ACL Tear

The anterior cruciate ligament (ACL) is one of the key ligaments that helps stabilize the knee. ACL injuries are common, especially in sports that involve cutting, pivoting, or sudden changes in direction. While these injuries are often associated with athletes, they can happen to anyone, including during everyday activities or accidents.

Understanding how the ACL works, how injuries happen, and treatment options can help you make informed decisions about your care.

What is the ACL?

The ACL connects the femur (thighbone) to the tibia (shinbone) in the center of the knee. It plays a critical role in:

• Preventing the tibia from sliding too far forward relative to the femur.

• Providing rotational stability, especially during pivoting or twisting motions.

The ACL works together with other knee structures like the posterior cruciate ligament (PCL), meniscus, and surrounding muscles to maintain knee stability.

How Do ACL Injuries Happen?

Most ACL injuries are non-contact, meaning they occur without direct impact. Common injury mechanisms include:

• Rapid change of direction

• Sudden stop or deceleration

• Landing awkwardly from a jump

• Direct blow to the outside of the knee (less common)

Patients often describe feeling or hearing a "pop," followed by swelling, pain, and a feeling of instability in the knee.

Symptoms of an ACL Tear

Typical symptoms include:

• Sudden knee swelling within hours of injury

• Pain, especially when bearing weight or moving the knee

• Feeling of the knee "giving way" or instability

• Decreased range of motion

• Difficulty returning to sports or pivoting activities

If you experience these symptoms, a physical examination and imaging (usually an MRI) can help confirm the diagnosis.

Treatment Options

Treatment for an ACL tear depends on several factors, including your activity level, degree of instability, and associated injuries.

• Non-Surgical Management:
  Some patients, especially those with lower activity demands or partial tears, may be managed with physical therapy to strengthen the surrounding muscles and improve knee stability.

• Surgical Reconstruction:
  For active patients, athletes, or those with ongoing instability, ACL reconstruction surgery is typically recommended. During surgery, the torn ligament is replaced with a graft — often from the patient’s own hamstring tendon, patellar tendon, or a donor graft.

The goal of surgery is to restore knee stability and allow a return to sports and other activities.

Recovery After ACL Injury

• Non-Surgical:
  Physical therapy focuses on strengthening the quadriceps and hamstrings, improving balance, and regaining full range of motion. Activity modification is often necessary to prevent instability.

• Post-Surgical:
  Recovery after ACL reconstruction typically involves:

  • Crutches and a brace early in recovery

  • Progressive physical therapy focusing on motion, strength, and control

  • Gradual return to sports-specific activities around 6–9 months, depending on progress and graft healing

Commitment to rehabilitation is essential for a successful outcome.

Associated Injuries

ACL tears often occur alongside other knee injuries, including:

• Meniscus tears

• Cartilage damage

• MCL injuries Addressing these issues during surgery can improve long-term outcomes and reduce the risk of arthritis.

Conclusion

An ACL tear is a significant injury that can impact knee stability and limit your ability to participate in sports and daily activities. Whether managed with rehabilitation alone or with surgical reconstruction, the goal is to restore stability, function, and confidence in your knee.

If you’ve experienced a knee injury or are concerned about instability, contact our office for a comprehensive evaluation and personalized treatment plan.