You may need to have your stitches or staples removed a week or so after your surgery. If you are having a decompression procedure, the surgeon may harvest your bone from the site of the decompression and use it as the graft. This type of graft is called a local autograft. Splints and casts. These patients may also have additional injuries to the head, chest, abdomen, or legs. Before you agree to the test or the procedure make sure you know: At Another Johns Hopkins Member Hospital: Femur Fracture Open Reduction and Internal Fixation, Ankle Fracture Open Reduction and Internal Fixation, Masks are required inside all of our care facilities, COVID-19 testing locations on Maryland.gov, The pieces of your leg are significantly out of alignment, Your broken tibia or fibula pierced through the skin, Your tibia or fibula broke into several pieces, Your bones havent healed normally after undergoing treatments that are more conservative, Irritation of the overlying tissue from the hardware, You will receive a general anesthesia. As you transition to wearing regular shoes, you will gradually stop wearing your brace. If you fracture your ankle, you might need ORIF to bring your bones back into place and help them heal. Your commitment to your recovery. Depending on your age and medical history, your surgeon may recommend that you are evaluated by your primary doctor to make sure that you have no medical problems that need to be addressed before surgery. In some cases, bone healing can be slow or not happen at all. Citations may include links to full text content from PubMed Central and publisher web sites. Youll need imaging of your tibia and fibula, either an X-ray or computed tomography scan (CT). At some point, you may need physical therapy to restore strength and flexibility to your muscles. These types of fractures are called intra-articular. In some cases, nerves may be injured at the same time that the bone is broken. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. Opioid dependency and overdose have become critical public health issues in the U.S. Depending on the extent of your injury and your other medical conditions, you might be able to go home the same day. You might need to take medicine to prevent blood clots (a blood thinner) for a little while after your surgery. Today, several artificial bone graft materials have also been developed: Your surgeon will discuss with you the type of bone graft material that will work best for your condition and procedure. You might need this procedure to treat your broken ankle. These challenging fractures are also most at risk for infection, and infection can cause bone healing problems. In general, you can expect the following: Talk to your healthcare provider about what you can expect after your surgery. from the American Academy of Orthopaedic Surgeons, The amount and size of the broken bone fragments. If your bone was fractured in many pieces or your bone is weak, it may take longer to heal, and it may be a longer time before your doctor recommends motion activities. Spinal fusion eliminates motion between vertebrae. You might not need ORIF if you fracture your ankle. In most cases, surgery is needed to restore the damaged bone to its normal position. You may have some fluid draining from your incision site. During this time, you will need to return regularly for follow-up X-rays to make sure your ankle remains stable. TUESDAY, Nov. 15, 2022 (HealthDay News) -- For patients with end-stage ankle osteoarthritis, total ankle replacement (TAR) and ankle fusion (AF) have similar clinical scores and harms, according to a study published online Nov. 15 in the Annals of Internal Medicine.. Andrew J. Goldberg, M.B.B.S., from the UCL Institute of Orthopaedics & Musculoskeletal Learn about the medical, dental, pharmacy, behavioral, and voluntary benefits your employer may offer. These fractures often take several months to heal completely, but you should be able to resume many of your activities before this time. You might need ORIF for a fracture that occurs anywhere along your ankle. Your own risk of complications may vary according to your age, the anatomy of your fracture, and your other medical conditions. Many types of medicines are available to help manage pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an Orthopaedist. Open reduction and internal fixation (ORIF) is a type of surgery used to stabilize and heal a broken bone. You may limp for several months after your fracture because of stiffness, discomfort, and weakness. A CT scan will also help your doctor plan your treatment. Because blood clots in your leg veins may develop after surgery, your doctor may also give you blood thinners. Nonsurgical treatment options for distal femur fractures include: Patients with distal femoral fractures of all ages do best when they can be up and moving soon after treatment (such as moving from a bed to a chair, and walking). Talk to your doctor if your pain has not begun to improve within a few days of your surgery. Will bone graft be necessary? You may have some pain after your procedure, but you may be prescribed pain medicines by your healthcare provider. Elderly people with distal femur fractures typically have poor bone quality. Most people do very well with ORIF for their ankle fracture. Possible complications include: There is also a risk that the fracture wont heal properly, and youll need to repeat the surgery. Masks are required inside all of our care facilities. If you participate in high-impact sports, you may be able to resume activities 6 months after your surgery or injury. These allow fusions to be performed with smaller incisions. Some patients with posttraumatic arthritis may need further surgery to relieve symptoms. In cases of severe arthritis that limits activity, a total knee replacement may be the best option to relieve symptoms. