patella). Your kneecap sits in front of the joint to provide some protection.
Bones are connected to other bones by ligaments. There are four primary ligaments in your knee. They act like strong ropes to hold the bones together and keep your knee stable.
These are found on the sides of your knee. The medial collateral ligament is on the inside and the lateral collateral ligament is on the outside. They control the sideways motion of your knee and brace it against unusual movement.
These are found inside your knee joint. They cross each other to form an "X" with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The cruciate ligaments control the back and forth motion of your knee.
The anterior cruciate ligament runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee.
About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.
Injured ligaments are considered "sprains" and are graded on a severity scale.
Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.
Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.
Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.
Partial tears of the anterior cruciate ligament are rare; most ACL injuries are complete or near complete tears.
Athletes often get ACL injuries when they stop and quickly change directions while they’re running. People who play soccer, football, tennis, basketball or volleyball, or who do gymnastics are more likely to twist their knees by mistake when they compete than, say, cross-country runners, who simply move forward at a steady pace. Your speed -- combined with the way that you twist or turn your knee -- makes it likely that you’ll stretch or tear your ACL.
Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control. Other suggested causes include differences in pelvis and lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.
The anterior cruciate ligament can be injured in several ways:
. Changing direction rapidly
. Stopping suddenly
. Slowing down while running
. Landing from a jump incorrectly
. Direct contact or collision, such as a football tackle
When you injure your anterior cruciate ligament, you might hear a "popping" noise and you may feel your knee give out from under you. Other typical symptoms include:
. Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
. Loss of full range of motion
. Tenderness along the joint line
. Discomfort while walking
. A loud "pop" or a "popping" sensation in the knee
. A feeling of instability or "giving way" with weight bearing
There are a number of factors that increase your risk of an ACL injury, including:
. Being female — possibly due to differences in anatomy, muscle strength and hormonal influences
. Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing
. Poor conditioning
. Wearing footwear that doesn't fit properly
. Using poorly maintained sports equipment, such as ski bindings that aren't adjusted properly.
. Playing on artificial turf surfaces
People who experience an ACL injury are at higher risk of developing osteoarthritis in the knee. Arthritis may occur even if you have surgery to reconstruct the ligament.
Multiple factors likely influence the risk of arthritis, such as the severity of the original injury, the presence of related injuries in the knee joint or the level of activity after treatment.
Proper training and exercise can help reduce the risk of ACL injury. A sports medicine physician, physical therapist, athletic trainer or other specialist in sports medicine can provide assessment, instruction and feedback that can help you reduce risks. Programs to reduce ACL injury include:
. Exercises that strengthen leg muscles, particularly hamstring exercises, to ensure an overall balance in leg muscle strength.
. Exercises to strengthen the core, including the hips, pelvis and lower abdomen
. Training and exercise emphasizing proper technique and knee position when jumping and landing from jumps.
. Training to improve technique when performing pivoting and cutting movements
. Training to strengthen muscles of the legs, hips and core — as well as training to improve jumping and landing techniques — may help to reduce the higher ACL injury risk associated with women athletes.
Treatment for an ACL tear will vary depending upon the patient's individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. The less active, usually older, individual may be able to return to a quieter lifestyle without surgery.
A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.
. Bracing. Your doctor may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.
. Physical therapy. As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.
. Rebuilding the ligament. Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Your doctor will replace your torn ligament with a tissue graft. This graft acts as a scaffolding for a new ligament to grow on.
Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.
There are advantages and disadvantages to all graft sources. You should discuss graft choices with your own orthopedic surgeon to help determine which is best for you.
Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.
. Procedure. Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.
Recovery from an ACL surgery can take anywhere from two to six months. However, it can nine months or more before you return to your pre-injury condition with a full range of motion and stability in the knee joint. A longer rehabilitation period doesn't mean that you're doing anything wrong.
The cost of ACL reconstruction surgery in Iran starts from $1000.
ACL surgery cost in India starts from $ 3200.
ACL surgery cost in Turkey starts from $3500.
ACL surgery cost in the USA starts from $20000.
ACL surgery cost in Pakistan starts from $2900.
ACL surgery cost in the UK starts from $6000.
ACL surgery cost in Mexico starts from $4900.
ACL surgery cost in Canada starts from $20000.
ACL surgery cost in Iran starts from $1700.