An ACL rupture can be a devastating injury, especially since this injury often occurs in athletes. The knee care specialists at Beacon Orthopaedics are highly experienced in the treatment of ACL injuries, including ACL reconstruction. Residents of Cincinnati and Dayton, Ohio, Northern Kentucky, and beyond trust our orthopedic surgeons to get them back on their feet and enjoying the activities they love after an ACL rupture.
- Causes of ACL Injuries
- Types of ACL Injuries
- Symptoms of a Torn ACL
- Non-Surgical Treatment for ACL Injuries
- What is ACL Reconstruction?
- Preparing for ACL Reconstruction
- The ACL Reconstruction Procedure
- Recovery After ACL Reconstructio
- Why Choose Beacon Orthopaedics for ACL Reconstruction?
- Frequently Asked Questions About ACL Reconstruction
Causes of ACL Injuries
The ACL (anterior cruciate ligament) is a strong band of tissue that attaches the shin bone (tibia) to the thigh bone (femur), and is one of the main ligaments in the knee. Many ACL injuries are suffered during sports such as basketball, football, soccer, tennis, and volleyball. Most ACL injuries occur because the athlete:
- Suddenly slows and changes direction
- Pivots when a foot is planted
- Lands incorrectly after a jump
- Makes a sudden stop
- Receives a blow to the knee1
Types of ACL Injuries
An ACL injury occurs when it stretches past its limits. These injuries are classified into three grades based on severity.
Grade I (Stretched Ligament)
- The ligament is stretched but not torn
- The knee exhibits little tenderness and swelling
- The knee is also able to bear weight and does not give out during activity
Grade II (Partially Torn Ligament)
- The ligament is partially torn
- The knee exhibits little tenderness and moderate swelling
- The knee feels unstable and gives out during activity
Grade III (Completely Torn Ligament)
- The ligament is completely torn into two parts
- The knee exhibits tenderness and swelling, with the former ranging from mild to severe
- The knee feels unstable and gives out during activity.
Symptoms of a Torn ACL
Without a doubt, a completely torn ACL is one of the most feared sports injuries. It’s important to recognize, however, that a damaged ligament also interferes with school, work, and even just everyday mobility. Because of this, it’s crucial for everyone—athletes and non-athletes alike—to recognize the signs of a torn ACL in order to seek immediate treatment from an orthopedic specialist.
Individuals with a sprained or torn ACL will experience:
- A distinct popping sound at the moment of their injury
- A sudden and intense pain immediately following their injury
- An inability to straighten or bend the knee all of the way
- Severe swelling around the knee
Non-Surgical Treatment for ACL Injuries
The ACL provides approximately 90% of the stability in the knee joint. Without a healthy ACL, the knee may not always withstand the amount of weight on it and can give out without warning.
RICE (Rest, Ice, Compression, and Elevation)
Individuals with a stretched or partially torn ligament (Grade I or Grade II), should utilize RICE (Rest, Ice, Compression, and Elevation) right after the injury. These methods will help reduce further ligament damage and help the body heal correctly. RICE is most effective during the first 72 hours of an injury.
- Rest: Refrain from using your knee. Consider using crutches and/or splints to ease movement.
- Ice: Apply ice or a cold pack to reduce swelling. Apply cold for up to 20 minutes, 3 or more times a day. Use a towel to avoid applying cold directly to the skin.
- Compression: Gently wrap the injured knee with an elastic bandage. Loosen the bandage if it causes numbness, tingling, increased pain, or increased swelling.
- Elevation: Keep your leg elevated above your heart level when sitting or lying down.
Individuals with a partially torn ACL should participate in physical therapy centered on developing their calf muscles, hamstring and quadriceps. A physical therapist will also teach patients how to modify their physical activities to put less stress on their knee.
What is ACL Reconstruction?
When the ACL is torn, the physician will need to graft a new ligament in its place. Generally a tendon is taken from the patient and substituted to act as the new “ligament.” A tendon is usually taken from the patella or the hamstring of the patient, although donor tissue can be used.
In some cases where a patient ruptures other ligaments (the MCL, for example), it is more common for an allograft or transplant to occur. This means that donor tissue is used, which comes only from tissue banks that have earned the rigorous American Association of Tissue Banks certification.
Preparing for ACL Reconstruction
The most important part of preparing for ACL reconstruction is to select an orthopedic surgeon who specializes in knee care, such as an expert from Beacon Orthopaedics. This doctor will evaluate your injury to determine the extent of the damage. If ACL reconstruction is deemed necessary, your procedure will be scheduled and you will be given detailed pre- and postoperative instructions.
The ACL Reconstruction Procedure
ACL reconstruction is an outpatient procedure, typically performed under general anesthesia.
