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Content
The Anterior Cruciate Ligament and the Knee

Causes of ACL Injury
ACL Tear Diagnosis
Treatment for ACL Tears
Non-Operative
There are some patients who may be better suited for non-operative treatment. Choosing whether to operate depends on the extent of the injury and the patient’s activities and goals. For example, if a patient is older, less active, and still retains a reasonable amount of function with their injury, non-operative management may be the best option. Often, this involves physical rehabilitation.
Operative
Surgery involves reconstructing the ligament itself. The surgeon does this through the use of grafts, meaning that they take another tendon and fashion it into a ligament. There are a variety of graft choices. Surgeons can take a tendon from the patient or from a donor. The two most common tendon grafts are either the patellar tendon or a tendon from the hamstring. The patellar tendon has the advantages of increased strength and better fixation to the bone. However, it may cause some more knee pain if taken from the patient. Using the hamstring causes less knee pain, can be very strong, but theoretically has slower fixation than the patellar tendon. Lastly, the surgeon can use a tendon from a donor. The advantage of the donor tendon is simply that using a donor avoids taking a tendon from the patient. The patient then does not experience the pain associated with using their own tendon. However, a donor tendon may integrate slower than a tendon taken from a patient. There is also the risk of infections from the donor.
Often there will be other co-existing injuries. Any injury to the meniscus, cartilage or other ligaments will be addressed at the time of surgery.
Summary
Frequently Asked Questions about Anterior Cruciate Ligament Tears (FAQ)
When you tear your ACL, patients often feel a sudden pop and their knee will give out from underneath them. Usually you will feel very unstable after the injury, as though your knee is “floppy”. Many patients will experience significant swelling and pain. The swelling and pain will gradually resolve. Without treatment, many patients continue to have discomfort and difficulty walking. It is important to see an orthopedic surgeon to make sure you have your knee addressed appropriately.
Minor, partial tears may not cause your knee to feel unstable, and you may be able to function fine. Complete tears of your ACL will not heal without surgery. Unfortunately, the ACL is located in an area of the knee joint that it will not heal on its own. However, some patients who are lower demand can consider a rehabilitation program to strengthen their knee and successfully manage their ACL tear without surgery.
Patients who are less active may consider delaying their surgery if they have other obligations. However, patients who continue to perform high levels of activity are placing the cartilage and meniscus at risk for further injury. Further injury to the knee can lead to arthritis later in life.
Yes, you can walk. Often times the knee is very swollen after the injury. Once you recover from the initial injury, However, without an ACL patients sometimes feel unstable. Patients who are athletes or require the use of their knee for high demand activities that involve pivoting or jumping are more likely to desire an ACL reconstruction.
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