The anterior cruciate ligament, or ACL, is one of the most common major ligaments to be injured. The ACL is in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding forward in front of the femur. Together with the posterior cruciate ligament (PCL) it provides translational stability to the knee.
An ACL tear usually occurs when an abrupt directional change combines with the foot fixed on the ground or when an sudden deceleration force crosses the knee.
If you rupture an ACL, you may hear a popping sound and feel as though the knee has given out. Within the first two hours after injury, your knee will swell and you may have a buckling sensation with attempts at walking.
Diagnosis of an ACL tear is made by a focused history, physical examination of the knee, and performing other diagnostic tests such as X-ray and MRI.
Treatment options include both non-surgical and surgical strategies. If the overall stability of the knee is intact and goals of activity are low, Dr. Fischer may recommend nonsurgical management. Non-surgical treatment consists of rest, ice, compression, elevation (RICE protocol), and bracing; all assist in controlling pain and swelling. Physical therapy may be recommended to improve knee motion and strength.
Younger athletes involved in pivoting sports will most likely require surgery to safely return to high demand activity. ACL reconstruction replaces the ligament and restores its stability. Surgery to reconstruct an ACL is done with an arthroscope using small incisions. Dr. Fischer will replace the torn ligament with a tissue graft that can be obtained from your knee (patellar tendon) or hamstring muscle. Following ACL reconstruction, a rehabilitation program is started to help you return to higher demand activity.