One of the most frequent injuries of the knee that can require surgery depending on the severity of the injury and your level of activity.

INJURY
Anterior Cruciate Ligament Injuries

ALSO KNOWN AS
ACL tear

ABOUT
An anterior cruciate ligament (ACL) injury is one of the most frequent injuries of the knee that can require surgery depending on the severity of the injury and your level of activity. The cruciate ligaments form an X inside the knee joint (ACL positioned in front of the posterior cruciate ligament) and together they control the back and forth motion of the knee. Severity of an ACL injury is determined on a grading scale. Grade 1 is considered mild in that the ligament has been stretched but continues to support the joint. Grade 2 is a partial tear with the ligament being loose. Grade 3 is an entire tear where the ligament is severed, leaving the knee joint completely unstable. The majority of ACL injuries are complete tears.

COMMON INJURY
ACL tears are a common high demand sports injury resulting from changing direction quickly, incorrect landing from a jump, result of a collision or direct contact, sudden stopping, or slowing down from running. Female athletes may be more prone than men due to physical strength, conditioning, hip width and alignment and/or effects of estrogen on ligaments.

DIAGNOSIS
Typically when the injury occurs you will hear a “popping” sound when the knee has given out. There is pain, swelling, tenderness, loss of motion and it is uneasy to walk. During a physical exam with your physician you will likely discuss your symptoms and history. Most ligament injuries are easily diagnosed with a physical examination.

NON SURGICAL TREATMENT
Older, less active people may be advised to use non surgical treatment if the knee is stable enough. Bracing can protect the knee and crutches may help to keep weight off of the injury. Physical therapy can also help to restore function.

SURGICAL TREATMENT
Arthroscopic surgery can be done using small incisions to reconstruct the severed ligament with a tissue graft. The best options for the source of the tissue graft can be discussed with your surgeon.

Anterior Cruciate Ligament Injuries
Image courtesy of AAOS