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This is usually a temporary way to stabilize your fracture and give it time to begin healing before you have an internal fixation. Tell your healthcare provider about all the medicines you take, including over-the-counter medicines like aspirin. This procedure is called a revision and may be necessary if the implant is loose or not supported by surrounding good bone. Smokers and overweight people are more likely to fracture their ankle and have increased difficulty with healing. These complications are most likely to occur during the first few weeks after surgery. The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields.This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and Further Treatment. This device is a stabilizing frame that holds the bones in the proper position until you are ready for surgery. Harvesting a bone graft requires an additional incision during the operation. To provide effective support, your cast must correctly fit your ankle. Many types of medicines are available to help manage pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. Strong muscles in the front of your thigh (quadriceps) and back of your thigh (hamstrings) support your knee joint and allow you to bend and straighten your knee. In extreme cases, a fracture may be too complicated and the bone quality too poor to fix. from the American Academy of Orthopaedic Surgeons, Questions and Answers for Patients Regarding Elective Surgery and COVID-19. Higher energy fractures may be in more pieces and slower to heal, especially if they are open with more damage to soft tissues. The whole operation may take a few hours. It is important to use opioids only as directed by your doctor and to stop taking them as soon as your pain begins to improve. If this happens, you may experience sudden chest pain and shortness of breath or coughing. If a follow-up x-ray shows rods, plates, and screws breaking or pulling out of the bone, it may be a sign that the bone is not healing. In a lateral approach, your surgeon approaches your spine from the side. Distal femur fractures can be closed meaning the skin is intact or can be open. The fracture on the right, however, has broken the joint surface into two pieces. The external fixator acts as a frame to help hold your ankle in a good position until a second surgery can be performed. (Left)A transverse fracture across the distal femur. It is important to tell you doctor if you have pain in other parts of your body. You may need to have your stitches or staples removed a week or so after your surgery. When the distal femur breaks, both the hamstrings and quadriceps muscles tend to contract and shorten. More severe infections may require intravenous antibiotics for several weeks at a time. Patients with pilon fractures usually experience immediate and severe pain. Get information on latest national and international events & more. If the soft tissues (skin and muscle) around your fracture are badly damaged, or if it will take time before you can tolerate a longer surgery because of health reasons, your doctor may apply a temporary external fixator. The internal fixation methods most surgeons use for distal femur fractures include: Both of these methods can be done through one large incision or several smaller ones, depending on the type of fracture you have and the device your surgeon uses. This might happen in the part of the bone near the knee, near the middle long part of the bone, or in the bone near part of the ankle. The injury to the surrounding soft tissues, such as muscle, tendons, and skin, Inability to bear weight on the injured leg, Deformity your ankle may look angled or crooked. Before your procedure, someone will take your medical history and perform a physical exam. Your doctor will closely monitor the healing of your fracture. Ankle stiffness is very common after a pilon fracture. It is also important for rotation of the forearm; that is, the ability to turn your hand palm up (like accepting change from a cashier) or palm down (like typing or Your surgeon may approach your spine from the front. Most people who have ORIF for their tibia or fibula fracture do very well. This information is provided as an educational service and is not intended to serve as medical advice. The entire operation usually takes place while you are asleep under general anesthesia. Deformity the knee may look "out of place" and the leg may appear shorter and crooked, Your doctor will assess your overall condition to make sure no other body parts have been injured (head, belly, chest, pelvis, spine, and other extremities), He or she will examine your skin around the fracture to make sure it is not an open fracture, Your doctor will also check the blood and nerve supply to your leg. 2014 Sep;44(9):690-701, C1-7. Rotator Cuff and Shoulder Conditioning Program. You may have significant pain after your procedure, but pain medicines may help to relieve the pain. You will get general anesthesia, so youll sleep through the operation and wont feel anything. ORIF often takes place as an emergency or urgent procedure. The most common symptoms of distal femur fracture include: In most cases, these symptoms occur around the knee, but you may also have symptoms in the thigh area. