What is an ACL Tear?

If you’ve experienced knee pain and a popping sound when making a quick turn or landing, you might have an ACL tear.

The ACL, or anterior cruciate ligament, is one of several ligaments in your knee joint. It helps to stabilize the knee when you twist and turn. It’s likely you’ve heard more about the ACL than other knee ligaments like the MCL. that’s because it’s common for it to become torn or ruptured during a sports injury.

If you injure your ACL, it may still be possible to walk and run in a straight line. But your knee will be unstable and can collapse or give way when you turn. You can also cause further damage to the other knee structures such as the medial meniscus. You can also risk a complete rupture if you only have a partial ACL Tear.

Common causes for injuring your ACL include:

• Landing awkwardly from a jump
• Sudden twisting motions
• Stopping suddenly while you are running
• Trauma to the knee during contact sports

It’s important to get checked out by your physician or orthopedic surgeon if you have sudden knee pain. Many other knee conditions such as meniscus tear cause similar symptoms. By “walking it off” you risk causing further damage.

How Do I Prevent an ACL Injury?

Involved in sports that require quick turns or potentially awkward landings?

There are some ways you can protect your knee from injury. Visit a physical therapist or sports medicine specialist (such as Dr. Mehta). They can develop a program to teach you:

• Core exercises to prevent inward motion of the knee while you squat
• Leg muscle strength exercises, especially for the hamstring
• Proper technique for sudden turns and when landing from a jump

ACL Tear Diagnosis

So, what does an ACL tear feel like?

ACL tears are usually found in those playing a sport such as soccer or basketball. When they make a sudden turn and hear a popping noise followed by sharp knee pain, it might be an ACL tear.

But even if it feels like an ACL tear, there are many other parts of your knee that could be damaged! Leaving a knee injury untreated can result in permanent damage. Look out for serious causes of knee pain.

To get a diagnosis of an ACL tear, you should visit an orthopedic surgeon to get a physical examination. By examining for any pain, swelling, or joint instability, your surgeon can tell you whether you can put weight on that leg. They will consider walking aids and can arrange further imaging.

You may need to go for an MRI scan of your knee, though first you will need an x-ray to make sure you don’t also have a fracture.

If the diagnosis is still unclear, your surgeon may need to look directly inside your knee joint. This is done by performing an arthroscopy (camera test).

You may have an ACL tear if you are experiencing any of the following symptoms:

• A popping noise, followed by pain in your knee
• Swelling or bruising of the knee
• Joint instability, like the feeling of your knee giving way
• Difficulty moving your knee

If you’re experiencing any of the above symptoms, you should book a consultation.  This will help you to avoid causing further injury.

X-Ray for ACL Tears

An X-ray alone can’t diagnose an ACL tear. The anterior cruciate ligament is a soft tissue and won’t show up on X-ray images like air, fluid, and bones do.

However, in cases where an ACL injury is suspected, you will still need a knee x-ray. This will to rule out the possibility of a fracture or other bone-related problems. X-rays are effective in identifying signs of bone damage. ACL tears don’t cause bone damage, but the xray might give us a clue of what may be causing your symptoms.

If the x-ray doesn’t show any fractures but the diagnosis is unclear, further tests may be required.

In such cases, an MRI (Magnetic Resonance Imaging) scan is often recommended. This can provide detailed images of the soft tissues, including other ligaments. An MRI scan can help confirm the presence and severity of an ACL injury. This enables your orthopedic surgeon to formulate an appropriate treatment plan.

If the diagnosis is unclear, or there are other factors, your surgeon may need to look inside the knee joint. This is done through knee arthroscopy. In arthroscopy, your doctor inserts a small camera into the joint through a small incision. This allows the orthopedic surgeon, such as Dr. Mehta, to assess the damage to the ACL. She can also directly examine other structures within the knee joint.

Arthroscopy gives your doctor the best possible chance to make a definitive diagnosis. This will help you to work together to plan the best course of treatment for you.

How is an ACL Tear Treated?

If you suspect that you have an ACL tear, you can first take steps to ease pain and swelling. These include:

• Resting and elevating the knee
• Avoiding putting any weight on the affected leg
• Using crutches to reduce the pressure on your knee
• Placing ice or compression bandages over your knee
• Anti-inflammatory Medication

Once your orthopedic surgeon has made a diagnosis, they will discuss treatment. For serious tears, you may need ACL reconstruction surgery. You may also need treatment for any associated injuries. Dr. Mehta utilizes an arthroscopic technique and individualizes graft choice for each patient.

