Anterior Cruciate Ligament (ACL) is in the center of the knee joint. Its function is to prevent the forward sliding of the tibia on the femur. ACL may be injured through contact placing force on the ligament or may be produced without contact by rapid twisting of the knee. At the time of injury, a loud pop may be heard. Symptoms of ACL tear include immediate onset of pain, swelling, instability (knee buckles under the body’s weight), and limitation of motion. Meniscus tears are common with ACL injuries. ACL tear is diagnosed by physical examination and confirmed by good quality MRI scans.

Most individuals involved in pivoting type of sports or heavy jobs will have recurrent symptoms of instability (knee giving way, buckling, wobbly). This may cause other injuries to the knee (wearing out of the cartilage, development of meniscus tear, etc.).

Treatment initially focuses on regaining full range of motion and strength in the knee. Once the ligament is torn, it cannot be repaired (cannot be sutured back together).

It should be replaced with a graft, which will later incorporate inside the knee as a new ligament.

There are a number of choices for ACL graft including patient’s own patella or hamstring tendons versus cadaver tendons. You should discuss the strengths and shortcomings of these graft choices with your doctor. Surgery is performed with small incisions and it is considered an outpatient procedure (patients go home the day of surgery). Recovery time varies based on the choice of the graft and concurrent injuries in the knee. Typically, weight bearing is initiated within 2 days. Patients may return to sedentary work within 7-10 days. Return to competitive sports is delayed for six to eight months.