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. In this x-ray of the knee taken from the side, the muscles at the front and back of the thigh have shortened and pulled the broken pieces of bone out of alignment. Keene D, et al. In rare cases, the artificial implant must be removed and replaced with a larger implant. If you fracture your tibia or fibula, you might need ORIF to bring your bones back into place and help them heal. In some cases, your healthcare providers might perform your ORIF a little later. This may require as much as 3 months or more of healing before weightbearing can be done safely. This will offer protection while your ankle continues to heal. Fractures and knee replacements. Do I have any specific risks for not doing well? Before your procedure, a healthcare professional will take your health history and do a physical exam. The amount of swelling will determine if and when surgery can be done. Together, these three bones tibia, fibula, and talus make up the ankle joint. As soon as your pain begins to improve, stop taking opioids. In this operation, your doctor makes small incisions into the skin and inserts metal pins through the bones. There are also different "approaches" your surgeon can take to reach your spine. Physical therapy is typically started 6 weeks to 3 months after surgery. Certain medical conditions may make tibia or fibula fractures more likely. Physical Therapy Guidelines for Ankle Fracture with Surgery. Infection following spine surgery occurs very rarely. The tibia may break in one place or shatter into multiple pieces. In many cases, the devices used to fix a fracture break or loosen when the fracture fails to heal. These tissues are highly processed, and the chance of infection or disease from this tissue is very low. You might need an external fixation. For information:Questions and Answers for Patients Regarding Elective Surgery and COVID-19. There will be blood loss during your surgery. Read latest breaking news, updates, and headlines. Talk to your doctor if your pain has not begun to improve within a few days of your surgery. A distal femur fracture is a severe injury. To fully evaluate your fracture, your doctor may recommend an x-ray. Exercises to strengthen the supporting muscles will be added around 6 weeks after surgery. Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of Cigna Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (LINA) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (NYLGICNY) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The ends of the tibia and the fibula both form part of the ankle joint. Some degree of posttraumatic arthritis occurs in about half of all patients with pilon fractures. Open fractures and high energy fractures are most at risk for not healing. (Related Articles: Posterolateral Lumbar Fusionand Posterior Lumbar Interbody Fusion and Transforaminal Lumbar Interbody Fusion). Many pilon fractures require surgery but, rarely, some stable fractures can be treated nonsurgically. Medications are often prescribed for short-term pain relief after surgery. (Related Article: Anterior Lumbar Interbody Fusion), A posterior approach is done from the back. Warning signs of a possible blood clot include: Occasionally, a blood clot will travel through the bloodstream and may settle in the lungs. If I have to have surgery, what are the benefits and risks? Check your pulse at key points of the foot to be sure that there is a good blood supply to your foot and ankle. Most patients are not able to put all of their weight on their injured ankle for 2 to 3 months. The theory is if the painful vertebrae do not move, they should not hurt. For those who received ankle replacement, wound-healing complications and nerve injuries were most common. In a closed reduction, a healthcare provider physically moves the bones back into place without surgically exposing the bone. Spine surgery is usually recommended only when your doctor can pinpoint the source of your pain. If so where will it come from? In other types of fractures, the injury moves the bone fragments out of alignment. These are the tibia (shinbone), the fibula (the smaller bone in your leg), and the talus (a bone in your foot). If you have significant swelling or blisters, your doctor will delay your surgery until the swelling goes down. Copyright 1995-2021 by the American Academy of Orthopaedic Surgeons. There are several different