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Anterior Cruciate Ligament (ACL) Tear

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What Is an ACL Tear?

The ACL is the main ligament that controls the movement of your shinbone (tibia) in relation to the thighbone (femur).

When the ACL tears and that restraint disappears, your knee can become unstable and may buckle or give way.

ACL tear causes and risks

ACL tears commonly occur in athletes who play high intensity sports such as:

  • Football
  • Basketball
  • Soccer

These sports can put you at higher risk for an ACL injury or tear because they involve quick, frequent movements — like jumping and stopping — and rapidly changing direction.

Athletes are 15 times more likely than the general population to have a second ACL injury following ACL surgery. About 30 percent will re-injure their ACL within 24 months of surgery.

Female athletes are especially at risk for ACL tears.

Compared to male athletes, women are:

  • Four times more likely to suffer a graft re-tear.
  • Six times more likely to injure the other side of the ACL.

ACL tear complications

Re-injury is the most common complication of an ACL tear.

If you've already torn your ACL and you play sports regularly, you're more likely to injure it again.

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ACL Tear Symptoms and Diagnosis

Symptoms of an ACL tear or injury

If you injure your ACL, you may experience:

  • A popping sound.
  • Your knee giving out from under you.
  • Pain and swelling.
  • Reduced range of motion in the knee.
  • Pain or discomfort when walking or putting weight on the knee.

ACL tear diagnosis

The best time to diagnose an acute ACL tear is within the first hour after injury, before the knee swells, if possible.

Your doctor at UPMC Sports Medicine will get a complete history of your injury and ask you:

  • How the tear happened.
  • If your knee was hyperextended.
  • If you heard a pop.
  • Where — and how much — your knee hurts.
  • If your knee feels unstable.
  • If you've had any previous knee injuries.

The doctor will then perform a physical exam or test of your knee to assess the stability of the ligaments. He or she can diagnose an ACL tear by applying force to the knee and feeling for abnormal motion.

Other tests — such as x-rays and MRI scans — can also help your doctor find out the extent of the ACL injury.

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ACL Tear Treatment and Rehab

Treatment for ACL tears and injuries can range from nonsurgical — such as knee braces — to ACL reconstruction surgery.

The experts at UPMC Sports Medicine will work with you to create a treatment plan based on your:

  • Age
  • Activity level
  • Degree of injury

UPMC also offers an ACL Injury Prevention Program for athletes who are either looking to return to their sport after experiencing an ACL tear or to prevent one from happening.

Nonsurgical ACL tear treatment

For minor ACL injuries, protective braces and physical therapy to strengthen the muscles around the knee may be enough.

To treat a minor ACL tear, your doctor may suggest that you:

  • Apply ice to the knee a few times a day.
  • Elevate the knee above the level of the heart.
  • Compress the knee with a bandage or wrap.
  • Reduce or halt activity for several weeks.
  • Take anti-inflammatory drugs — such as ibuprofen — to reduce swelling and speed up recovery.

ACL tear surgery

A full ACL tear will not heal on its own. If you want to continue in high-intensity sports or an active lifestyle, surgical repair may be the best treatment option.

In ACL reconstruction surgery, surgeons rebuild the ligament using tissue from your own body or from a donor.

Without surgery, your knee may be unstable and increase your risk for future injuries.

ACL tear rehab and recovery

Physical therapy is a vital part of healing from an ACL tear or injury.

Your physical therapist will ask you to complete exercises. You can do most of these at home or at the gym.

The goals of rehab are to restore range of motion and strengthen the quadriceps and hamstring muscles, which help stabilize the knee.

The ACL Injury Prevention Program from UPMC Sports Performance helps athletes reduce the risk of non-contact ACL injuries while improving athletic performance.

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