The Diagnosis and Treatment of a Torn Anterior Cruciate Ligament

John V. Tiberi';

By John V. Tiberi

Posted on February 26th, 2021 in Orthopedics

Every year, between 80,000 and 100,000 people with torn anterior cruciate ligaments undergo surgery for their injuries in the United States.

It is worth noting that women experience anterior cruciate ligament tears up to 9 times more often than men. This injury is widespread in the athletic population, such as people who play soccer, basketball, and football, as they frequently make vigorous and repeated movements.

It is estimated that 1 in 3,000 people suffer a tear of their anterior cruciate ligament annually throughout the country.  The most common cause of a torn anterior cruciate ligament is non-contact pivoting injuries, namely when your body is moving in one direction, you plant your foot,you try to turn, and the anterior cruciate ligament tears as a consequence.

However, landing from a jump with a twisting motion, which may happen in volleyball or basketball, and hyperextension of the knee and deceleration can also cause a torn anterior cruciate ligament.

What Is the Anterior Cruciate Ligament?

As one of the four main ligaments in the knee, the anterior cruciate ligament is very strong, allowing you to twist, pivot, and turn. The main purpose of the anterior cruciate ligament is to connect a bone to a bone, namely the femur, commonly known as the thigh bone, to the tibia, also known as the shin bone.

It also helps stabilize your knee joint by controlling the back and forth motion of your knee. In addition, the anterior cruciate ligament runs diagonally in the middle of the knee, and it also prevents the tibia from sliding out in front of the femur. Lastly, it provides rotational stability to the knee.

How Can You Tear Your Anterior Cruciate Ligament?

The majority of injuries that result in a torn anterior cruciate ligament occur when the person is playing a sport such as a basketball, soccer, volleyball, or football. Numerous injuries to the anterior cruciate ligament occur when the athlete takes a sudden turn or cut, but their foot remains planted on the ground. Nevertheless, the hyperextension of your knee can also result in a torn anterior cruciate ligament.

While it is not entirely clear why women tend to experience a torn anterior cruciate ligament more frequently than men, some medical researchers suggest that this is because females have altered firing patterns to their lower extremity muscles during physical activity that makes them more susceptible to tearing their anterior cruciate ligament.

What Are the Symptoms of a Torn Anterior Cruciate Ligament?

It is not uncommon for people to hear a popping sound and immediately experience pain when they tear their anterior cruciate ligament. They may also have difficulty putting weight on their injured leg.

However, there are other symptoms of a torn anterior cruciate ligament, including:

  • deep, aching pain at the knee joint, especially when bending or walking
  • immediate swelling of the knee
  • a feeling of instability in the knee
  • the inability to continue physical activity
  • loss of range of motion
  • tenderness around the knee joint
  • bruising around the knee
  • a feeling of warmth to the touch of the injured knee
  • numbness of the knee

It is important to know that your symptoms will worsen within the following days if you have a torn anterior cruciate ligament. This is the best time to seek medical attention for your injury. If the torn anterior cruciate ligament is not treated timely, it may develop into a chronic anterior cruciate ligament deficiency.

When this occurs, the ligament cannot control and support knee movement, severely impairing your ability to walk and cause you difficulty in performing simple tasks. Furthermore, untreated torn anterior cruciate ligaments may cause increasing weakness and further damage to the knee. This is why it is essential to be seen by a medical professional.

How Is a Torn Anterior Cruciate Ligament Diagnosed?

As the most effective and accurate diagnostic tool for a torn anterior cruciate ligament, the Lachman test entails bending the hip 45 degrees and the knee 90 degrees, followed by pulling the knee forward with a sudden jerk to evaluate the range motion of the leg. If the leg moves 0.2 inches beyond the normal range of motion, you may have a torn anterior cruciate ligament.

The second most common and useful test to diagnose a torn anterior cruciate ligament is magnetic resonance imaging, which allows the medical professional to assess the extent of the damage caused to your anterior cruciate ligament by the injury you experienced. Other tests and exams employed for the diagnosis of a torn anterior cruciate ligament are ultrasound and X-rays.

What Is the Treatment for a Torn Anterior Cruciate Ligament?

For young and active people, the most effective treatment approach is surgery, as it can easily restore the function of your knee. In addition, surgery is associated with low risks of postoperative complications and fast recovery in this demographic.

Nonetheless, returning to playing sports will take up to 9 months following surgery, as it would not be safe to resume physical activity sooner.

Because directly repairing a torn anterior cruciate ligament by suturing the fibers back together has proved unsuccessful, as the ligaments cannot heal, surgery entails the medical professional introducing a piece of tissue, known as a graft, in your knee that will serve as your new anterior cruciate ligament.

The piece of tissue can be either an autograft (your own tissue) or an allograft (tissue from a donor). Usually, autografts are harvested from the tendon that connects your kneecap to the bottom leg bone or from your hamstring tendons.

After the surgery, you will be encouraged to begin physical therapy within 48 to 72 hours. In addition, you will receive training in the exercise program developed for you, as every patient is unique and, thereby, their postoperative needs are different.

Furthermore, you will also learn how to take care of your incision and how much weight you can put on your injured leg for the next weeks.

There are numerous exercises performed during physical therapy following surgery for a torn anterior cruciate ligament, such as:

  • bridging
  • glute sets
  • hamstring curls
  • heel raises
  • heel slides
  • quad sets
  • shallow standing knee bends
  • straight leg raise to the front
  • straight leg raise to the outside

The orthopedic surgeons at Cedars-Sinai Marina del Rey Hospital have vast knowledge and impressive experience in treating torn anterior cruciate ligaments, which guarantees low rates of postoperative complications and a fast recovery.

If your anterior cruciate ligament is torn and requires surgery, we strongly recommend you to choose our hospital for treatment, as we have the privilege of having state of the art technology, by which our talented and skillful orthopedic surgeons can perform a wide range of procedures for a torn anterior cruciate ligament.

You will receive the healthcare and treatment you need in a warm and compassionate environment, as we have always valued our patients' comfort and well-being.