ACL vs PCL

Dave: Man, that Haiku about Dani last week was lame.

Feisty: A Haiku is a seventeen syllable Japanese Poem three lines long with the form of five syllables in the first and third line and seven syllables in the seventh. It was a Limerick - a light humorous, nonsensical, or bawdy verse of five anapestic lines usually with the rhyme scheme AABBA.

Dave: Whatever. Let me know how you make out with the RAP career.

Feisty: She got the shut-out didn’t she?

Dave: Oh, so now you’re taking credit for that as well?

Feisty: Of course not! She played awesome… So how’s the knee?

Dave: Still sore. I wrecked my ACL.

Feisty: I thought it was your PCL?

Dave: The PCL is usually injured through hyperextension of the knee or bending it backwards. You see, the knee can be thought of as having four ligaments holding it in place, one at each side to stop the bones sliding sideways and two crossing over in the middle to stop the bones sliding forwards and backwards. It is the latter two in the middle that are called the cruciate ligaments, the posterior cruciate ligament (meaning back - PCL) and anterior cruciate ligament (meaning front- ACL).

Feisty: So when can you play next?

Dave: The anterior cruciate ligament is considered to be the principal ligamentous restraint to anterior tibio-femoral displacement and is the most commonly injured of the major knee joint ligaments.

Injuries to the anterior cruciate ligament range from partial to complete rupture and result in varying degrees of knee joint instability and loss of function. An unfavourable interaction of the dynamic and static stabilising factors may predispose team-game players to increased threat of anterior cruciate ligament disruption. In particular, optimal functioning of the dynamic muscle stabilisers of the knee joint may be fundamental to the prevention of or limit the severity of ligamentous injury.

This may be important also in preventing re-injury since, if not treated by means of surgery or aggressive compensatory muscle rehabilitation towards optimal function, the extent of the original tear is highly related to the extent of subsequent further injury to the anterior cruciate ligament. The knee joint instability associated with the anterior cruciate ligament-deficient knee is thought to be related to significant and progressive damage to articular components, which may ultimately lead to early onset osteoarthritis.

This injury has progressed from representing a career-threatening event to that of an extended absence from the game for most players. Contemporary surgical interventions demand typically a subsequent six-month rehabilitation programme prior to the player recommencing competitive match-play. Thus this injury still presents extensive physiological and psychological challenges to the player and often a logistical threat to the employer. Despite the advances in contemporary treatment, the latter potential costs suggest that wherever possible, factors that may contribute to the prevention of this injury or a reduction of its severity should be explored fully. However, in the absence of appropriate compensatory rehabilitation, even relatively minor anterior cruciate ligament trauma (which may remain undiagnosed) may act as a precursor for more severe subsequent ligamentous injury and other co-morbidity factors such as meniscal injury.

Feisty: Thanks for clearing that up.

Dave: Did you know he only animal with 4 knees is the elephant?

Feisty: Hope to see you on the ice soon.

Dave: Another Beer?

Feisty: Sure!