ACL Injuries

One of your knee’s most important ligaments is the ACL, the anterior cruciate ligament. Its job is to keep your lower leg bone from sliding too far forward. This ability to maintain the stability of the knee is lost when the ACL tears.

A lot of people think that the ACL has to be torn by a violent contact injury, but in fact it can happen as a result of a set of non-contact events such as going up for a rebound or twisting on the knee.

The ACL can handle a lot, but it is susceptible to injury from movements that involve suddenstops, changes in direction, pivoting, jumping and improper landing — motions that are typical of sports such as soccer, football, basketball, gymnastics and skiing. Direct trauma, such as with football tackling, can also lead to an ACL tear.

ACL tears have a very predictable way of presenting. They often cause a loud popping sensation when they tear, followed by a very swollen knee which is usually caused by bleeding from the tear into the knee.

The treatment for ACL tears depends largely on the activity level of the patient. For people who have relatively low athletic demands or who do not experience a lot of instability, the ACL can be treated without surgery, with physical therapy or a brace. In other cases, if there is significant giving way of the knee, surgical repair may be necessary.

A damaged ligament will need to be replaced with a new ligament. This can be done either with an expendable tendon from the patient's own knee or from a cadaver donor.

If the knee remains unstable with an ACL tear, pain and giving way can worsen over time. There is a chance that a sufferer will develop osteoarthritis by damaging other structures in the knee. There can be slow damage to the knee gradually culminating in osteoarthritis 10 years or more later.

Arthroscopic ACL repair

Repair of the ACL ligament can be done during an outpatient procedure using an arthroscope. This narrow tube includes a miniature camera at its head that allows a surgeon to explore the interior of the joint or other internal structure and determine the extent of any damage. We use the arthroscope in performing repair of the ACL. It allows us to clear up the remnants of the old ligament and to place the new ligament in exactly the right position.

After ACL reconstruction, you will often have limited weight-bearing with crutches for about four weeks to allow for some early healing of the new ligament. The post-surgery physical therapy is very important after ACL reconstruction.

For more information on the causes and treatment of ACL injuries, please request an appointment with us by giving us a call, or email us at Joint Preservation in Sacramento or the San Francisco Bay Area.