Anterior Cruciate Ligament Tear or ACL Tear

Knee diagram - anterior cruciate ligament tear

Athletes who participate in high demand sports such as skiing, soccer, football, and basketball are more likely to injure their anterior cruciate ligaments. This is known as an anterior cruciate ligament tear or ACL tear.

How does an anterior cruciate ligament tear feel?

When the ACL tears it is typically quite traumatic, necessitating a stop to the game or a ski patrol ride to the base of the mountain. You may feel a pop with acute pain. Then you might feel unstable, like you cannot bear weight, followed by swelling.

How does an ACL tear happen?

You can injure your ACL during a twisting non-contact event. Or, it may happen secondary to a contact injury where the knee is hit on the lateral or posterior side. Most ACL injuries occur in cutting sports such as basketball, soccer, and lacrosse, as well as skiing.

How can an anterior cruciate ligament tear be fixed?

When you twist or pop your knee and it swells immediately, it is often due to a tear of the ACL. You initially treat this injury with physical therapy, rest, and ice. Those who want to return to sports, such as skiing and soccer, usually require surgery.

Occasionally, I have a patient whose goal is to run and cycle; these patients may only require non-operative treatment. However, the vast majority people with ACL tears opt for surgical intervention. This arthroscopic procedure drills tunnels through both the femur (thigh bone) and tibia (shin bone) in order to pass a tendon through the center of the knee.

Patients can choose the type of graft used to reconstruct the ACL. For young, high demand athletes, I recommend using their own hamstring or patellar tendon. For less active or slightly older patients, I prefer the relatively less invasive allograft or cadaver tissue option. After surgery, patients need physical therapy for 4 to 6 months and can return to cutting sports within six to eight months.

For more information about treating knee pain, visit the HSS Patellofemoral Center site.