Torn ACL: What it means and what to do about it

Torn ACL: What it means and what to do about it

By Camille D. Khalily MD and Austin V. Stone MD, PhD

What is the ACL?

The anterior cruciate ligament (ACL) is a structure that helps stabilize the knee joint. Specifically, this strip of connective tissue prevents anterior translation of the tibia relative to the femur. In other words, it keeps your shin bone from sliding forward away from your thigh bone. It’s a strong and vital ligament, but it also commonly injured. Landing or pivoting on your knee in the wrong way or sustaining a hard strike on the side of your knee can cause an ACL tear. This injury often happens during cutting or pivoting activities like soccer, basketball, football, and skiing.

How do I know if I’ve torn my ACL?

You may have torn your ACL if you feel a “pop” in your knee, followed by immediate pain and swelling. After the injury, it may be difficult to walk due to pain and instability in your knee. At the orthopeadic sports medicine office, you will likely get an x-ray, which will typically look normal aside from some swelling. An MRI is used to confirm the ACL tear and will likely be ordered.

What do I do about my torn ACL?

ACL tears may be treated with or without surgery depending on patient goals. Most patients desire to have the ACL reconstructed and address any meniscus tears. The ACL can be rebuilt by using a graft. The graft for a reconstruction can be obtained from another area of your knee (an autograft) or a graft from a donor (an allograft). The graft is secured into the site of the former ACL using a technique called arthroscopy which uses cameras and instruments inserted through small incisions in the knee. When compared to more invasive procedures, arthroscopy reduces the amount of trauma and scarring to the knee, decreases the risk of infection, and shortens recovery time.

What is the recovery like?

Following surgery, range of motion and quadriceps activation are the most important aspects.  Weightbearing depends on the specifics of the surgery and should be discussed with your surgeon. Physical therapy should begin within the week of surgery, and will focus on range of motion, quadriceps and hamstring strengthening (your thigh muscles) and will progress over several months. ACL reconstruction is a reliable operation, and most individuals return to a high level of activity. Return to full, unrestricted activity typically occurs in 8-10 months after surgery, but may be longer in certain cases.

It is important to discuss your ACL reconstruction options with a knowledgeable sports medicine surgeon to reach your desired goals following knee injury. For additional questions regarding your injury, please click here.

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