techniques that may be used to fuse the spine. Recovery. This website is not intended for residents of New Mexico. During this time, your doctor may recommend that you use crutches or a walker. (Related Article: Lateral Lumbar Interbody Fusion). Other options include the use of artificial bone fillers. Your healthcare provider will make other repairs, if necessary. The entire operation usually takes place while you are asleep under general anesthesia. Your risk for arthritis is determined by a number of factors, including the number of broken pieces of bone, the degree of displacement, and whether the bones broke through your skin (open fracture). If you have chronic pain or experience other complications, you may need further treatment. Ask if there are any medicines you should stop taking ahead of time, like blood thinners. Sometimes larger, solid pieces are used to provide immediate structural support to the vertebrae. Your doctor will talk with you about the best treatment option for you and your injury. Generally the recovery time for a broken bone is 4 to 6 weeks, depending on the circumstances of the injury. In the past, a bone graft harvested from the patient's pelvis was the only option for increasing the material needed for fusing the vertebrae. Complications, although rare, can sometimes happen. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an Orthopaedist. Your doctor may place your ankle in a splint until your surgery, or recommend that you have an initial smaller surgery to protect your ankle while waiting for the second surgery. Open reduction and internal fixation; Revision of the total joint implants; A combination of both; You may also require a hip brace for several weeks after surgery to further protect your hip while the fracture heals. When you are allowed to put weight on your leg, it is very normal to feel weak, unsteady, and stiff. An ankle joint metal/composite semi-constrained cemented prosthesis is a device intended to be implanted to replace an ankle joint. You might not need ORIF if you fracture your tibia or your fibula. In this X-ray of posterolateral lumbar fusion (PLF), a rod and screws have been used to prevent motion at the spinal segments being fused. There are different types of fractures and symptoms include pain, swelling, and discoloration of the skin around the injured area. Pilon fractures vary. Learn more about your spine: Spine Basics. After the healthcare provider and surgery team have secured the bone, the layers of skin and muscle around your leg will be repaired. In many cases, surgeons will use plates, screws, and rods to help hold the spine still. Your healthcare provider can help explain the details of your surgery. Sometimes, a new plate or screws may also be needed. This Friday, were taking a look at Microsoft and Sonys increasingly bitter feud over Call of Duty and whether U.K. regulators are leaning toward torpedoing the Activision Blizzard deal. Instead, your surgeon will fix a plate or rod at both ends of the fracture without touching the many small pieces. When will I be able to put weight on my leg. Your own risk of complications may vary according to your age, the anatomy of your fracture, and your other medical conditions. It can be treated like other forms of osteoarthritis with physical therapy, braces, medications, and lifestyle changes. Is my pain gone or less, and are my knee motion, stability and strength improving? Your surgeon will put screws or pins in your bone on either side of your fracture inside your body, then connect them to a brace or bracket around the bone outside of your body. This might happen in the part of the bone near the knee, near the middle long part of the bone, or in the bone near part of the ankle. A bone fracture may be the result of high force impact or stress, or a minimal trauma injury as a result of certain Make sure to keep all of your follow-up appointments. A rehabilitation plan will be designed to help restore normal muscle strength, joint motion, and flexibility. Learn more: Vaccines, Boosters & Additional Doses | Testing | Patient Care | Visitor Guidelines | Coronavirus. It is important to note that this study was published prior to the introduction of the Torg et al[ 13 ] classification. Distal femur fractures in younger patients are usually caused by high energy injuries, such as falls from significant heights or motor vehicle collisions. This information is provided as an educational service and is not intended to serve as medical advice. Internal fixation refers to the method of physically reconnecting the bones. In many pilon fractures, the bone may be crushed or split into several pieces due to the high-energy impact that caused the injury. How severe your injury is. If the infection is deep, it may involve the bone and the device used to fix the bone. Different kinds of injury can damage the lower tibia, lower fibula, or talus. Talk to your doctor if your pain has not begun to improve within a few days of your treatment. Youll have an image of your tibia and fibula taken, with either an X-ray or a CT scan. Details. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. If their injuries cause significant blood loss, it could lead to shock a life-threatening condition that can result in organ failure. Although relatively uncommon, pain can also be caused by irritation from the plates or screws. You probably wont need ORIF unless there is some reason your fracture might not heal normally with these conservative treatments. Tarsal tunnel syndrome (TTS) is a compression neuropathy and painful foot condition in which the tibial nerve is compressed as it travels through the tarsal tunnel. This type of fracture is particularly serious because, once the skin is broken, infection can occur in both the wound and the bone. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids. Youll receive instructions about how you can move your leg and whether you can put weight on it. Complications can include: Acute compartment syndrome (ACS): In this syndrome, pressure building in your muscles keeps your blood from getting to your muscles and tissues. The most common ankle injury is ankle sprain and of ankle sprains, a lateral ankle sprain is by far the most common, accounting for up 75 If you experience any of these symptoms, you should notify your doctor immediately. Newer techniques and implants may help prevent this risk, but cannot eliminate it entirely. Make sure to keep all of your follow-up appointments. This is normal. Whether or not your doctor recommends surgery often depends on how out of place (displaced) the fractured pieces of bone are. Medications are often prescribed for short-term pain relief after surgery or an injury. Smokers may also have an increased risk. Once your doctor determines that your fracture is stable enough, you can begin weightbearing activities. Different kinds of injury can damage the tibia or the fibula, causing them to break into one or more pieces. For example, it may be difficult to bend it the same way, go up and down stairs, or climb a ladder. The distal femur is where the bone flares out like an upside-down funnel. Certain medical conditions may make fracturing your ankle more likely. In both the elderly and the young, the breaks may extend into the knee joint and may shatter the bone into many pieces. Ask your healthcare provider about the risks that most apply to you. He or she will assess your pain level (if any), strength, and knee motion, and also how well you are able to perform daily activities. This will keep the overall shape and length of the bone correct while it heals. Different kinds of injury can damage the tibia or the fibula, causing them to break into one or more pieces. Minimally invasive techniques have also been developed. A bone infection can require long-term, intravenous antibiotic treatment, as well as several surgeries to clean out the infection. Screws have been placed to provide stability to the spine while the fusion heals. The bone graft will come from either your own bone (autograft) or from a donor (allograft). Examine your lower leg and ankle, looking for cuts from the injury and gently pushing on different areas to see if it hurts. Even though this is expected, be sure to share your concerns with your doctor and physical therapist. Motor vehicle or cycling accidents, contact sports, falls, and repetitive impact activities are common sources of injury that can lead to a tibia or fibula fracture. Because of the forceful nature of these fractures, many patients also have other injuries, often of the head, chest, abdomen, pelvis, spine, and other limbs. Your satisfaction with doing normal everyday activities, as well as work and sports activities, is the final assessment of your recovery. If you have lost significant knee motion and your fracture is healing, your doctor may suggest an additional operation to break up scar tissue around the kneecap. Microsoft pleaded for its deal on the day of the Phase 2 decision last month, but now the gloves are well and truly off. Blood clots. You will most likely be unable to bear weight on your ankle for up to 12 weeks after your injury. Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster. Masks are required inside all of our care facilities. Pilon is the French word for "pestle" an instrument used for crushing or pounding. J\DP Also, let your healthcare provider know if there is increased redness, swelling, severe pain, or loss of feeling in your leg, or if you get a high fever or chills. You are more likely to need ORIF if: In these cases, ORIF can place your bones back into their proper configuration, increasing the chance that your bone will eventually heal properly. Depending on several factors such as your age, general health, and the type of fracture you have it may take a year or more of rehabilitation before you are able to return to all everyday activities. Even though you can put weight on your leg, you may still need crutches or a walker at times. Your doctor may use a combination of these medications to improve pain relief, as well as minimize the need for opioids. In the quadruped stifle joint (analogous to the knee), based on its anatomical position, it is also referred to as the cranial cruciate ligament. Once the swelling and blisters go away, your doctor can then fix your tibia bone with metal plates and screws. If your fracture