The Anterior Cruciate Ligament or ACL is one of four major ligaments of the knee that is responsible for the stability of the knee during activities. What is an ACL tear? Anterior Cruciate Ligament Tears are some of the most common knee injuries in athletes participating in sports such as soccer, football or basketball. The ACL is a ligament that connects the femur and tibia bones in your knee and prevents one bone from shifting forward on the other. It is a strong rope-like ligament that is very important to the knee. Most ruptures to the ACL will occur when somebody rapidly changes direction, stops suddenly, or lands incorrectly from a jump. These injuries can happen in non-sport activities as well if you fall with your leg positioned in just the right way.
How to diagnose Anterior Cruciate Ligament Tears?
With a good history and physical examination, I can often determine if there is the possibility of an Anterior Cruciate Ligament Tear. Often there will be pain and swelling within the first 24 hours of the injury and loss in the range of motion of the knee. Many patients feel like their knee goes out or gives way on them when they try to cut and twist. X-rays may be used to evaluate any injuries to the bone and often times an MRI is necessary to completely understand your ACL injury. There are many types of injuries to the ACL. Sometimes it is just sprained, stretching the ligament, to where it becomes loose but not actually torn. Other times it may be partially or completely ruptured giving a sense that the knee gives out!
What are the treatments for Anterior Cruciate Ligament Tears?
Initial treatment for ACL injuries are to reduce the swelling in the knee, often times I may draw the fluid off of the knee to reduce that swelling and then brace the knee to protect it from any further damage. Physical therapy to help recondition the strength about the leg also helps. When the swelling is decreased and the range of motion returns ACL surgery may be recommended if I anticipate a high demand on your knee either in sports, work, or lifestyle.
ACL reconstructions are usually performed arthroscopically and there are several different techniques. Keep in mind that my goal is to return each patient back to a pain free full range of activities and motion. Because the fluid in your joint prevents the injured ACL from healing well an ACL reconstruction generally requires replacement of the entire ligament. The new ACL may come from your own patella tendon below your kneecap or your hamstring tendon. There are also opportunities to use a ligament graft called an allograft from a cadaver. This will have certain advantages and disadvantages you should discuss with your surgeon. In each patient I try to match the type of reconstruction to the patient’s specific circumstances – their physical activities, size, and preferences. After Anterior Cruciate Ligament Tears reconstruction there is a significant amount of rehabilitation that will be very important to getting you back to your full activities. This may involve many weeks of rehabilitation. If you have questions about ACL injuries and reconstructions, please feel free to contact me or schedule an appointment.