You will require physical therapy following an ACL tear. This is especially true if you have undergone surgery. Depending on whether you have a partial or complete ACL tear, recovery can take from weeks to months. If you undergo ACL reconstruction surgery, recovery time is a few weeks. Full recovery and return to sport can take nine to twelve months.

Knee injuries have a complex diagnostic process and a range of treatment approaches. So, it’s important that you get treated by someone who listens to your priorities.

ACL Tear Surgery

ACL tear surgery, also known as ACL reconstruction, aims to repair a torn anterior cruciate ligament (ACL) in the knee. The surgery involves replacing the damaged ACL with tissue, known as a graft, taken from another part of your body.

This can be obtained from your own tissue (autograft) or a donor (allograft). A graft is usually taken through keyhole surgery ( which uses a camera and specialized instruments. The torn ACL is removed, and bone tunnels are created to secure the graft in place. The graft is then positioned and fixed to provide stability and support to the knee joint.

You will need physical therapy following an ACL tear, especially if you have had surgery. Depending on whether you have a partial or complete ACL tear, recovery can take from weeks to months. If you undergo ACL reconstruction surgery, recovery time is usually a few weeks. Full recovery and return to sport can take nine to twelve months.

With such a complicated diagnosis and a wide range of treatments, it’s important that you get treated by someone who listens to your priorities.

ACL Hamstring Graft

One common type of graft used for ACL reconstruction is the ACL hamstring graft (warning: link is to a video – not for the faint of heart!). Tendons are taken from your own hamstring muscles (the semitendinosus and gracilis tendons).

These are used to create a new ACL within the knee joint. A hamstring graft is a good option for several reasons, including a good balance between strength and flexibility. This allows for more natural knee movement and function after the surgery.

During the ACL hamstring graft procedure, Dr. Mehta will make a small incision to access the hamstring tendons. These tendons are carefully removed and prepared for use as the graft. They are then inserted into the knee joint and secured in place using screws or other fixation devices. The graft serves as a replacement for the torn ACL, providing stability and support to the knee.

ACL Hamstring Graft Scar

Like any surgery, an ACL hamstring graft leaves a scar at the incision site where the hamstring tendons were harvested. Scar appearance varies based on factors like skin type and healing. With time, the ACL graft scar typically fades and becomes less noticeable.

You can cut the risk of scarring by following the care and post-operative guidelines. Dr. Mehta will give you these after surgery. They will try to focus on restored knee stability over scar concerns. Physical therapy is vital for recovery. It also improves symptoms after an ACL hamstring graft.

Do All ACL Tears Require Surgery?

Not all ACL tears need surgery. The decision to skip or have surgery depends on several crucial factors, including:

• Your Age
• Your Activity Level
• The Extent of the ACL Tear

Surgery is not the only option, and non-surgical treatments are available.  If you have a partial tear, or have a less active life, you may have more relief and improved symptoms through non-surgical approaches. These treatments may include:

• Physical Therapy
• Rehabilitation Exercises
• Knee Braces
• Lifestyle modifications
• PRP or Stem Cell Injections

Seeing an orthopedist for a thorough evaluation is important to make a decision on the best treatment options available to you. The key is to focus on long-term knee health and functional goals. Dr. Mehta provides personalised care, allowing for a bespoke treatment and recovery plan.

What Are the Long Term Effects of ACL Tear Without Surgery?

Without surgery, an untreated ACL tear may cause several long-term knee problems. Here are some key points to consider:

Ongoing Instability

An untreated ACL tear can result in persistent instability in the knee joint. This instability can make activities that involve pivoting, twisting, or changing direction challenging. If left untreated this can also lead to further injuries.

Recurring Knee Injuries

Without
surgical repair, the risk of recurring knee injuries, such as meniscus tears or
further ligament damage, is much higher. The instability of the knee puts
stress on other parts of the knee, making them more susceptible to injury.

Increased Risk of Arthritis

ACL
tears left untreated can lead to degenerative joint conditions such as
osteoarthritis. The change in your movements and knee instability can worsen
wear and tear, leading to joint pain, stiffness, and reduced mobility.

