Torn ACL

The anterior cruciate ligament (ACL) is a common term, but what is that thing inside the knee that athletes term as their "torn ACL"? The ACL refers to a ligament or strap that connects the femur (thighbone) to the tibia (shin) in the center of the knee, limiting rotation and the forward motion of the tibia.

The injury may occur as a result of stepping in a hole, causing wrenching of the knee. In this case, there is immediate pain, swelling, and difficulty bearing weight on the leg. Sometimes a person may have locking or inability to move the leg because of a trapped cartilage tear. Medical evaluation is necessary if a person has persistent pain, stiffness, and/or noise in the joint. Oftentimes, there will be a feeling of giving way or shifting of the bones. These symptoms indicate difficulty with healing and the need for evaluation.

Unhealed tears can allow the knee to give way or shift. This is felt as a sensation of giving-way or instability. This creates a shearing force on the knee joint, and over a long period of time leads to abnormal wear, roughness, and deterioration of the cushion within the knee.

ACL injuries are initially treated with a rehab program in order to regain the range of motion and to try to minimize any loss in strength. Anti-inflammatory medicines can also be quite helpful. At times, bracing and physical therapy are all that are necessary for treatment.

Other times there are persistent symptoms which may require surgical treatment. This is one of the biggest areas of recent advancements in orthopedics. ACL reconstructions are now done arthroscopically. A graft must replace the old ligament. This graft is frequently obtained from tissues around the knee. The graft is then strung through the knee to replace the ACL and is anchored with screws.

Oftentimes the cushion in the knee, the cartilage or meniscus, is injured when the ACL is torn. Any damage to the meniscus must also be addressed with either repairing or removal of the meniscus. This is a very serious knee injury, but frequently people are able to return to sports and previous activities with minimal difficulties.