BRYAN LEE
Tucson Citizen
May 12, 2008

One of the most dreaded mishaps in sports, from pickup basketball to the NFL, is the knee injury.

It can start you on the cycle of pain, surgery, rehab and the mental task of healing for three to four weeks for a meniscus tear to six months to a year for a torn anterior cruciate ligament.

The knee's ACL connects muscles near the tibia (shin) to the femur (thigh). The menisci are two sets of cartilage in the upper tibia that reduce friction during movement.

"They are cushions," says Jennifer McLean of the Tucson Orthopaedic Institute, who conducts knee injury rehab. "The ACL stops the knee joint from sliding forward and from rotating. Injuries come from sheer force in which the ligament usually buckles and ends up being torn."

The cutting, acceleration and deceleration in activities like basketball, soccer, rugby and lacrosse are riskier for ACLs.
Other knee ligaments are the MCL (medial cruciate), PCL (posterior) and LCL (lateral) that connect the thigh and

shin to the knee. Injuries to these, says McLean, are usually not as serious as the ACL.

The institute's Dr. Todd J. Tucker treats many ACL tears- less than 10 percent need reconstruction surgery.
But "if you play a 'cutting' sport or activity, it's better to have reconstruction," he says.

Tucker says it's speculative but patients lose an average of 3 percent of effectiveness, hardly noticeable to the active person or weekend warrior.

Tucker added many ACL tears can be fixed arthroscopically. Such repairs can be made with small incisions, reducing recovery time and increasing the chance of the surgery being successful.

The dynamics of knee injury involve prevention, treatment and rehab. Exercise, rest and therapy are key.
Says McLean, "Muscles stabilize the area, so building up those muscles - hips, quadriceps, calves, hamstrings - is needed."

Sources: Tucson Orthopaedic Institute; Children's Memorial Hospital, Chicago; Mayo Clinic; bigkneepain.com; Massachusetts General Hospital