Diagnosis: During the physical examination, your doctor will assess your injured knee by comparing it to your uninjured knee. They may also manipulate your knee into various positions to evaluate its range of motion and overall function.
While a diagnosis can often be made based on the physical exam alone, additional tests may be necessary to rule out other causes and determine the severity of the injury. These tests include:
- X-rays: Used to rule out bone fractures. However, X-rays do not reveal soft tissues like ligaments and tendons.
- Magnetic Resonance Imaging (MRI): This technique uses radio waves and a strong magnetic field to create detailed images of both hard and soft tissues in your body. An MRI can show the extent of the ACL injury and any damage to other knee tissues.
Diagnosing an ACL Injury: During the physical examination, your doctor will assess your knee, comparing the injured one to the uninjured side. They may manipulate your knee into various positions to evaluate its range of motion and overall function. While a diagnosis can often be made based on the physical exam alone, additional tests may be necessary to rule out other causes and determine the severity of the injury. These tests include:
- X-rays: Used to rule out bone fractures. However, X-rays do not reveal soft tissues like ligaments and tendons.
- Magnetic Resonance Imaging (MRI): This technique uses radio waves and a strong magnetic field to create detailed images of both hard and soft tissues in your body. An MRI can show the extent of the ACL injury and any damage to other knee tissues, including cartilage.
- Ultrasound: Utilizing sound waves to visualize internal structures, ultrasound may be used to check for injuries in the ligaments, tendons, and muscles of the knee.
Treatment and Rehabilitation: Prompt first-aid care can reduce pain and swelling immediately after a knee injury. Follow the R.I.C.E. model of self-care at home:
- Rest: Allow your knee to rest for healing and limit weight-bearing.
- Ice: Apply ice to your knee at least every two hours for 20 minutes while awake.
- Compression: Use an elastic bandage or compression wrap around your knee.
- Elevation: Lie down with your knee propped up on pillows.
Medical treatment for an ACL injury typically involves several weeks of rehabilitative therapy. A physical therapist will guide you through exercises, either with continued supervision or at home. You may also wear a brace to stabilize your knee and use crutches temporarily to avoid putting weight on it. The rehabilitation goal is to reduce pain and swelling, restore your knee’s full range of motion, and strengthen the surrounding muscles.
Surgery for ACL Injuries: Your doctor may recommend surgery in the following situations:
- Athletic Goals: If you’re an athlete and wish to continue participating in your sport, especially if it involves activities like jumping, cutting, or pivoting.
- Multiple Ligament or Cartilage Injuries: When more than one ligament or the fibrous cartilage in your knee is also damaged.
- Knee Instability: If the injury causes your knee to buckle during everyday activities.
ACL Reconstruction Procedure: During ACL reconstruction, the surgeon removes the damaged ACL and replaces it with a segment of tendon—similar tissue to a ligament that connects muscle to bone. This replacement tissue is known as a graft. The surgeon typically uses a piece of tendon from another part of your knee or a tendon from a deceased donor.
Post-Surgery Rehabilitation: After surgery, you’ll undergo several weeks of rehabilitative therapy. A physical therapist will guide you through exercises, either with continued supervision or at home. You may also wear a brace to stabilize your knee and use crutches temporarily to avoid putting weight on it. The rehabilitation goals include:
- Reducing pain and swelling
- Restoring your knee’s full range of motion
- Strengthening the surrounding muscles
Return to Play: There’s no fixed timeline for athletes to resume play. Recent research suggests that up to one-third of athletes experience another tear in the same or opposite knee within two years. A more extended recovery period may reduce the risk of re-injury.
In general, it takes a year or more before athletes can safely return to play. Doctors and physical therapists will assess your knee’s stability, strength, function, and readiness for sports activities at various intervals during your rehabilitation. Optimizing strength, stability, and movement patterns is crucial before returning to activities with an ACL injury risk.
Preparing for Your Appointment: When dealing with an ACL injury, it’s essential to be well-prepared for your medical appointment. Here’s what you can do:
Seek Timely Attention: The pain and limitations caused by an ACL injury often lead people to seek immediate medical care. However, some individuals may initially consult their family doctors. Depending on the severity of your injury, you might be referred to a specialist in sports medicine or an orthopedic surgeon specializing in bone and joint issues.
Key Questions to Consider:
- Timing: When did the injury occur?
- Activity: What were you doing at the time of the injury?
- Sensations: Did you hear a loud pop or feel a “popping” sensation?
- Swelling: Was there significant swelling afterward?
- History: Have you experienced knee injuries in the past?
- Symptoms: Are your symptoms continuous or occasional?
- Movement Patterns: Do specific movements improve or worsen your symptoms?
- Locking or Instability: Does your knee ever “lock” or feel blocked during movement? Do you perceive instability or an inability to support your weight?
