An ACL Tear

The ACL is one of the most important ligaments in the knee as the ACL provides the most stability to the knee.  The ACL is responsible for preventing the knee from shifting forward, but more importantly, from the knee buckling when twisting.  This prevention of twisting of the knee, or pivoting, is the main reason that the ACL is required for cutting sports.

What happens when I tear my ACL?

A tear to the ACL commonly occurs after a non-contact injury to the knee where the foot is planted to the ground the the knee buckles or shifts.  Often a pop can be heard, and there is swelling in the knee.  This commonly occurs while playing sports and is most common in Soccer, football and skiing.  However, an ACL injury can occur with any type of injury to the knee.  Because of the tear of the ACL in the knee, the knee will often swell up quite large and the knee can feel tight and it is difficult to completely bend the knee.

Even after an ACL tear, the pain in the knee usually will get better in a few weeks, but the instability of the knee will remain.  The instability to the knee is usually noted with any type of cutting activity or side to side sports, where the knee will feel like it gives out.

How do you treat an ACL tear?

Because the ACL functions to give stability to the knee, an ACL reconstruction is usually required to allow for return to sports and cutting type of activities and to give stability to the knee.  An ACL reconstruction is performed arthroscopically and a graft, commonly the central portion of the patellar tendon, is used to recreate the ACL.  See the images below for an ACL tear to the left and then the new graft to the right.

What is recovery after an ACL reconstruction?

ACL reconstruction is an outpatient procedure and patients are discharged home the same day in a knee brace and crutches.  Most of the time, you can put full weight on your leg day 1 after surgery.  Knee range of motion is begun immediately and crutches are used as needed the first week or two.  Physical therapy is then prescribed after the first visit and involves initial range of motion followed by strengthening of the leg.  Use of a stationary bike begins after full range of motion is achieved and running can begin at about 3-4 months.  Full return to sports is often after 9 months, which allows the ACL graft to mature into the new ACL ligament.

ACL injuries can be devastating injuries, but with the right surgery, therapy and mindset, an ACL reconstruction can allow patients and athletes return to their active lifestyle.