What Is An Acl Tear What Does It Feel Like
An ACL tear is damage to the anterior cruciate ligament , located at the center of your knee. The tear may be partial or total . It will hurt if you tear your ACL. Your knee may give out and you may hear or feel a pop. Typically, your knee will immediately start to swell up.
Ligament is what the medicine world calls the tough bands of tissue that connect bones or hold organs in place. The word anterior means towards the front of the body. Cruciate means cross-shaped, and in medical terms it refers to the two ligaments in your knee that form the shape of a cross: the ACL in the front and the posterior cruciate ligament in the back.
What Is The Function Of The Knee Joint
The purpose of the knee joint is to bend and straighten , allowing the body to change positions. The ability to bend at the knee makes activities like walking, running, jumping, standing, and sitting much easier and more efficient.
The thighbone and the shinbone meet the kneecap to form the knee joint. The rounded ends of the femur, or condyles, line up with the flat tops of the tibia called the plateaus. There are a variety of structures that hold the knee joint stable and allow the condyles and plateaus to maintain their anatomic relationship so that the knee can glide easily through its range of motion. The knee is a hinge joint, but there is also some rotation that occurs when it bends and straightens.
There are four thick bands of tissue, called ligaments, that stabilize the knee and keep its movement in one plane.
- The medial collateral ligament and the lateral collateral ligament stabilize the sides of the knee preventing side-to-side buckling.
- The anterior cruciate ligament and the posterior cruciate ligament form an X on the inside of the knee joint and prevent the knee from sliding back to front and front to back respectively.
The major muscles of the thigh also act as stabilizers: the quadriceps in the front of the leg and the hamstrings in the back.
If left untreated, the knee will feel unstable and the patient may complain of recurrent pain and swelling and giving way, especially when walking on uneven ground or climbing up or down steps.
Causes Of Anterior Cruciate Ligament Injury
Most anterior cruciate ligament injuries happen during sports, especially football, basketball and skiing. Women are more likely to injure their ACL than men. An ACL injury may happen if you:
- twist your knee, particularly when your foot is on the ground for example, you land from a jump and twist in the opposite direction
- quickly change direction when running or walking
- slow down or stop suddenly when running
- over extend your knee joint
If youre playing contact sports, you can also injure your ACL if you have a direct blow to your knee from a collision with another player.
You can access a range of treatments on a pay as you go basis, including physiotherapy. Find out more about physiotherapy >
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How To Diagnose Torn Acl In The Knee
The diagnosis made by your doctors will involve a check of the knee by moving it in different positions to understand the extent of movement and thus the whole function of the joint and a look at the swelling and the tenderness of the injured knee with that of the uninjured knee. Diagnosis can be made depending on the physical exams all together but certain tests like X-rays, MRIs and ultrasounds may be needed so as to exclude other causes.
What Torn Acl Surgeries Are Available
Arthroscopic ACL SurgeryThe majority of ACL surgeries involve replacing a torn ACL with a graft from another ligament or tendon. This type of ACL surgery is often performed with an arthroscope, which is a small tube with a camera on the end. The internal images of your knee seen through an arthroscope will be displayed on a monitor in the room, offering a live view of your knee. This type of ACL surgery does not require the actual knee joint to be surgically opened. The arthroscope is used to locate the damaged ACL, which will then be repaired. Arthroscopic ACL surgery is less invasive than open knee surgery, so the majority of patients are able to return home the same day as their surgery.
ACL Surgery with Hamstring GraftA graft from the hamstring may be used to replace the damaged ACL. Hamstring grafts are generally favored because the hamstrings do regenerate with time. Once the damaged ACL is removed, the hamstring graft will be prepared and placed through the tunnel in the femur. The bottom of the graft will be anchored with a bio-absorbable screw, which will slowly be incorporated into the bone with time.
Patellar Graft for ACLSimilar to a hamstring graft, a patellar graft can also be used during ACL surgery. A small tunnel will be made in the upper tibia, which will create an opening where the ACL would attach to the tibia. Another tunnel will be made through the femur where the ACL would attach.
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How Do You Tear Your Acl
A partial or complete ACL tear often occurs during a sudden twisting movement, in which a person stops quickly and changes direction, especially while pivoting or landing after a jump.
A sudden, high-energy impact to the knee can also cause the ACL to tear. ACL tear injuries are often accompanied by injuries to other tissues in the knee, including cartilage or additional knee ligaments, such as the .
What Causes Acl Injuries
ACL injuries typically happen while playing sports. Athletic moves that strain the knee include:
- Changing direction rapidly: A rapid turn or cut, common games like soccer, football, field hockey, lacrosse, and rugby, can put extreme pressure on the ACL and other ligaments in the knee.
