Q. What are the most common causes of ACL tears?
A. ACL tears are most commonly caused by a rapid change in direction. This can occur when a person stops suddenly, lands awkwardly from a jump or makes a cut. These injuries most commonly do not involve direct contact but certainly can be caused by a direct blow.
Q. What are the symptoms a patient with an ACL tear will experience?
A. At the time of the injury, an athlete may feel a pop. The injured player is generally unable to complete the game. Frequently, there is signiﬁcant swelling and stiﬀness after the injury and usually a feeling of instability.
Q. What can a patient expect to experience during a physician examination of an ACL tear?
A. If an ACL injury is suspected, a careful history of the injury will be taken along with a physical exam. There are a few tests a physician can use to determine the stability of the ACL. X-ray’s will usually be obtained to ensure there is no fracture. An MRI is also typically sought in order to conﬁrm the diagnosis, as well as to evaluate for other ligament injuries or meniscal tears.
Q.What is the treatment options (surgical and nonsurgical) for ACL tears?
A. The ﬁrst decision that should be made is whether or not to “ﬁx” or reconstruct the ACL. The ACL, unfortunately, will not heal itself. Less active, typically older patients may be able to modify their activity so that their knee functions adequately. Athletes and active patients will generally require surgery.
The procedure itself involves replacing the torn ligament with a tissue graft. This graft can be obtained from the patient or a cadaver (allograft). Grafts can be harvested from the patellar tendon, hamstrings or quad tendons. Each approach has individual advantages and disadvantages. The surgeon will choose the approach based on the patient, their activity level and their expectations for return to sport.
Q. How long will rehab take for patients recovering from an ACL tear injury?
A. The length of recovery depends on the type of graft used, response of the patient to therapy and the speciﬁc sport. This typically takes at least five to six months. Generally, athletes do not feel “back to normal” athletically for up to a year.
Q. Is there a way to prevent ACL tears from happening, especially with athletes?
A.There are ACL prevention programs available such as SportsMetric and PEP. These have shown some improvement for young athletes particularly female athletes. The goal is to improve the neuromuscular control of the athlete.
Q. Anything else you would like to add?
A. ACL injuries are certainly a frightening prospect for the young athlete; however, with proper reconstruction and rehabilitation, most are able to return at a similar level to their pre-‐injury status.