The anterior cruciate ligament (ACL) can be injured as a result of getting hit very hard on the side of the knee, overextend injury to the knee, or landing from a jump incorrectly. Symptoms include a “popping” sound heard at time of injury, swelling within 6 hours, and pain. A mild injury may only result in a feeling of instability of the knee or it seems to “give way” when using it.
ACL injury can sometimes be diagnosed during a physical exam alone, but diagnostic testing may be required to rule out other causes and determine the severity of the injury. Tests could include x-rays, magnetic resonance imaging (MRI), and/or ultrasound.
Initial treatment is aimed at reducing pain and swelling, with rest, ice, compression and elevation. Several weeks of rehabilitation can be expected, with a physical therapist initially teaching exercises which can be performed with continued supervision and/or at home. A brace can stabilize the knee and possible crutches to avoid weight bearing. The goal is to restore full range of motion and strengthen the knee.
Surgical repair could be recommended if more than one ligament or the cartilage of the knee is injured, the claimant is young and active, and/or the injury is causing the knee to buckle. The procedure, an ACL reconstruction, involves removing damaged ligaments and replacing with a segment of tendon. After surgery, rehabilitation takes place to restore strength, stability and function to the knee.
There is a revolutionary new procedure, called BEAR (Bridge-Enhanced ACL Repair) that is currently in testing stages. A “bridge” is surgically inserted into the ACL which allows the ACL ends to heal back together themselves. So far, the procedure when tested in pigs showed significantly less arthritis (a complication of ACL injuries). Three months after surgery on the first human trials, all BEAR recipients had healing ACLs, flexibility close to that of the healthy knee, and recovered strength more quickly than the traditional ACL repair. While more testing is needed, this new procedure appears to show extreme promise.Back to Blog