- Slowing down or stopping suddenly: Sprinting, then slowing down or coming to a complete stop can put a twisting force on the knee.
- Jumping and landing: In any activity that involves jumping, a hard or awkward landing can damage the ACL. This includes sports like volleyball, basketball, figure skating, and gymnastics.
- Contact and collisions: The ACL is at risk when an athletes knee is hit by or collides with another player or object. This is why ACL tears are common in contact sports
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Acl Recovery And Outlook
ACL Recovery typically takes 6 to 9 months, depending on the tear and what treatment options are determined to be the best for you. This will depend on your age, grade of ligament tear, and involvement in sports. When possible, a conservative approach will always be taken first focusing on restoring knee function via swelling management, range of motion, and strengthening with a physical therapist. With proper treatment and a good response from the knee, you can expect to make a full recovery.
If the tear is severe or there is excessive instability or laxity in the knee joint, surgery is another option. During a surgical procedure, the ACL will be tightened or re-attached to restore stability and function. In the end, full recovery from an ACL tear takes time and a very gradual return to daily activities as it heals.
For more details about the treatment process, see ACL Tear Rehab.
What Questions Should I Ask My Healthcare Provider
- What are the pros and cons for surgery to repair my ACL tear?
- Do I have a partial ACL tear or is it torn in two?
- What medications should I take?
- Do I need to see a specialist?
- Who is a good orthopedic surgeon?
- Should I see a specialist in sports medicine?
- When can I return to work/school?
- How soon can I have surgery?
- How long do you predict it will take me to recover?
- What kind of graft is best for me?
A note from Cleveland Clinic
An ACL tear will only temporarily stop you from working your job or playing the sports you love. Remember, your healing depends on your own choices: choices to use crutches, to have surgery or not, to work hard at your physical therapy, etc. If you commit to your physical therapy and listen to your healthcare providers instructions, then your life will be back to normal soon.
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What Causes Torn Acl In The Knee
ACL is a ligament that binds the femur and tibia bones at the knee and helps in stabilization. Most of the ACL injuries are noticed in sports or in fitness activities during which the chances of stress and sudden movements are high. Some of them include
- Quick change in direction
- Landing or exercising or jumping patterns
- Little longer responding or reflex time
Older Teens And Adults: Acl Reconstruction
Patients who have finished growing, typically 15 to 16 years or older for females and 16 to 17 or older for males, are candidates for ACL reconstruction. ACL reconstruction is actually two surgeries. First, the orthopedic surgeon takes a graft from the patients hamstring or patella tendon. Second, the surgeon removes the end of the torn ACL and drills tunnels through the growth plate to attach the graft with screws or other means. The graft will now serve as reconstructed ACL. This second surgery can be done through tiny incisions in the skin around the knee. The tunnels in the bone fill in as the knee heals. The risk of re-tearing the ACL is 5 to 10 percent.
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What Are The Complications Of Surgery
- Infection. Infection is rare, but still a risk with any type of surgery.
- Stiffness. Stiffness in the knee is common post-surgery, but physical therapy can help it. This can be avoided by performing rehabilitation to regain all of your motion before surgery.
- Viral transmission. Receiving a graft from a cadaver always comes with a risk of contracting diseases like HIV and Hepatitis C. There is less than a one in a million chance that youll get an HIV-infected graft.
- Blood clot. A blood clot can be life-threatening, but its rare. The clot can break off in the bloodstream and cause a pulmonary embolism in the lungs or a stroke in the brain.
- Kneecap pain. This complication is common when using patellar tendon grafts.
- Growth plate injury. Early ACL reconstruction in a child or adolescent risks this. If possible, the surgeon will delay the procedure until the skeleton is fully grown or utilize special techniques to avoid injuring the growth plate.
Prepare And Train Your Body
Proper warm-up and stretching before working out goes a long way in preventing injuries. Proper body mechanics and alignment during exercises must also be done to ensure that the right muscles are being targeted. Other structures, including ligaments that support the joint, will not be subjected to excessive stress.
Studies have shown that athletes who train and condition their bodies all year round are less likely to become injured because they have better neuromuscular control, improved feed-forward mechanism, and increased reaction speed.
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Treatment Of Anterior Cruciate Ligament Injury
Youll usually need to go to A& E with this kind of injury, where theyll examine you and take some X-rays of your knee. They may then refer you to an acute knee clinic, which will organise any investigations and treatment you need.
The treatment youre offered for your ACL injury will depend on how severe the damage is and how active you normally are. The initial treatment will be to control your pain and swelling using the POLICE and HARM self-help measures . Further treatments may include physiotherapy, medicines and occasionally, surgery.
