Anterior cruciate ligament
The anterior cruciate ligament or ACL is one of the four main stabilising ligaments of the knee, along with the posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). The ACL attaches to the distal end of the Femur, at the posterior of the joint and passes down through the knee joint to the anterior of the flat superior surface of the Tibia. The ACL prevents the tibia from sliding too far forward.
One of the most common problems involving the knee joint is an ACL tear. The ACL can be injured by trauma or sporting activities. If the ligament is completely torn, it will not heal. When torn, it can make make sudden, pivoting movements difficult, and it may make the knee more prone to developing arthritis and meniscus tears. In college basketball, women players may be eight times more likely than their male counterparts to suffer from an ACL injury.
There are several standard tests used to determine if the ACL has been damaged. Lachmans test: The Lachman test is performed to evaluate abnormal forward movement of the tibia One hand secures and stabilizes the distal femur while the other firmly grasps the proximal tibia. A gentle anterior translation force is applied to the proximal tibia. The examiner assesses for a firm / solid or soft endpoint.
Tendons and ligaments are avascular and therefore heal at a slow rate. Knee replacement surgery is an option for patients with damaged ACL's, but many find that unless extended performance is required (as in for instance, professional sports or heavy physical labor) a deteriorated ACL can be tolerated by limiting activity to a modest level.