A tear in the anterior cruciate ligament (ACL) is a common knee injury that occurs from a sudden twisting or pivoting motion, typically during sports like skiing, football, soccer and basketball.
Treatment depends on the severity of the injury. It may involve only rest and physical therapy, but to properly heal most people need ACL reconstruction surgery followed by rehab and physical therapy. Whatever your situation is, UCHealth specialists can help you get back in the game.
Symptoms and diagnosis
An ACL injury may result in a partial or complete tear of the ligament, and symptoms at the time of injury typically include:
- A popping sensation.
- Severe pain and inability to continue activity.
- Rapid swelling.
- The knee feels unstable and loses range of motion.
Your orthopedic specialist will perform a physical exam on the injured knee, but you may need additional tests to rule out other causes and to determine the severity of the injury, such as:
- Magnetic resonance imaging (MRI) can show the extent of an ACL injury and any damage to other tissues in the knee, including cartilage.
- Ultrasound may be used to check for injuries in the ACL, collateral ligaments, tendons and muscles of the knee.
Treatment for ACL injuries
Determining nonsurgical and surgical approaches.
If you can, use the RICE model of self-care to reduce pain and swelling immediately after an injury to your knee:
- Rest. General rest is necessary for healing and limits weight-bearing on your knee.
- Ice. Ice your knee at least every two hours for 20 minutes at a time.
- Compression. Wrap an elastic bandage or compression wrap around your knee.
- Elevation. Lie down with your leg propped up on pillows.
Our nonsurgical medical treatment starts with rehabilitative therapy to reduce pain and swelling, to restore your knee’s full range of motion and to strengthen muscles. We will teach you exercises to perform at home or under supervision at our physical rehab facility. You may also need to wear a knee brace and use crutches to avoid putting weight on your knee.
A nonsurgical approach may successfully treat an ACL injury if the tear was only a partial tear, or if you are relatively inactive. If you participate in anything more than moderate exercise, though, surgery is likely the best option to stabilize your knee.
Your personalized treatment plan will likely include surgery if:
- You are an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting.
- More than one ligament or the meniscus in your knee is also injured.
- The injury is causing your knee to buckle or shift during everyday activities.
During ACL reconstruction, your surgeon removes the damaged ligament and replaces it with a segment of tendon (graft) from another part of your knee or a tendon from a deceased donor. Successful ACL reconstruction followed by rehabilitation can fully restore stability and function to your knee.
Getting back to the things you love to do
Athletes typically require nine months to a year before they can safely return to play, but a less serious ACL injury may heal more quickly than that. Your orthopedic specialist and physical therapists will gauge your knee’s stability, strength, function and readiness to return to sports activities during your rehabilitation. We will help you follow a proper training program to help reduce the risk of another ACL injury.
Orthoinfo: American Academy of Orthopaedic Surgeons. Anterior Cruciate Ligament (ACL) Injuries (https://orthoinfo.aaos.org/en/diseases–conditions/anterior-cruciate-ligament-acl-injuries/)
Orthoinfo: American Academy of Orthopaedic Surgeons. ACL Injury: Does It Require Surgery? (https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/)
MedlinePlus: National Library of Medicine. Anterior cruciate ligament (ACL) injury (https://medlineplus.gov/ency/article/001074.htm)
National Center for Biotechnology Information (NCBI): National Library of Medicine. Anterior Cruciate Ligament Knee Injuries (https://www.ncbi.nlm.nih.gov/books/NBK499848/)