Tissue needed to replace a ruptured ACL comes from either the patient’s own body (autograft) or from a deceased donor (allograft).
ACL reconstruction is performed arthroscopically, which means that a tiny camera is inserted into the knee. The camera is connected to a video monitor, which gives the surgeon ideal visibility while reducing scars and healing time for the patient. In addition to the tiny incision for the camera, the surgeon makes more small cuts around the knee to insert the instruments needed to conduct ACL reconstruction.
During ACL reconstruction, the ruptured ligament is removed. If the patient is receiving an autograft, the surgeon will remove the donor tissue at this time. Next, the surgeon will place the new tissue where the old, injured ACL was located. The new ligament is attached with screws or stabilizing devices to hold it in place. Finally, the incisions are closed with sutures.3
Recovery After ACL Reconstruction
At Beacon Orthopaedics, we know how eager our ACL reconstruction patients are to get moving again. This is why rehabilitation begins immediately after reconstruction surgery. Our goal is to return the patient to their complete level of function in as short a time as possible. With that said, a full recovery can take anywhere from six months up to a year.
First Two Weeks after Surgery
Immediately following surgery, the knee will be swollen and difficult to bend. As with the initial injury, RICE will help manage the pain and swelling that follows surgery.
The knee will also be unable to bear weight, so patients will use crutches in order to remain mobile. Patients will learn exercises to perform daily in order to support their recovery.
Two to Six Weeks after Surgery
The knee will be able to bear weight but will remain vulnerable at this point. Although many patients become less dependent on crutches for mobility, a protective knee brace is used to protect the knee from unnecessary stress. Patients will also continue to participate in physical therapy programs to help regain their strength, stability, and full range of motion.
Six Weeks to Six Months after Surgery
After three months, many patients are able to perform low-impact activities such as light jogging as well as functional movements such as jumping. By six months, many patients have achieved a complete or nearly complete recovery. Patients who closely follow their doctor’s instructions and are committed to physical therapy are more likely to speed up the recovery process.
Why Choose Beacon Orthopaedics for ACL Reconstruction?
While ACL reconstruction surgery may sound like a very commonplace procedure, it should only be performed by a fellowship trained, board certified sports medicine physician. This ensures that the doctor has experience selecting and placing the graft. Clear communication between the physical therapists and orthopedic surgeons is also paramount for an effective recovery after ACL reconstruction.
At Beacon Orthopaedics and Sports Medicine, we started the Bridge Program for athletes who recovered through physical therapy, but want to pursue a high level of activity. Expert therapists and athletic trainers then help the athletes redevelop skills, strength, endurance, flexibility, power, and so on, all while ensuring that they learn and exhibit proper technique and form.
Frequently Asked Questions About ACL Reconstruction
When should I have my ACL fixed?
For many of our patients who are athletes, the timing of their ACL is an important consideration. We recommend that patients regain their full range of motion, are able to properly use their quadriceps, and experience reduced swelling before their ACL reconstruction surgery. This can help shorten recovery after ACL surgery and may also lead to better postoperative range of motion. To assist in this, we provide a preoperative therapy program.
In patients who also suffer meniscus tears or damage to cartilage, delaying ACL surgery may cause further damage. In these cases, it may be beneficial to perform ACL reconstruction sooner. This is why it is so important to have your injury examined and diagnosed promptly through an MRI and consultation with an orthopedic surgeon.
Can I avoid an ACL rupture?
To reduce risk of an ACL injury, it is important to practice good technique when playing sports. This is often accomplished through specialized training and exercises designed to establish muscle memory for specific types of movements. It also helps develop and train the stabilizing muscles and ligaments responsible for activities like cutting, jumping, or stopping quickly.
Contact Beacon Orthopaedics
The first steps following an ACL injury are to apply first aid and then see an orthopedic specialist. At Beacon Orthopaedics and Sports Medicine, we provide a walk-in clinic in Northern Kentucky for immediate orthopedic care, as well as the ability to schedule an appointment online for any of our locations in the Greater Cincinnati. If you have suffered an ACL injury, please contact us so that we can address your injury immediately
1 Mayo Clinic. ACL Reconstruction. Available: https://www.mayoclinic.org/tests-procedures/acl-reconstruction/about/pac-20384598#:~:text=During%20ACL%20reconstruction%2C%20the%20torn,or%20from%20a%20deceased%20donor. Accessed August 5, 2022.
2 American Academy of Orthopaedic Surgeons. Anterior Cruciate Ligament (ACL) Injuries. Available: https://orthoinfo.aaos.org/en/diseases–conditions/anterior-cruciate-ligament-acl-injuries/. Accessed August 5, 2022.
3 U.S. National Library of Medicine. ACL Reconstruction. Available: https://medlineplus.gov/ency/article/007208.htm. Accessed August 5, 2022.