The Dreaded ACL Tear (Part 2) – What to Do and When

The Dreaded ACL Tear (Part 2) – What to Do and When

Posted by Anup Shah, M.D. on Oct 14, 2015 11:38:00 AM

ACL (anterior cruciate ligament) injuries aren’t always about full-contact, rough-and-tumble sports. In fact, many ACL injuries come about after landing from a jump incorrectly or pivoting and twisting the wrong way. That being said, there are some things you should know about ACL injuries if you play a sport where jumping, pivoting and twisting are prevalent.

It Starts with a ‘Pop’

Patients don’t always know when they have an ACL injury. There’s usually a lot going on, especially if it’s during the middle of a game, and then the initial pain of the injury can make remembering what happened difficult. There are typically some universal signs of an ACL injury, however:

  • You hear a pop.
  • There is swelling in the knee.
  • The injury is painful for the first couple days, but you gradually, feel like it’s getting better.
  • Attempting to pivot or twist is difficult or impossible and you notice there is now instability.
  • You are unable to return to the sport you were playing because of pain or stability issues.

If you notice any of these things, it’s time to triage that knee.

What to Do 

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Injuries don’t always happen when it’s convenient. If you think you’ve injured your ACL and cannot immediately go in for a physician to examine it, there are steps you should take to make sure you don’t injure it further:

  • Get off of it – do not add unnecessary stress to the knee. There may also be other structures that were injured.
  • Rest it – not only do you need to get off of it, you need to stay off of it.
  • Ice it.
  • Take some over-the-counter anti-inflammatory medication to help with swelling and pain.

If you have any of the symptoms of an ACL injury, or even if you’re unsure, have a physician examine your knee immediately.

What to Look for in a Physician

For any knee injury in general, you need to seek out a physician who specializes in Orthopedic Sports Medicine. This can be a surgeon or even a family practitioner who is sports medicine trained.

If your family practitioner is trained in Sports Medicine, he or she can tell you whether the injury is a sprain or something more serious that requires the care of an orthopedic surgeon. They will help triage you and are a good first point of medical evaluation. If they’ve been trained in Sports Medicine, their clinical judgment is typically very good.

If you’re looking for an orthopedic surgeon, make sure you find someone who was specifically trained in sports medicine and specializes in knee injuries. Orthopedic surgeons go through five years of residency and after that, they typically pursue an additional year of training in a subspecialty of orthopedics, such as knee, shoulder, spine or hand. Sports Medicine surgeons are usually incredibly good at focusing on ACL reconstruction from sports injuries, because it is a common procedure and they’ve seen a lot of them. 

Most ACL Tears Require Reconstruction

Whether or not you have surgery to repair an ACL will depend on where you are in your life and your activity level

Most cases of ACL tears with complaints of instability require a reconstruction of the ligament. To do this, we have to build an entirely new ligament to help prevent the rotary instability that comes from ACL tears. A new ligament can be rebuilt with either your own tissue or donor tissue. With most young people, we use their own tissue and borrow from their patellar tendon, hamstring or quad tendon. If you are a patient that isn’t involved in a high level of activity, donor tissue is an excellent option. 

Physical therapy after an ACL reconstruction typically starts between three days to a week after surgery and is vital to showing patients how they can safely move and ease back into their normal routine.  

Do you have an ACL or other orthopedic question? Leave a comment!

 

Shah_Anup Dr. Anup Shah is an orthopedic surgeon with Kelsey-Seybold specializing in shoulder and knee injuries.

 

Topics: reconstruction, choosing a doctor, acl tear, treatments for ACL injury

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