This progresses with time because in an untreated knee the knee is unstable and produces greater stress on the cartilage. There is an incidence of approximately 1 in 3 patients who at the time of the anterior cruciate ligament tear will tear their cartilage as well. Over time and with more usage these other structures stretch out as well, resulting in increased instability and then associated meniscal (cartilage) tears. The other structures of the knee try in vain to provide some stability to the knee. If left untreated the laxity which is immediately present only becomes worse. Natural History of the Torn Anterior Cruciate Ligament It might actually be easily missed in the initial stages. The injury is often missed because the physical examination requires some experience and training. Surprisingly, sometimes the knee will not get very swollen, although it certainly can. Usually the patient will feel a sudden pop in their knee immediately in injury to the knee. In basketball it is usually a result of a hyperextension and internal rotation of the tibia on the femur, associated with deceleration. As the patient turns and pivots the ligament tears.
Mostly it is a non-contact deceleration where the athlete suddenly turns to the opposite side of the planted and injured knee. Interestingly, most people would expect that it is due to contact, but this is not true. We’ve seen bilateral ACL tears in a weight lifter who was doing an incline bench and popped both his knees at the same time when bench-pressing 350 pounds. It is, however, possible to injure the anterior cruciate doing a variety of activities. The most common sports are football and basketball in younger patients skiing injuries predominate in older patients. There have been a variety of reasons proposed for this, such as muscle imbalance and slight variations in the anatomy of the knee joint in women compared to men. When you consider the number of sport hours played, they are more common in women. Most anterior cruciate ligament tears occur during a sporting activity and usually in younger patients. The ligament sits just in front of its counterpart, the posterior cruciate ligament, directly in the middle of the knee joint. This instability is particularly problematic when participating in pivoting sports such as soccer and football. When it is injured or torn the patient feels the instability of the knee when they turn or pivot. This ligament is very important for maintaining stability of the knee. This is a type of surgical procedure that entails the insertion of a tiny camera into your knee through a small incision.The anterior cruciate ligament is a thick band of tissue which has two major strands that extend from the lower leg bone (tibia) to the thigh bone (femur). If there’s no evidence of any breaks, a magnetic resonance imaging (MRI) test may follow to assess the damage to your ACL.Ī doctor may also choose to perform arthroscopy to check out the damage to your ACL and treat it. Next up is an X-ray to see if any bones have been fractured. Then your doctor will apply pressure behind the knee and see if your leg moves out of place, which would signal an injury to your ACL. While lying on your back, you’ll bend your knee and keep your foot on the exam table. This test can help the doctor determine what grade of injury you’ve probably sustained.Īnother test that a doctor might use during the physical exam is the anterior drawer test. Then the doctor will bend your knee and rotate it to assess its ability to move. This may entail the use of a diagnostic test called a Lachman test, during which you lie on your back.
They will also check your knee’s range of motion. After you experience an injury to your ACL, a doctor will first examine your knee and take note of the swelling.