ACL Injuries
What is it?
Like all other forms of ligaments, the anterior
cruciate ligament (ACL) connects one bone (the
femur or thigh bone) to another (the tibia or leg
bone) and helps stabilize the joint. When torn,
the ligament does not have significant healing
capability and the individual is prone to episodes
of instability and further damage to the joint.
Who gets it?
Injuries of the ACL of the knee can affect
individuals of all ages and levels of activity.
What are the symptoms?
The ACL is most frequently injured in
athletics, but certainly can be torn by any method
that applies unusually high stresses to the knee
joint. In sports, the injury typically occurs in
association with sudden twisting or deceleration
activities, and sometimes with a direct blow to
the knee. As a rule, swelling develops shortly
thereafter. Many athletic events occur in the
evening, and patients may not notice the swelling
until the following morning. In the event of an
acute knee injury (which is marked by pain,
followed shortly thereafter by swelling), there is
approximately an 80% chance of a torn anterior
cruciate ligament. The patient does not have to
feel something pop or experience a sense of
instability at the time of injury.
Diagnosis
The diagnosis of an ACL tear is made based upon
a carefully performed history and physical
examination. X-rays are usually normal, and
magnetic resonance imaging (MRI) is usually not
necessary to make this diagnosis.
Treatment
The treatment must be individualized and is
based upon the age and activity level of the
patient. In general, young individuals involved in
agility sports are best treated with
reconstructive surgery. Older individuals not
participating in activities which require jumping,
change of direction, and other agility activities
can frequently be treated with strengthening of
the muscles of the leg. The most important aspect
of non-operative (conservative) treatment of
patients with anterior cruciate ligament tears is
the avoidance of high-risk activities.
At the time of surgery, the anterior cruciate
ligament cannot be repaired. It is therefore
reconstructed using an alternate material. The
most frequently used materials are tissues from a
strip of the patella tendon from the front of the
knee, or hamstring tendons from the back of the
knee. Most orthopaedic surgeons prefer using the
patient’s own tissue, although some prefer
donated cadaveric tissue from a tissue bank.
Return to play typically takes six to nine months.
Physician's Who Treat ACL Injuries
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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