ACL Injuries

Traumatic injury to the ACL occurs in athletes who participate in high-risk sports such as skiing, soccer, football, and basketball. The majority of ACL injuries result from a sharp twisting of the knee; sudden deceleration while cutting, pivoting, or performing sidestepping movements; an abrupt stop when running, or an awkward landing from a jump. Other, less common, causes include direct contact, a fall, or a traumatic accident. Women who participate in college sports, such as soccer, basketball, softball, lacrosse, or rugby are four times more likely than men to rupture their ACL.

The combination of a detailed history, comprehensive physical examination, x-rays, and an MRI (magnetic resonance imaging) is the key to a successful diagnosis of an ACL injury.  Dr. Jorge Chahla and his team use stability tests as part of his physical exam, including the Lachman and Anterior Drawer tests, to properly diagnose an ACL Injury. Because almost half of all ACL injuries occur in combination with other knee injuries, imaging studies such as an MRI are important to evaluate the full extent of your injuries.

ACL injuries can be classified into different types based on the severity and extent of the damage to the ACL fibers. The grading of severity is based on the amount of ligament disruption and the extent of knee instability present following an injury. It is important to accurately diagnose the extent of an ACL injury, as the appropriate treatment plan can vary based off the type of ACL injury that an individual has suffered.

Grade 1: ACL Sprain

An ACL injury that stretches the fibers of the ligament but does not lead to a full thickness tear of the fibers is called an ACL Sprain. This is the least severe injury to the ACL, and often, these injuries can heal on their own with conservative treatment including rest, ice, compression, elevation, oral anti-inflammatory medications, and physical therapy.

Grade 2: Partial ACL Tear

An ACL injury that tears some of the ligament fibers is called a “partial tear” of the ACL. When partial tearing of the ACL occurs, patients may experience some episodes of mild instability or pain. However, the severity can vary depending on the extent of the partial tear. In some cases, a partial tear of the ACL may heal with conservative treatment including rest, ice, compression, elevation, oral anti-inflammatory medications, physical therapy, and possibly the need of a specialty brace called a functional ACL brace. However, when instability persists despite conservative treatment, it is reasonable to consider surgical intervention. The decision to perform surgery to fix a partial tear depends on the severity of instability of the knee and patient’s desire to return to sport. When discussing surgery for a partial ACL tear, Dr. Chahla and his team may discuss both the option of an ACL repair and an ACL reconstruction. The options available to you for surgery will depend on the location and extent of your partial ACL tear. Please see treatment options below for further information.

Grade 3: Complete ACL Tear

A complete tear of the ACL describes an injury in which the ligament is non-functional and will require surgery to fix it. Professional athletes and most recreational athletes will likely require surgery to return to play, especially if their desired sport includes pivoting, cutting, and lateral movements.