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ACL Tears

By Thomas Connolly, M.D.

Two female soccer players fighting for possession.

The knee joint is held together by four ligaments: the medial collateral ligament (MCL), the lateral collateral ligament (LCL), the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL). The ACL extends across the front center of the knee, enhancing rotational stability and stopping the tibia from sliding in front of the femur.

Unfortunately, over the past two decades, injury to this vital connective tissue has been on the rise in young athletes.

ACL Tear Causes

ACL tears happen during a number of activities, but are most common in contact sports or activities that require quick changes of speed and high impact. A tear can result from:

  • Rapid change in direction
  • Slowing down while running
  • A sudden stop
  • A collision
  • Landing incorrectly from a jump
  • Unnatural twisting or hyperextending of the knee joint

Female athletes are three to four times more likely to tear their ACL, most commonly from ages 15 to 20.

ACL Tear Symptoms

At the time of the injury, one might hear a popping sound and feel the knee give out. Following the tear, an individual may experience:

  • Loss of full range of motion
  • Joint tenderness
  • Discomfort while walking
  • Pain and swelling

Though symptoms may seem to improve over time, the injury is not healing itself. Continued activity can lead to further injury and decreased joint stability. To ensure a healthy future, see a doctor if you think you may have injured your ACL, or any other knee ligament.

Diagnosing ACL Tears

Often, an ACL tear can be diagnosed with a physical exam. A doctor will examine both legs; flexing and straightening at the knee to see if there is a difference in reaction that might suggest a torn ACL.

If physical tests are inconclusive, MRIs can be used to diagnose the injury.

Recovering from an ACL Tear

Treating an ACL injury often requires surgery. In fact, if an athlete wishes to return to his or her sport, surgery is a necessity. The ligament will be reconstructed using a tissue graft from another part of the body, such as the patellar tendon or hamstring, or an allograft from a cadaver donor.

Following surgery, a rehabilitation program is required. With proper attention and diligence to therapy, recovery can be achieved in approximately six to nine months. We commonly do ACL reconstructions on adolescent and adult patients at the Boys Town West surgery center.

Dr. Connolly is a Board Certified sports medicine orthopaedic surgeon at Boys Town National Research Hospital. He is a team physician at Boys Town and Creighton University. Dr. Connolly has had children participating in soccer and baseball at the club and select levels, all the way to Division I. He is able to relate to his patients and get them active as quickly and safely as possible.