ACL Tear

What is the anterior cruciate ligament or ACL?

The knee is made up of bones, ligaments, tendons, and cartilage. The ligaments within the knee act as strong ropes that connect bones to other bones. The knee contains four primary ligaments that work together to keep the knee stable and in its proper position when bending, moving, or running. The anterior cruciate ligament (ACL) connects the femur (thigh bone) to the tibia (shin bone) and is located in the center of your knee joint. The job of the ACL is to keep the tibia from sliding out in front of the femur. The ACL also provides rotational stability to the knee. Dr. Joseph Lamplot, orthopedic knee specialist, treats patients in Arlington Heights, Kildeer, Lake Zurich, Barrington, and the surrounding Northwest Suburbs of Chicago, IL, who have experienced a torn or injured ACL or anterior cruciate ligament injury.

What is an ACL injury or tear?

An ACL tear occurs when the anterior cruciate ligament becomes partially or completely torn within the knee. Athletes are more prone to ligament tears in the knee, and ACL tears are most often seen in individuals who participate in sports such as football, soccer, hockey, skiing, Lacrosse or MMA.

Examples of when an ACL tear can occur:

• When someone plants the foot and abruptly changes direction, often seen in cutting or pivoting.
• When the knee is bent backward (hyperextended) or twisted.
• With a direct blow to the knee
• Repeated stress on the knee which can cause the ligament to lose elasticity (like a stretched-out rubber band)

Surgery combined with physical therapy is usually the recommended course of treatment for a torn ACL. ACL reconstruction offers the best chance for the return to an active lifestyle free of pain, with stability, range of motion and strength restored to the knee.

What are the symptoms of an ACL tear?

• A popping sound or feeling in the knee at the time of injury
• Severe pain
• Rapid swelling
• Loss of range of motion
• Discomfort when walking
• Feeling that the knee will “give way”

How are ACL tears diagnosed?

Dr. Lamplot will take a medical history and ask specific questions about the mechanism of injury and will compare the injured knee it to the non-injured knee with a physical exam. An MRI scan (magnetic resonance imaging) may also be used to assess for damage to the anterior cruciate ligament, as well as damage to other soft tissues within the knee joint. On occasion, a CT scan may be used for pre-surgical planning.

How are ACL tears classified?

When a ligament is injured, Dr. Lamplot may grade the injury on a scale of one to three:

• Grade 1: The ligament has been stretched but continues to stabilize the knee joint. (Least severe – ligament functional)
• Grade 2: The ligament has been stretched and partially torn. (Rare – ligament may not be functional)
• Grade 3: The ligament has been completely torn into two pieces. (Most severe, and fairly common-ligament not functional.)

 What is the treatment for an ACL Tear?

Non-Surgical:

Immediate first-aid treatment can help reduce pain and swelling after a knee injury by using the R.I.C.E. method which means rest, ice, compression and elevation. A completely torn ACL cannot be repaired without surgery, but for some elderly or less active patients, surgery is not required. Rest and anti-inflammatory medication are the most recommended non-surgical treatments for pain and inflammation. Some patients may also be given a leg brace to wear during activities that put a strain on the knee. Physical therapy may be prescribed by Dr. Lamplot and is critical to avoid future injury.

Surgical:

A torn ACL should be reconstructed surgically in order to restore knee stability. In rare circumstances in selected patients, if the ligament can be repaired, Dr. Lamplot may sew the torn ligament and fix to the bone.  Most often, an ACL reconstruction will need to occur, which involves a tissue graft. There are different types of tissue grafts, the most common being an autograft (tissue taken from the patient) or an allograft (tissue from a donor). Dr. Lamplot will provide an evidence-based summary of graft options for ACL reconstruction in order to personalize your surgery.

ACL Tear Specialist