The Anterior Cruciate Ligament (ACL) is a strong ligament inside the knee that connects the thighbone (femur) to the shinbone (tibia). It may become torn, resulting in instability of the knee.
Common Causes
Falls that cause the knee to twist or pivot. Rapid deceleration or pivoting in sports. Common in skiing, basketball, and soccer.
Symptoms
At the time of injury, many patients recall a ‘pop’ in their knee. Swelling usually develops. The knee may feel unstable, with patients not being able to ‘trust’ the knee, or complain of the knee ‘giving way’. Pain is unpredictable.
Physical Findings
Swelling in the knee, especially at the time of injury. Instability of the knee can be demonstrated on physical exam.
Workup
History and physical examination are the main aids to diagnosis. X-rays are usually necessary to rule out a fracture or other injury. Your doctor may obtain an MR scan as well.
Non-operative Treatment
Initial treatment includes rest, ice, and elevation. A torn ACL will not heal on its own. Some patients, however, can reduce their symptoms with physical therapy, bracing, and activity modification.
Surgical Treatment
The ACL may be successfully repaired with an arthroscopic ACL reconstruction, using one of several surgical techniques.
Injury Comment
Left untreated, ACL tears do not heal on their own. Persistent knee instability may predispose the knee to early wear, leading to arthritis. Patients with a damaged ACL are at much high