1. An ACL tear is a common cause of knee pain resulting from knee injury that can occur during sports activities, accidents, or sudden twisting motions. The ACL is one of the strong bands that help connect your thigh bone (femur) to your shin bone (tibia). This crucial ligament provides stability to the knee joint, and when it is either stretched, partially torn or completely torn, it can significantly impact a person's ability to perform daily activities and sports. 

  2. Clinical Presentation

  3. Patients with an ACL tear often present with a history of a non-contact injury, such as a sudden change in direction, a sudden stop or landing after a jump, or a twisting motion of the knee. Common symptoms include severe pain and inability to continue activity, rapid joint swelling, knee instability with “giving way” sensation when weight bearing. Often an audible cracking sound or popping sensation may be noted at the time of injury.

  4. Diagnostic Modalities

  5. Diagnosis is made by a thorough physical examination which may be notable for tenderness around the knee joint with reduced range of motion, joint effusion as well as increased looseness or instability of the knee joint. Magnetic resonance imaging (MRI) may be useful for evaluating ligament injuries and can provide additional information about the extent of the tear, associated injuries, and the condition of other structures in the knee joint. X-rays may be performed to rule out fractures or degenerative changes in the joint. 

  6. Management Options

  7. The management of ACL tears can be classified into non-surgical and surgical approaches and treatment recommendations depend on various factors including extent of injury and desired level of activity. Non-surgical management may be recommended for patients with partial tears or those who are not candidates for surgery. This may include physical therapy to include core strengthening and neuromuscular training and bracing to support the knee joint. Surgical intervention, such as ACL reconstruction, may be indicated for active individuals or those with significant functional limitations and is generally performed after initial inflammation from the injury has resolved. 

  8. ACL Reconstruction Surgery

  9. Surgical repair via Arthroscopic Anterior Cruciate Ligament Reconstruction involves replacing the torn ligament with a graft, typically sourced from the patient's own hamstring or patellar tendon or from cadaver donor. The surgery is usually performed with an arthroscope, allowing for smaller incisions, less postoperative pain, and faster recovery. Post-surgery, patients undergo a structured rehabilitation program to regain strength, range of motion, and neuromuscular control of the knee. 

  10. Rehabilitation Strategies

  11. Rehabilitation plays a crucial role in the recovery process following ACL reconstruction. Physical therapy focuses on strengthening the surrounding muscles, improving proprioception, and restoring functional abilities. Gradual progression of activities is essential to prevent re-injury and ensure a safe return to sports or high level activities. 

  12. The diagnosis and treatment of knee pain  from an ACL tear require a comprehensive approach that includes a thorough physical exam and comprehensive evaluation, appropriate imaging studies, and individualized management strategies. Early recognition of an ACL tear and timely intervention can help optimize outcomes and facilitate a successful return to an active lifestyle.

  13. If you are experiencing persistent knee pain, reach out to Dr Ram Aribindi, Board Certified Orthopedic Surgeon at Southland Orthopaedics Ltd, where you will receive a comprehensive orthopedic evaluation and an individualized treatment plan of care targeted to treat your knee pain. 
    Remember, pain is your body's way of signaling that something is wrong - don't ignore it!

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