Monday, December 23, 2013

from the Doctor's Desk: ACL Tear

What is an ACL (Anterior Cruciate Ligament) Tear and How is it Treated?

The ACL is one of the four primary ligaments that connects the femur bone and the tibia bone (see Fig 1).  Many patients have heard of this ligament injury in relation to professional athletes injuring their knee and missing much or all of their season.  The ACL helps stabilize the knee both in a front-to-back direction and also rotationally.  Without an ACL many patients report that their knee “gives way” or feels unstable when they turn or pivot. 
Fig 1 - courtesy AAOS

Usually an ACL injury is traumatic.  Many patients describe a specific event where their knee is either hit or turns quickly and they feel a “pop” and immediate pain. Usually swelling and stiffness develops very soon after the injury.  This typically decreases over a week or so from the injury.   Often, when an ACL is torn there are other injuries to the knee.  One of the most common associated injuries is the meniscus, the cartilage padding or cushion between the bones.  A meniscus injury causes pain along the side of the knee and a sharper, catching pain at times.

An ACL tear is typically identified through a physical exam and an MRI.  The physical exam often shows that the tibia will slide forward relative to the femur.  An MRI will show that the ligament is torn (see Fig 2).
Fig 2 - courtesy AAOS

Treatment options fall into two primary categories, surgery or more conservative treatment.  A choice to consider surgery depends on multiple variables including:  current symptoms (does the knee feel unstable?), expected activity levels (does the patient expect to return to an active lifestyle that requires pivoting on the leg?), and the patient’s age and medical status.

For example, an older patient that doesn’t complain of the knee instability, has medical problems, and walks on flat surfaces for exercise, may do well with conservative treatment.  In this case, we start with physical therapy to regain motion and strengthen the surrounding structures of the knee.  Some patients also benefit from a knee brace to further stabilize the knee.  

In comparison, a younger and more active patient that has ongoing instability of the knee and expects to return to sporting activities, would likely benefit from surgery.  We’ll talk more about the surgery and the recover process in the next article.  

Click Here is a little information and Video from our Website.

DaneGlueck, MD – December, 2013

There is a fine line between blogging and giving medical advice. The content of this blog is for informational purposes only and should not be construed as medical advice.  Nothing contained in this blog is intended to replace the medical advice of a trained, licensed physician.
In all matters relating to your health, you are urged to consult a physician. You can contact Advanced Bone & Joint to set up a formal consultation appointment with Dr. W. Anthony Frisella, Dr. Dane Glueck, Dr. Brandon Larkin, Dr. Anthony Lombardo, Dr. John McAllister, II, Dr. Brian Meek, Dr. Paul Spezia, Jennifer Eickhoff, FNP-BC, or Matt Pliske, PA-C.

1 comment:

  1. Very informative post. Thanks for taking the time to share your view with us.
    anterior cruciate ligament