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DIAGNOSIS

A sports physician can easily diagnose a torn ACL. By moving the knee and testing its motion, doctors can determine that the ACL has been damaged. Also, if there is blood found inside the knee joint, there is a 70-80% chance that the ACL is torn. An MRI (magnetic resonance image) also can detect the injury.

TREATMENT

Just 5-7 years ago, torn ACLs commonly ended athletes' careers. For athletes and other patients involved in pivoting sports or labor-intensive jobs, ACL reconstruction surgery is recommended. For less active people, there is nonoperative treatment. Instead, they can strengthen the quadriceps and the hamstrings and wear a brace. But neither exercises nor braces can give them full support, stability, or strength. The surgery commonly entails taking a graft of another ligament either from the patient or from a cadaver. That graft is then placed in the knee, where the original ACL had been, and fixed in place using a screw, glue, or a staple. During the recovery period, the body incorporates the new ligament, which eventually replaces the ACL.

PREVENTION

There is no sure way to prevent ACL injuries in contact sports. However, recent studies have shown that female athletes are at a higher risk of sustaining ACL injuries than male athletes. There are several theories on this, but most sports medicine doctors believe that if women are trained adequately, the frequency of these injuries will decline.

RECOVERY

The average recovery period is 6-8 months. The patients are walking quickly after the surgery, and physical therapy begins within 2 weeks. At that time, the patient begins stationary bicycle exercises and quadriceps and hamstring strengthening. In 10-12 weeks, patients can begin jogging on a treadmill, swimming, and golfing. After about 4 months, the patient can begin pivoting maneuvers and drills. The athlete should be able to return to his or her sport after about 6-8 months.

LONG-TERM OUTLOOK

With modern treatment, a torn ACL is no longer career ending. Treatment works very well and allows athletes to compete at the same level that they had in the past. Some athletes recover from the injury and say that it did not change their performance from their pre-injury level. Others may feel that they lose some of the maneuverability or explosiveness that they had before the injury. Nemcova will have surgery and hopes to play again by January or February.

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