ACL and MCL Injury
The following describes the symptoms, diagnosis and treatment of ACL, MCL and other ligament injuries. For specific information regarding your health and treatment options, please contact your Hurley physician or medical professional.
What are the ACL, MCL and other knee ligaments?
There are four main ligaments in the knee, but the ACL (anterior cruciate ligament) and LCL (lateral collateral ligaments) are those that most frequently require surgery. The PCL (posterior cruciate ligament) and the MCL (medial collateral ligaments) are often treated primarily with bracing and physical therapy. These ligaments stabilize the knee, by preventing it from rotating too much and moving beyond its normal range of motion. For the purposes of this description, we will focus on ACL injury specifically, although the information provided applies generally to the other ligaments, as well.
What causes ACL injury?
Typically, ACL injuries occur during sports. These ligaments may be injured or torn when you twist or overextend your knee; for example, your foot remains planted while your knee turns, you land improperly during a jump, or you experience a blunt trauma. Women are more likely than men to suffer an ACL injury.
What are the symptoms of ACL injury?
At the time of the injury, you may hear a popping sound, experience sharp pain, and may find it difficult for your knee to support your weight. Swelling often occurs quickly, and there is limited range of motion in the joint. However, some ACL injuries go undiagnosed immediately after the injury. Later symptoms include the knee giving way regularly or arthritis.
How is ACL injury diagnosed?
Your Hurley physician will conduct a complete physical exam by gently moving your lower leg forward. If your leg moves without reaching a firm endpoint, your ACL is likely torn. Your doctor may also turn the knee gently to observe if the shinbone shifts on the thighbone.
The best treatment can be provided by discovering which ligament or ligaments are affected and by determining the severity of the tear. An MRI may be ordered to evaluate the ligaments, which do not appear on x-ray.
How is ACL injury treated?
After an injury, seek immediate medical attention, especially if the foot turns cool and blue. Do not attempt to move the knee and use a splint to provide additional stability.
You should also follow the PRINCE method for immediate self-care:
P: Protect your knee with a supportive brace and, if necessary, use crutches.
R: Rest your knee.
I: Iceyour knee several times a day for 10 to 20 minutes each time, to reduce pain and swelling. (Be sure to use a cloth between the ice or ice bag and your knee, in order to avoid damage to your skin.)
N: Nonsteroidal anti-inflammatories (NSAIDs) may be used to help with pain relief and to reduce swelling.
C: Compression with an elastic compression wrap also helps reduce swelling; however, do not rely on the wrap for support while walking.
E: Elevation—raise your knee above the level of your heart (using a pillow for support) to reduce swelling and bruising.
Your Hurley physician will determine appropriate and specific ACL injury treatment options based on your age, overall health and fitness, and medical history.
Nonsurgical treatment options may be appropriate if your knee is stable during daily activities; the knee cartilage is undamaged; and you are willing to cease participation in activities that require pivoting movements, sudden slowing down or jumping. Typical nonsurgical treatment includes wearing a knee brace or using crutches, and physical therapy.
Surgical reconstruction may be recommended if your knee continues to give way, you want to return to significant sports activity, and you are able to participate in several months of physical therapy after the surgery. Surgical treatment is typically done arthroscopically and often on an outpatient basis. Your surgeon will rebuild the ACL by replacing it with another tendon from your own body or from a cadaver. If the meniscus is torn, that cartilage will be repaired at the same time.