ACL Tears Specialist

ACL Tear Q & A

What is an ACL tear?

The anterior cruciate ligament (ACL) is one of the main ligaments in the center of your knee. It runs from the back of the femur (thigh bone) to the front of the tibia (shin bone), and assists in proper knee joint movement. In particular, the ACL prevents the tibia from shifting out from underneath the femur.

An ACL tear can create an unstable knee that gives way during activities, especially during cutting and pivoting sports. It is most commonly injured when the knee twists with the foot planted on the ground. However, it can also occur due to a direct blow to the knee or knee hyperflexion or extension. This damage can result in a partial ACL tear or, more commonly, a complete tear.

What are ACL tear symptoms?

Usually, an acute tear to the ACL results in sudden pain and a sense of giving way. Many patients report feeling or hearing a “pop.” The knee often swells within the first 1 to 3 hours after the injury. When the ACL injury is chronic, knee shifting or giving way frequently occurs with activities.

An examination in an orthopaedist’s office can often determine when there is a significant ACL injury. However, sometimes if the injury has just occurred, it can be difficult to tell if the ligament is injured because pain and stiffness often limit the exam.

Do I need X-rays or an MRI?

Your physician will usually obtain X-rays to evaluate the bones for a fracture or arthritis. An MRI can be helpful to confirm damage to the ACL and assess for additional injuries.

What are the treatment options for ACL injuries?

An ACL tear cannot heal on its own. However, not all ACL tears require surgery. Whether or not the ACL needs treatment primarily depends on your activity level. The ACL is most important for cutting and pivoting sports, such as tennis, basketball, and skiing. Those with strenuous jobs involving heavy lifting and climbing also usually need a functioning ACL. For those who desire unrestrained activities, or who are unable or unwilling to modify their activity level, ACL surgery is encouraged.

People who lead a more sedentary lifestyle may get by with exercise and sometimes a brace to stabilize the knee. However, some may experience giving way with simple activities such as going down stairs or stepping off a curb. In these cases, your surgeon will often recommend surgery to restore normal activities and prevent further damage to the knee.

What happens during ACL tear surgery?

Since the ACL does not heal, the ligament needs to be replaced (reconstructed). During ACL surgery, the ACL is reconstructed using a minimally invasive camera (arthroscope), and specially designed instruments, inserted through small incisions.

During the procedure, a replacement ligament (graft) is placed in the joint at the site of the old ACL and fixed to the ends of the bone, creating a new graft and resulting in a stable knee. Your surgeon can use either an “autograft” (your tissue) or “allograft” (cadaver donor tissue) to replace your ACL. You and your surgeon will discuss the specific options appropriate for you.

What should I expect from my recovery?

Every procedure is different. As a result, recovery times vary. Typically the surgery is performed as an outpatient procedure, so you go home the same day. Your surgeon will prescribe pain medication to minimize your discomfort during the initial postoperative period.

In most cases, physical therapy will start immediately after your surgery to restore range of motion and strength. Physical therapy is a vital component of a successful recovery.

When can I return to sports?

In general, you must have good motion, strength, and control of your knee. How quickly you return to sports depends on several factors, including:

  1. Your rate of healing.
  2. The damage found at surgery.
  3. If you have any postoperative complications.
  4. How hard you work in rehabilitation.

In most cases, it will take a minimum of six months to return to more basic athletic activities and nine months to a year for cutting and pivoting sports.

At Town Center Orthopaedics, the surgeons and physical therapists work together to ensure each patient achieves a successful recovery after ACL surgery.

If you suspect that you may have injured your ACL or other knee ligaments, we would be glad to discuss treatment options. To schedule your sports medicine evaluation, call Town Center Orthopaedics any time at (703) 435-6604, or book online today.

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