does not heal properly, further surgery may be required. Better quality bone (younger patients) may keep the plates, screws, and rods better in place. In most cases, your doctor will first apply a splint to hold your ankle in place. When this happens the bone fragments change position and become difficult to line up with a cast. Determine whether you have sustained any other injuries by examining the rest of your body. These details will depend on where the injury is and how serious it is. Will I develop arthritis or any other complications. Illustration of a posterolateral lumbar fusion (PLF) shows bone graft material placed over the transverse processes of the vertebrae. It is important that your doctor knows the circumstances of your injury. PRIME Education is an accredited provider of continuing medical education. You might need to take medicine to prevent blood clots (a blood thinner) for a little while after your surgery. Pilon fractures most often result from high-energy trauma such as a car or motorcycle accident, fall from a height, or skiing accident. The study reported an average healing time of 7.5 wk and return to sport in an average of 8.5 wk with no postoperative complications or re-fractures[1,2,4]. In some cases, surgery may be necessary to get rid of an infection. Newer techniques in treating these difficult fractures have cut the infection rate by more than a half: Currently less than 5% of patients have infections. Ask your healthcare provider about the risks that most apply to you. Your healthcare provider can help explain the details of your particular surgery. This might involve special screws, plates, rods, wires, or nails that the surgeon places inside the bones to fix them in the correct place. The tibia forms part of the knee joint. When will I be able to start putting weight on my leg? Your surgeon will bring the pieces of your tibia or fibula back into alignment (reduction). It is important to use opioids only as directed by your doctor. A broken bone is a fracture. Your healthcare provider might not want you to take certain over-the-counter medicines for pain because some of these can interfere with bone healing. Surgery is commonly recommended for unstable fractures in which the bones are out of place. These details will depend on the location and severity of your injury. Doctors have seen an increase in pilon fractures since the introduction of air bags in motor vehicles. The whole operation may take a few hours. During an open reduction, orthopedic surgeons reposition your bone pieces during surgery to put them back into their proper alignment. Because the knee is the largest weightbearing joint in the body, any defect can damage the protective articular cartilage and, over time, result in arthritis. When the femur breaks into several pieces, new bone will grow and fill in gaps during the healing process. If you cannot reach your doctor, have someone take you to the hospital emergency room or call 911. This prevents the bones from healing abnormally. Bone grafts may be obtained from the patient (most often taken from the pelvis) or from a tissue bank (cadaver bone). If you have surgery, your doctor will give you antibiotics to help prevent infection. Three bones make up the ankle joint. It is just as important for your doctor to know if you sustained any other injuries and if you have any other medical problems, such as diabetes. This might involve special screws, plates, rods, wires, or nails that the surgeon places inside the bones to fix them in the correct place. You might need this procedure to treat your broken shin bone (tibia) or your fibula. Casts and braces hold the bones in place while they heal. Surgical Treatment. In a closed reduction, a healthcare provider physically moves the bones back into place without surgically exposing the bone. Learn about the different types of fibula fracture or breaks that impact the calf bone at the back of the lower leg. The basic idea is to fuse together two or more vertebrae so that they heal into a single, solid bone. Infection. Opioid dependency and overdose has become a critical public health issue in the U.S. J Orthop Sports Phys Ther. iy!ceGcp5vg @)q4Xm[- (#"2p}{9Q{rc3n"PT,b|S~FIhU"8Pg NOAkH . Distal femur fractures vary. These types of fractures are often treated by removing the fragments and replacing the bone with a knee replacement implant. An orthopedic surgeon will do the surgery aided by a team of healthcare professionals. For a while after your surgery, you may need to keep your leg immobile. In more severe cases, the bone may be broken into several fragments, known as a comminuted fracture. Because they damage the cartilage surface of the bone, intra-articular fractures can be more difficult to treat. Your commitment to physical therapy and making healthy choices can make a big difference in how well you recover. It may be several months before the bone is solid, although your comfort level will often improve much faster. The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee.The two ligaments are also called "cruciform" ligaments, as they are arranged in a crossed formation. 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