You may see an orthopaedic surgeon or a sports medicine professional, such as a sports doctor or physiotherapist. There are different treatments that your doctor or physiotherapist may suggest, and a lot that you can do yourself to help you recover.
Understanding The Anatomy Of The Knee
Your childs knee joint is at the intersection of three bones:
The kneecap is positioned in front of the knee joint to provide some protection for the four ligaments that connect the thighbone and shinbone, and keep your childs knee stable.
Collateral ligaments are on the side of the knee the medial ligament is on the inside of your childs knee the lateral ligament is on the exterior. These ligaments control the sideways motion of the knee.
Cruciate ligaments run diagonally inside the middle of the knee, forming an X, with the anterior cruciate ligament in the front part of the knee, and the posterior cruciate ligament in the back. These ligaments control the back and forth motion of the knee. Additionally, the ACL provides stability to the knee and prevents the tibia from moving in front of the femur.
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Treatment And Recovery For Acl Vs Mcl Tears
Immediately after injuring your knee, apply ice to the area, use a compression garment to stabilize the joint, and prop up your knee to elevate it until you can get medical treatment.
Dr. Heiden will evaluate the condition of your knee and guide you in rehabilitation. He will provide a stabilizing brace and may recommend crutches during the initial healing process.
Moderate to severe ACL tears can require surgery to resolve. In most cases, a graft is used to replace the torn part of the ligament. Recovery can take six months or more depending on the severity of the injury. Dr. Heiden will help you determine if surgery is necessary. An MCL tear rarely needs surgery and typically heals after approximately eight weeks of focused rehab. Heiden Orthopedics treats a range of ligament injuries, including ACL and MCL tears. Learn more about the knee anatomy and procedures.
What Is The Treatment For An Acl Injury
Do R.I.C.E. therapy immediately after the injury:
- R: Rest.
- C: Compression.
- E: Elevation.
The type of treatment you receive is up to you. Many people with ACL tears decide to have surgery so that they can return to the activities they did before the injury. If your activity level isnt as high, you might choose to not have surgery. But, keep in mind that your torn ACL wont heal on its own.
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What Is An Acl Tear Symptoms Causes Diagnosis Treatment And Prevention
An ACL tear, or torn anterior cruciate ligament, is one of the most common knee injuries.
ACL tears are common among athletes and occur more frequently among female athletes.
Ligaments connect bones to bones. As one of the four primary ligaments of the knee, the ACL connects the front top part of the shinbone to the back bottom part of the thigh bone. The ACL also keeps the shin from sliding forward, and provides rotational stability to the knee.
Surgical Treatment And Acl Reconstruction
Once the ACL tears, it has usually sustained enough damage that attempts to surgically repair it are not successful. Consequently, better results are obtained if the ACL is surgically replaced or reconstructed with another tendon from around the knee. There are a number of surgical options for reconstructing the ACL. The type of procedure done may vary from patient to patient depending on a specific surgeons preference as well as factors unique to an individual patient.
The surgical procedure is most commonly performed using arthroscopic techniques. Using one or two small incisions on the knee, the graft is taken from the patellar tendon or hamstring tendons, and a tunnel is drilled into both the tibia and femur. The graft is threaded across the knee, leaving a piece of bone in each of the tunnels and the patellar tendon in the position of the original ACL, thus reconstructing the ligament. The graft is then secured in this position, most commonly by wedging a screw between the side of the bone and the tunnel. Alternatively, the graft can be secured by other techniques staples, sutures, buttons, etc. These fixation devices are usually left in place permanently.
In addition to the ACL reconstruction, additional procedures may be done to other structures within the knee if an injury is present. A torn meniscus can be either repaired or trimmed , and other ligaments can be repaired or reconstructed as well.
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Features To Look For In The Best Knee Brace For Torn Acl
Theres no denying that theres a whole plethora of knee braces available out there, and they all claim to be the best.
So, how do you decide which one lives up to the hype?
Its a tough decision but a great way to narrow down your options would be to consider your specific needs and look out for qualities and features that make the brace ideal for you.
Here are a few of the most important features to look for in the best knee brace for torn ACL.
Open vs. Closed Patella
A knee brace should either come with a closed or open patella for support.
If patella support is of high importance to you, then you should look out for this feature.
Usually, a knee brace with closed support is more likely to weigh heavily on the patella, while an open patella makes for a more lightweight design.
You need good quality support. Without it, a knee brace is practically useless. Knee braces made from low-quality materials or poor design usually fail in this regard.
However, just because a knee brace is made of very few materials doesnt mean that it wont provide the type of quality you want.
There are plenty of knee braces that feature a simple design and yet they work effectively. This includes models that strap onto the part below your knee cap, while others are large enough to cover a whole leg segment.
The level of support as well as the materials used are some of the most important indicators of quality.