Diagnosis and Treatment of an ACL Injury
Knees absorb the impact of your everyday activities. Whether you’re walking to and from the car, running on the treadmill or playing a pick-up basketball game at the gym, your bones, ligaments, tendons and cartilage are in constant engagement.
This leads to vulnerability to knee trauma. Your knee is more susceptible than other joints because it is located between the two longest bones of your body, and the weight of your body is transferred to your foot through the knee. Your knee’s stability decreases as the joint bends.
One of the common forms of knee trauma is an ACL (anterior cruciate ligament) injury. ACL injuries often occur during athletic activity or through consistent, rigorous strain. Typical symptoms of an ACL injury include instant swelling, pain and instability in your knee, sometimes accompanied by a popping sound. If you experience these symptoms, you should immediately consult a doctor for diagnosis and treatment.
Diagnosis
- Before diagnosis, your doctor will want to know your medical history, especially any previous issues you may have had with your knee. Any details you can give concerning past problems may be able to give insight into your current situation.
- The next step is typically a series of manual tests that will gauge overall instability in your knee. The Lachman Test, Anterior Drawer Test and Pivot Shift Test are used to check the movement of your tibia in relation to your femur. If swelling inhibits these tests, a doctor may use an arthrometer to measure joint looseness in your knee. X-rays are also obtained to view any bone damage.
- Ultimately, an MRI (Magnetic Resonance Image) may be used to assess the damage in your knee. While X-rays show bones, an MRI allows the doctor to see potential tears or strains in ligaments, cartilage and tendons. This non-operative procedure should give your doctor the final verdict on the damage of your knee.
Treatment
- The first response typically recommended for an ACL injury is “RICE” - Rest, Ice, Compress, Elevate. You should rest the knee and keep weight off it for some time, apply ice, compress the affected area with a wrap and keep it elevated. This will keep the swelling down immediately following the injury.
- To remove further swelling, the doctor may need to use a syringe drain fluid from your knee.
- Non-operative treatment with rehabilitation and bracing is an option for about one-third of ACL injuries. This is the most common treatment method for older or less active patients.
- Surgery is the final treatment option for ACL injuries. Candidates for surgery include active individuals, patients who continue to experience instability after a rehabilitation program, or patients with an injury involving more than one ligament. The most effective and reliable type of surgical treatment is ACL reconstruction. Others include direct repair - sewing ends of the torn ligament together - and extra-articular - securing a portion of a tendon on the outer part of the knee across the outside of the joint.
ACL injuries can be damaging, both in the pain of your knee and the doubt it creates in your mind. Understanding the process you will go through after experiencing a knee injury will help relieve the uncertainty.