Functional Limitations

Living with an untreated  ACL tear can result in limitations in your daily life. The movement difficulties can affect your ability to take part in sports and physical activities. You may also be unable to do your day-to-day tasks that involve knee movement and stability.

Long-Term Impacts on Quality of Life

The effects of knee instability, recurring injuries, and joint degeneration can worsen your quality of life. Chronic pain, reduced mobility, and physical limitations can affect your independence and wellbeing.

ACL Injury Self-Care

When it comes to self-care for an ACL injury, there are several steps you can take to improve your symptoms, including:

– Rest & protect your injured knee
– Avoid weight-bearing
– Use crutches if necessary
– Apply ice to the affected area every 20 minutes for a few hours

You should always see a healthcare professional after a knee injury, as some conditions need urgent treatment.

Compression and elevation are also essential components of self-care. Wrap your knee with a compression bandage to provide support and reduce swelling. You can also try elevating your leg above the level of the heart. These steps help to promote blood circulation and reduce swelling.

Over-the-counter pain medications are a good option to manage discomfort. Make sure you follow the recommended dosage and talk to your healthcare provider if necessary.

Exercise can strengthen the muscles of the knee and maintain your knee mobility. Help your recovery with gentle exercises and stretches. Your physical therapist or orthopedist can help you find the best exercise program. You should avoid high-impact or intense exercise until your knee is fully healed.

While self-care is important, you should always seek medical advice following a knee injury. Your healthcare provider can give you the most appropriate self-care measures. They can provide guidance on when to start gentle exercises. They can also help you track your progress, and ensure your symptoms are improving. Remember to follow their recommendations. Finally, be patient – ACL injuries need time to heal!

Can a Torn ACL Heal on its Own?

The healing potential of a torn ACL on its own is limited. The ligament has a poor blood supply. Particularly in the central part of the ligament where tears often occur. As a result, a torn ACL struggles to receive the right nutrients and healing factors to heal by itself.

It’s important to note that your specific circumstances may influence the treatment approach. If you live a sedentary lifestyle or who engage in low-impact activities, you may not need ACL surgery. Instead, you might be offered physical therapy. This strengthens the surrounding muscles and support the knee joint. Your doctor may also recommend lifestyle changes and the use of a knee brace.

If you lead an active lifestyle or take part in sports, surgery is often recommended. If you have persistent difficulties with your knee, it might also be the best option. ACL reconstruction surgery aims to improve the stability and function of the knee. This is usually done by replacing the torn ligament with a graft. The graft is obtained from your own tendon or a donor source.

You should make the decision on the treatment of a torn ACL with a doctor who can review your case with you. They will discuss personalized recommendations based on your goals, lifestyle, and activity level.

Testimonials

Gajan T.San Francisco, CA
I write only a few Yelp reviews a year, and hope that this will help anyone who is trying to find the right orthopedic doctor.
I went to 3 orthopedic doctors when I had a serious knee issue earlier this year. Although, I received good advice from all the doctors, I chose Dr. Mehta because she spent a considerable amount of time helping me to understand the root cause of my knee pain and then created a blueprint moving forward of preventative measures.
She was definitely very insightful in her diagnosis and more importantly her treatment. What actually inspired me to really write this yelp review was because of her follow up calls and how much I realized that she really wanted to see me get better.
I’ve been to many good doctors in the bay area but only a handful that offer this much personalized care. I highly recommend Dr. Mehta and happy to talk to anyone about my experience if you trying to decide on an orthopedic doctor.

Isiah HarrisGoogle Review
Dr. Mehta has provided me with some great resources and answers to my knee pain. She was able to diagnose my knee problem even before an MRI confirmed it. She spent almost an hour with me and answered all of my questions. She has an incredible bedside manner as well. She made me instantly feel comfortable. I would highly recommend her and so glad I found her.

Isiah HarrisDerek Maravilla
I am so impressed by (and grateful) for the care given to me by Dr. Pamela Mehta. Any time I get the opportunity to give her a referral or recommendation I can’t resist. The level of care she provides far surpasses that of any other doctor I have ever seen. I was so impressed with Dr. Mehta’s approach. She patiently explained every detail of my ACL reconstruction surgery, and really took the time to listen and answer all the questions I had. If I ever have to refer anybody I know to an orthopedic surgeon, I will insist they see Dr. Mehta! There isn’t anybody else I would go to if I needed surgery again. Thanks Dr. Mehta for the great care you have provided me!