Diagnosis & Treatment
Anterior Cruciate Ligament (ACL) Injury
How are ACL Injuries Diagnosed?
DiagnosisPhysicians use the Lachman test as the most accurate method for determining a torn ACL. This test allows doctors to see whether the tibia (shinbone) has increased motion relative to the femur (thigh bone), positioning the knee flexed. MRI (magnetic resonance imaging) is the primary imaging study used by doctors to diagnose ACL injuries. An MRI can also identify additional injuries sustained in addition to a torn ACL.
If you believe you are experiencing symptoms of an ACL tear, you should contact a health professional for immediate treatment. A torn ACL is painful and will likely require a sports medicine professional visit. Once there, the sports medicine specialist may perform various tests to determine if the ACL is torn. Some of the tests your doctor might include are:
- The Lachman test is considered the most accurate in determining the extent of the ACL injury
- An MRI (magnetic resonance imaging). This test will also enable your doctor to view injuries that may be concurrent with a torn ACL.
ACL Tear Treatment
TreatmentACL injury treatment differs according to levels of severity—grade 1, 2, or 3. ACL injuries can vary from sprains to partial ruptures to complete ruptures. About half of all ACL injuries include damage to other knee structures. Damage to the articular cartilage, meniscus or other ligaments is possible.
If you suspect you have torn your ACL, you should first rest and elevate your feet first. Apply ice to the area to keep the swelling at a minimum. Refrain from bearing weight on your knee or walking without support. Do not try to extend your knee fully.
Contact your doctor or orthopedic professional to determine whether the ACL is completely torn or partially torn. Your healthcare professional can then establish the severity of the injury and whether surgery will be necessary. Surgical options may take longer than non-surgical, and recovery time is needed once treatment is applied.
- Rest your leg
- Ice the area of pain
- Compression is recommended to keep the leg straight
- Elevate the leg to reduce swelling
Types of treatment
Treatment for ACL tears can vary according to the severity of the injury and may include:
- A knee brace to keep it from bending may be suggested
- Physical therapy will include strength training exercises to help you regain range of motion, stabilize the knee and strengthen your leg muscles in order to support the joint
- Surgery may be recommended in cases of complete ACL tears. The surgeon replaces the damaged ligament with a tendon called a graft if reconstruction is recommended. Some patients require physical therapy to regain motion prior to having surgery. Other surgeries can be performed arthroscopically by threading the graft through small holes in the knee. Following surgery, your doctor will recommend rehabilitation exercises designed to help you regain strength in the muscles that support the joint and help you restore your range of motion.
Reconstruction of an ACL in teenagers was previously considered too risky for teens who are still growing. Injury to the growth plate can lead to bone growth problems. In the past, surgeons were hesitant to perform surgery on teens until they were older and their bones were more mature. However, the orthopedic surgeons at NewYork-Presbyterian are experienced in techniques designed to avoid damage to the growth plates. Our surgeons are experts in orthoscopic surgery, which is minimally invasive and allows for accelerated downtime after surgery.
FAQs
FAQsACL injuries are common and widespread across many demographics. Fully understanding what an ACL tear is and who is at the biggest risk is key to helping prevent this injury yourself. Here are some commonly asked ACL questions.
Where is your ACL?
The ACL (anterior cruciate ligament) is located at the center of your knee and connects the upper leg bone with the lower leg bone.
What does an ACL tear feel like?
A torn ACL feels like a "popping" sensation with pain, swelling and the inability to put pressure on the leg.
How do you know if you tore your ACL?
A health professional can determine whether the ACL is torn by performing the Lachman test or an MRI.
How long does an ACL surgery take?
ACL surgery usually takes about 2 to 3 hours to perform with no need for an overnight stay in the hospital.
How long does a torn ACL take to heal?
Patients can usually return to active sports within 9 months after surgery.
How should I sleep after ACL surgery?
It would be best if you slept on your back or side. Do not place a pillow under your knee. You must keep your knee straight.
How long after ACL surgery can you walk?
You will need a walking aid following your operation to keep the weight off the leg for about two weeks. A sports medicine physical therapist will teach you the correct way to use the stairs.
Trust NewYork-Presbyterian for ACL Injury Treatment
Knowing your symptoms is important for the successful treatment of an ACL tear. NewYork-Presbyterian sports medicine specialists and orthopedic surgeons are experts in sports medicine rehabilitation. NewYork-Presbyterian is there for your treatment and recovery needs with locations throughout the New York City and its surrounding areas.