The Anterior Cruciate Ligament (ACL) is one of the 4 main stabilizing ligaments of the knee. It is located within the middle of the knee joint and connects the femur (thigh bone), to the tibia (shin bone) and stops the tibia from sliding forward. It also has a role in protecting against excessive internal rotation of the tibia. It is most commonly injured during a non-contact mechanism of planting and pivoting, often seen in sports that are higher impact and require a lot of cutting, quick stops, or jumping.
When an ACL is torn, the knee will feel very unstable. Patients often complain that their knee will give out on them even with just walking straight ahead. The ACL is unable to heal itself after being torn and more often than not will require surgical reconstruction in order to be able to return to sport. Even a partially ruptured ACL may require surgical intervention. A stretched or strained ACL can make the knee feel unstable and may continue to cause buckling symptoms. An ACL tear diagnosis can be made by physical examination of an orthopedic provider and is often confirmed with MRI imaging.
It is quite possible to treat an ACL tear non-operatively. It would require extensive physical therapy as well as specialized bracing to help prevent the forward translation of the tibia. However, those who participate in sports or higher impact activity where cutting, pivoting, and quick motions are required, will likely require surgical ACL reconstruction to return to full activity.
ACL reconstruction surgery requires removal of the old ACL tissue and creation of a new ACL with a graft. Grafts can be from a cadaver which is called an allograft, or from another location on the patient called an autograft. Autografts can include using the patella tendon, hamstring tendons, or quadricep tendon. Graft choice is always discussed with the patient and with the surgeons help, the best choice for the patient is decided. Post surgical rehabilitation can take 9-12 months before return to sport. Custom bracing is required after surgery as well to continue to protect the graft the first year after surgery.
If you have been told you have an ACL tear, or if you have instability in your knee, contact Sports and Orthopedic Specialists today for a full evaluation and discussion of your options.