Anterior Cruciate Ligament (ACL) Injuries

Anterior cruciate ligament (ACL) tears are common among professional athletes, as well as sports activity enthusiasts. Approximately half of all ACL injuries are accompanied by damage to other structures in the knee as well. These other structures can include the menisci, articular cartilage, or other knee ligaments. If you think you may have an ACL injury, come to YourOrthoSolution. We specialize in ACL injuries and will develop a customized plan that will get you back to the things you love as quickly as possible.

Most ACL injuries are complete or almost complete tears. Partial tears are rare. Injured ligaments are considered “sprains”, which can be rated on a severity scale from Grade 1 to Grade 3 (shown below). According to this system, most ACL injuries are classified as Grade 3 sprains.

• Grade 1 sprain – the ligament is mildly damaged and slightly stretched but still keeps the knee joint stable.
• Grade 2 sprain – the ligament is stretched to the point where it becomes loose and becomes a partial tear.
• Grade 3 sprain – the ligament is completely torn into two pieces, and the knee joint is unstable.

Here at YourOrthoSolution, we have some of the top orthopedic surgeons and sports medicine physicians in the country. We are dedicated to getting you back to the things you love through a customized plan that fits only you. Our caring team always goes that extra step to make you feel like part of our family. We specialize in treating ACL injuries and want to help you start the healing process as quickly as possible to get you on the path to recovery.

Cause

There are many ways the ACL can be injured. Here are a few examples:

• Quickly changing directions while running
• Stopping suddenly
• Landing incorrectly on your feet
• Direct trauma, such as being hit directly on the knee

Female athletes are more likely than males to develop an ACL injury. Several factors may account for this, such as differences in physical conditioning, muscle strength, and/or neuromuscular control between males and females. Other potential reasons include differences in the alignment of the pelvis and legs between males and females, increased ligament looseness in females, and the effects of estrogen on ligaments in females.

Symptoms

At the time of an ACL injury, you may hear a “pop” and/or feel your knee give out from under you. Shortly afterwards, you will develop other knee symptoms, including:

• Pain – especially when walking or trying to run
• Swelling
• Decreased range of motion (stiffness)
• Tenderness when touching the joint line – the joint line is the area between the femur (thighbone) and the tibia (shinbone).
• Feeling that the knee is unstable, like it may give out

Treatment

Treatments for an ACL tear are evaluated in relation to your individual needs. At YourOrthoSolution, a customized plan based on your activity level will be designed to get you back to the things you love most. An athlete, for example, will most likely require surgery to be able to return to sports, whereas an older individual might be able to resume a quieter lifestyle without surgery. Make an appointment with us today to talk with our experts about the best plan for you.

Nonsurgical

A torn ACL will not heal without surgery, but nonsurgical treatments can be effective for patients who have a low activity level. If this is you and your knee is fairly stable and intact, nonsurgical options may be the best choice and allow you to avoid surgery.

In the early period after your ACL injury, reduced activity is recommended to help protect your knee from further injury, and a knee brace is generally suggested to help stabilize your knee. Crutches may be recommended at this stage as well, to help you avoid putting weight on the knee. Once the swelling has subsided, physical therapy is usually started to help restore mobility to the joint and to strengthen the muscles around your knee. Strong muscles will help support and stabilize your knee.

Surgical

To repair a complete ACL tear, surgery is required. Typically, surgery is delayed until after the swelling in the knee has resolved. Surgery performed too early greatly increases the risk of scar forming in the joint (known as arthrofibrosis), which causes permanent stiffness of the knee.

Generally, the ACL cannot simply be stitched back together. It must be replaced by a tissue graft, in an operation called ACL reconstruction or ACL repair. The graft acts as a scaffolding upon which a new ACL will grow. The tissue graft is most commonly taken from your patellar tendon, which is the tendon located between the patella (kneecap) and the tibia. This is called a patellar tendon autograft. Hamstring and quadriceps muscle tendon autografts are other options. Sometimes, a graft from the patellar or other tendon of a cadaver (referred to as an allograft) is used instead. There are advantages and disadvantages to all graft sources. Discuss the graft choices with your surgeon to help determine which is best for you.

After surgery, it will take time for the ACL to regrow and become a functioning part of your knee. It typically takes at least six months before you can return to any type of sports or strenuous activities like running.

ACL repair is generally performed via arthroscopy. This minimally invasive procedure can easily be done on an outpatient basis in a surgery center setting. There are many advantages to surgery centers, including better outcomes, lower infection rates, no overnight stay, lower costs, and the convenience that comes with a smaller, yet highly skilled, staff.

During the surgery, a small camera (an arthroscope) is inserted into the knee joint through a very small incision. The camera displays images on a high-definition screen, allowing your surgeon to have a detailed view of the joint while he or she uses miniature surgical instruments to perform the ACL repair. This type of surgical technique produces minimal damage to the surrounding areas and muscles, which leads to less pain and a quicker recovery, compared to open knee surgery.

As with all of our procedures, the goal is to get you back to full strength and doing the activities you want to do. Our highly trained specialists will take into account several factors and create a customized treatment plan designed specially for you and your needs.

At YourOrthoSolution, all of our doctors and staff are committed to ensuring that you not only receive the best orthopedic care in the area but also have an exceptional experience each time you visit our locations. Our dedicated staff will handle all insurance processes for you. You can expect to be in a friendly atmosphere and receive top orthopedic treatment to help you return to full mobility as quickly as possible.