ACL/MCL Tears
What causes a tear of the ACL?
An ACL tear most often occurs during sporting activities when an athlete suddenly pivots causing excessive rotational forces on the ligament. Other mechanisms that can cause an ACL tear include severe trauma and work injuries.
Individuals who experience ACL tears usually describe a feeling of the joint giving out, or buckling—patients also often say they hear a “pop.”
How do you know if you’ve sustained an ACL tear?
There are a variety of symptoms associated with an ACL tear. Those include the following:
- Sudden giving way of the knee
- Hearing a ‘pop’ at the time of injury
- Sudden swelling of the knee joint
- Pain in the knee when walking
What should I do if I think I have an ACL tear?
Patients who think they have an ACL tear should be evaluated by their doctor. An ACL tear may be difficult to diagnose immediately after the injury because of associated pain and swelling. There may also be muscle spasm that contributes to making the knee difficult to examine. Therefore, it may not be possible to conclusively determine the presence of an ACL tear soon after the injury.
If an ACL tear is suspected, you will need to undergo a follow-up evaluation with your orthopedic surgeon.
How does my doctor make the diagnosis of an ACL tear?
The presence of an ACL tear is suspected whenever a patient has an injury to their knee. In the orthopedists office, knee instability can be assessed by specific maneuvers performed by your physician. These maneuvers test the function of the ligament to determine if an ACL tear is present.
A complete examination of the knee is also necessary to determine if other injuries may have occurred that could be causing your symptoms.
Your physician will also evaluate x-rays of the knee to assess for any possible fractures, and a MRI will more than likely be ordered to evaluate for ligament or cartilage damage. While many patients are concerned when their doctor does not order a MRI, it is not necessary to diagnose most ACL tears.
Will I need an operation for an ACL tear?
The decision as to whether or not to operate on an ACL tear is dependent on several factors.
Some patients who experience ACL tears are able to resume normal daily activities without surgical reconstruction of this ligament. Factors include the age of the patient, the activity level of the patient (both recreational and occupational), the expectations of the patient, the ability and willingness of the patient to participate in post-operative rehabilitation, the degree of instability of the joint, and any other associated injuries to the knee.
Types of ACL surgery
There are different types of ACL surgery. The typical ACL surgery involves grafting with a patella tendon, hamstring tendon or using a donor tissue graft. The patella tendon surgery is generally considered the most secure type of graft while the uses of a donor tissue graft is considered the least painful post-surgery.
Dr. Hoffman also performs a procedure known as a Double Bundle ACL. (more information to come)
