What is the ACL (anterior cruciate ligament)?
The ACL is ligament which connects the thigh bone (femur) to the shin bone (tibia). It is located inside the knee joint.
What does the ACL do?
The ACL functions to provide knee stability during activity. It prevents excessive translation and rotation of the knee joint. It stabilizes the knee during actions requiring cutting and pivoting of the knee. The ACL also serves to facilitate the normal motion of the knee and provides protection to other cartilage structures in the knee like the meniscus.
What is an ACL tear?
An ACL tear occurs when an abnormal force in either rotation or translation (or both) occurs on the knee. The ligament ruptures (tears).
What activity can cause an ACL tear?
ACL tears are common sports injuries. In any high impact sport where the knee is twisted or there is sudden stopping during play can result in a ACL tear. ACL tears are commonly associated with meniscus tears.
Which sports are commonly associated with ACL tears?
- Any sport where the knee suffers impact on the side or front
- Sports that involve pivoting and sudden change in direction, as in soccer, basketball, and football
- Sports that cause a twisting injury to the knee while the foot is fixed (skiing)
What happens when the ACL is torn?
When the ACL is torn, abnormal motion occurs between the femur and tibia at the knee joint. This results in the loss of stability to the knee with certain movements, especially twisting, pivoting, and cutting from side to side.
What are the symptoms of a torn ACL?
- Instability is typically the most common complaint
- Complaints of “not trusting my knee” or “giving way” are commonly reported with even simple activities like turning, twisting.
- The sensation of shifting of the knee can occurs during sports, making cutting and pivoting activity difficult.
Can an ACL tear heal without surgery?
No, an ACL tear will not heal on its own. Surgical reconstruction is typically required.
How is an ACL tear diagnosed?
Your orthopedic surgeon at SCOS will diagnose your condition based on a description of the injury, physical examination, and an MRI.
What are the treatment options?
Treatment options depend on the severity of the injury, the patient’s age and physical activity, and quality of life.
- Nonsurgical treatment includes activity modification and bracing
- Physical Therapy: strengthening the knee can help with recovery but generally will not restore stability
- Arthroscopically assisted ACL reconstruction is typically recommended. It is generally outpatient surgery. The procedure uses the assistance on a fiber-optic camera to reconstruct the ACL. The use of a graft (tissue) is required to replace the torn ACL. ACL tears cannot be repaired directly. Your surgeon will choose the graft that best fits your lifestyle and activity needs. Recovery and return to sports without restriction typically averages 9-12 months.
If you have suffered a knee injury while playing sports, your orthopedic surgeon at SCOS can help diagnose your condition quickly, and provide you with treatment options to return you to an active lifestyle as quickly as possible.
Dr. Nimish Kadakia is a sports medicine expert at SCOS Orthopedic Specialists. He and his fellow sports medicine specialists including Dr. Scott Graham and Dr. Chris Veneziano are experts at evaluating and treating ACL tears. Over the years, they have provided care to thousands of athletes and active individuals, getting them back to play and back to their pre-injury activities.