What is Anterior Cruciate Ligament Tear, Its Symptoms, and Treatment

The anterior cruciate ligament (ACL) is a connective tissue that helps to connect the femur (thigh bone) to the tibia (shin bone). Anterior cruciate ligament tear is a condition characterized by the tearing or rupture of this connective tissue. Such injuries commonly occur in sports activities that involve sudden stops, changes in direction, jumping, and landing, such as football and basketball. Symptoms can include swelling in the knee, a feeling of instability, and severe pain. Depending on the severity of the injury, treatment methods may include surgery to repair the torn ligament, followed by rehabilitation, physical therapy, and rehabilitation exercises.

What is Anterior Cruciate Ligament Tear?

The anterior cruciate ligament (ACL) is one of four main ligaments in the knee joint that play a crucial role in its functioning. The knee joint is located at the junction of the end of the femur (thigh bone) and the upper part of the tibia (shin bone). These two bones are connected by four main ligaments. The medial collateral ligament is found on the inner side of the knee and prevents inward bending of the knee. The lateral collateral ligament runs along the outer side of the knee and prevents outward bending. The posterior cruciate ligament works alongside the anterior cruciate ligament to prevent the tibia from sliding backward under the femur. The anterior cruciate ligament is located in the center of the knee. Its primary function is to prevent the tibia from sliding forward relative to the femur. Anterior cruciate ligament tear occurs when the ligament is overstretched and tears due to trauma or sudden load on the knee. At the moment of injury, a person may hear a "pop" or "crack" sound from the knee area. Severe pain and sudden swelling in the knee can develop within the first few hours after the injury. It is a condition that requires urgent intervention.

What are the Causes of Anterior Cruciate Ligament Tear?

Anterior cruciate ligament tears often occur in sports activities or accidents. Tears of the ligament are frequently accompanied by injuries to cartilage, other knee ligaments, and tissues. In mild injuries, the ligament may be strained rather than torn. Common causes of anterior cruciate ligament tears include:

• Impact from sports competitions or sudden knee movements during the competition
• Sudden movements such as quick stopping, turning, or jumping
• Situations where the knee is excessively bent or overstretched
• Accidents and injuries such as car accidents or falls
• Sudden rotation of the knee

What are the Symptoms of Anterior Cruciate Ligament Tear?

Anterior cruciate ligament tear is a painful condition that causes discomfort in the knee area. Common symptoms include:

• A popping sensation or sound in the knee
• Pain, especially when bending or twisting the knee
• Swelling, stiffness, and bruising
• A feeling of locking
• Strain and limited movement

How is Anterior Cruciate Ligament Tear Diagnosed?

The diagnosis of anterior cruciate ligament tear is made using a series of clinical evaluations and imaging tests. The specific steps in diagnosing anterior cruciate ligament tear include:

1. Patient History and Physical Examination: In the initial stage, the patient's symptoms, injury history, and physical examination are reviewed. Signs such as swelling, bruising, and limited movement in the knee are assessed.
2. Magnetic Resonance Imaging (MRI): MRI provides detailed images of the soft tissues in the knee area. This imaging test is often used if an anterior cruciate ligament tear is suspected.
3. X-rays: X-rays are typically used to assess bone damage or fractures. Anterior cruciate ligament injuries are usually not visible on X-rays, but they may be performed to evaluate other potential damages.
4. Ultrasound: This test is often used in lighter injuries or for monitoring treatment. However, it is not as detailed as an MRI.
5. Knee Arthroscopy: This is an invasive method and is used when the results of other tests are inconclusive or for treatment purposes. Knee arthroscopy allows for direct examination of the joint using a camera inserted inside.

Treatment for Anterior Cruciate Ligament Tear

The treatment for an anterior cruciate ligament tear may vary depending on the damage to the knee area. Surgical treatment is one of the primary methods used in treatment. Anterior cruciate ligament tears are typically treated with arthroscopic surgery, which involves small incisions to repair the torn ligament or to add a new ligament in its place. If the anterior cruciate ligament is completely torn, the surgeon may reconstruct the ligament using grafts taken from the patient's own tissues, such as the patellar tendon or hamstring tendon. Additionally, medication may be used by the doctor to alleviate pain and inflammation. To enhance stability and improve muscle strength in the knee after surgery, physical therapy sessions that include strengthening exercises and stretching techniques are planned. A knee brace may be used to allow the knee to rest and assist in healing. Cold compresses can be applied to the knee several times a day.

What Are the Types of Anterior Cruciate Ligament Injury?

Anterior cruciate ligament (ACL) injuries can occur in different types depending on the degree of damage to the ligament. The types of ACL injuries are as follows:

1. Torn or Strained Anterior Cruciate Ligament (Sprain): This type of injury occurs as a result of the ligament being overstretched. The fibers of the ligament may be partially torn or damaged. This condition can usually cause mild to moderate pain.
2. Complete Tear (Rupture): This is the complete tearing of the fibers of the anterior cruciate ligament. It occurs as a result of more severe trauma and is usually accompanied by severe pain, swelling, and a feeling of instability in the knee.
3. Partial Tear (Partial Rupture): This refers to situations where the fibers of the ligament are not completely torn but there is a partial tear. This type of injury typically results from damage to a portion of the ligament, and the symptoms may resemble those of a torn ACL.
4. Avulsion Injuries: These injuries result in the anterior cruciate ligament separating from the bone. The detachment from the bone usually occurs at the points where the ligament attaches to the bones, rather than the ligament itself.

How Long Does It Take for Anterior Cruciate Ligament Tear to Heal?

The recovery process for an ACL tear can vary in duration depending on the severity of the injury, the treatment method, and the patient's health status. A complete recovery process usually takes between 6 to 12 months. In cases requiring surgical intervention, patients are expected to gradually start regaining function in the knee within the first few weeks post-surgery. However, it may take longer for the knee to fully heal and regain its healthy function

Frequently Asked Questions

An anterior cruciate ligament tear is a sudden, traumatic, and painful serious condition. Diagnosis and treatment require urgent intervention.

How Long Does Anterior Cruciate Ligament Tear Surgery Take?
ACL tear surgery generally lasts between 1 to 2 hours in less severe cases. When surgical intervention is performed using arthroscopic methods, it can result in smaller incisions and quicker recovery times. However, the duration may vary depending on the condition of the injury and the damage done to the surrounding tissues and ligaments. Additionally, the patient's overall health can affect the duration of the surgery. Early initiation of rehabilitation and physical therapy after surgery can support successful recovery.

Is There a Chance of Anterior Cruciate Ligament Tear Recurring?
The likelihood of a recurrence of an ACL tear is low, even if surgical intervention has been performed on the knee. However, in many cases, especially among athletes or individuals engaged in high-impact physical activities, repeated injuries may occur if adequate protective measures are not taken and physical activities are not performed in a controlled manner.

An anterior cruciate ligament tear is a serious knee injury that can cause significant damage. Immediate first aid should be provided to individuals who experience a ligament tear. Following the initial intervention, treatment should begin in the orthopedic departments of hospitals.