ACL Tears

ACL injuries often result from high-impact or rapid-motion activities and involve:

• Rapid changes in direction: Pivoting or cutting movements can stress the ligament.
• Sudden stops: Decelerating quickly or awkward landing from a jump or a fall.
• Direct collision: A direct blow to the side of the knee, such as during a football tackle.
• Overextension: Stretching the knee joint beyond its normal range of motion.

• The patient may hear or feel a pop at the time of initial injury
• Knee buckling or giving way
• Loss of range of motion
• Joint tenderness
• Pain and swelling within 24 hours after the injury. This may resolve on its own, but instability will remain.
• Quadriceps muscle weakness

Your Hyper Regen Sports Medicine doctor will review your medical history and inquire about the circumstances of your injury. They will conduct a detailed clinical examination and perform specific tests such as the Lachman test, anterior drawer test, and pivot-shift test which are specific maneuvers used to assess ACL integrity. Most ACL tears can be diagnosed by physical exam.

Because 50% of ACL tears are accompanied by damage to other parts of the knee joint, including the meniscus, the collateral ligaments and/or articular cartilage, additional imaging studies will be ordered to identify such associated injuries.   Specifically x-rays will be ordered to assess for alignment and to rule out any bony injury. An MRI (Magnetic Resonance Imaging) is the gold standard for visualizing soft tissue injuries and will be arranged to assess for associated meniscal and/or cartilage tears.

The treatment approach for ACL tears depends on the severity of the injury, the individual’s age, activity level, and associated injuries.

• Conservative Treatment: This approach may be suitable for individuals who do not participate in activities that involve pivoting or twisting. The success of non-operative care is dependent on a neuromuscular rehabilitation program that emphasizes quadriceps and core strength and may involve custom knee bracing.  For patients who experience giving way of the knee and/or lack of trust in the knee during sporting activities despite an attempt at non-operative care, surgery may be warranted.
• Surgical Treatment: For patients who participate in high level sports, daily activities that involve frequent cutting/pivoting and/or experience knee instability, ACL reconstruction is recommended. Furthermore, the presence of associated ligament, cartilage or meniscus injury may also influence the decision to pursue surgery.  The ACL reconstruction procedure entails using a graft to replace the torn ligament. The graft can be autograft (from the patient, commonly from the patellar tendon or hamstring tendon) or less commonly in low demand patients an allograft (from a donor).