ACL Injury

Diagnosis

Diagnosis typically begins with a physical examination of the knee:

• The healthcare provider checks for swelling, tenderness, and instability.

• The injured knee is compared to the uninjured knee to assess differences in function and range of motion.

• Specific movements may be tested to evaluate ligament integrity and joint stability.

Imaging Studies

Although a clinical exam often suffices, imaging may be necessary to confirm the diagnosis and assess the severity of the injury:

• X-rays:
  Used to rule out fractures. X-rays do not visualize ligaments, tendons, or cartilage.

• Magnetic Resonance Imaging (MRI):
  MRI provides detailed images of both soft tissues and bone, allowing evaluation of the ACL, meniscus, cartilage, and surrounding ligaments.

• Ultrasound:
  May be used to assess damage to ligaments, tendons, and muscles around the knee.

Treatment of ACL Injury

Immediate Care

After an ACL injury, prompt first-aid care helps reduce pain and swelling. The R.I.C.E. method is commonly recommended:

• Rest: Limit weight-bearing and activity to prevent further injury.

• Ice: Apply ice packs to the knee every 2 hours for 20 minutes when awake.

• Compression: Use an elastic bandage or compression wrap.

• Elevation: Keep the knee raised on pillows to minimize swelling.

Rehabilitation

• Initial treatment usually involves physical therapy to restore range of motion, strength, and stability.

• Braces and crutches may be used to stabilize the knee and reduce stress on the joint.

• Rehabilitation exercises are tailored to the patient’s activity level and may include at-home routines or supervised therapy sessions.

• Non-surgical management may be sufficient for less active individuals or those involved in low-impact activities.

Surgical Treatment

Surgery may be recommended for:

• Athletes wishing to return to sports that involve pivoting, jumping, or cutting movements.

• Injuries involving multiple ligaments or cartilage damage.

• Knees that give way during everyday activities.

ACL Reconstruction:

• The torn ligament is replaced with a graft, which may be taken from the patient’s own tendon (autograft) or from a donor (allograft).

• Surgery restores stability and allows proper knee mechanics.

Post-Surgery Rehabilitation:

• Extensive physical therapy follows surgery to regain strength, range of motion, and coordination.

• Athletes may require up to a year or more to safely return to competitive sports.

• Functional testing by healthcare professionals evaluates knee stability, strength, and readiness before resuming high-risk activities.

• Early return to sports may increase the risk of re-injury; recent studies show up to one-third of athletes experience a second tear within two years.

Long-Term Considerations

• Adequate rehabilitation and strengthening programs are essential for reducing re-injury risk.

• Patients should focus on optimizing movement patterns, balance, and joint stability before returning to high-intensity or pivoting sports.

• Ongoing monitoring by a physician or physical therapist ensures proper recovery and supports safe participation in athletic activities.