Torn ACL

There are 4 ligaments that stabilize the knee. The four are the MCL, LCL, PCL and ACL. The MCL is the medial collateral ligament; the LCL the lateral collateral ligament. These are the two that run down the sides of your knee, the MCL is on the inside, the LCL the outside. Contrastingly, the PCL is the posterior cruciate ligament and the ACL the anterior cruciate ligament. The PCL runs down the back of the knee, and the ACL runs down the front.

Last year, I sprained my PCL in dance. It is much more difficult to do that than to sprain or tear the ACL. However, it is much more difficult to repair the ACL and to rehab it than it is to work with rehabbing the PCL.

The ACL is crucial to knee stability. It helps to prevent excessive motion. Most people who have torn their ACL will complain of a feeling that their knee is "giving out" from under them.

An ACL tear is usually sports related, but can happen in motor vehicle accidents, falls and work related injuries as well. Approximately 80% of sports related ACL tears are non-contact tears. This means that they don't involve another athlete in the injury. Most of them are from landing from a jump or from pivoting on the leg while running. Interestingly, women are more prone to injury involving the ACL than men are, but it is unclear as to why this is.

Symptoms
People who have a torn ACL often complain of hearing or feeling a pop in their knee at the time of the injury. The loudness of the pop surprises a lot of people; people can usually hear it from the sidelines of a game. Even if you don't hear the pop, you will usually feel the shift in the joint. There are always those people though who have no idea that they've sustained an injury. It has been known that people don't always feel the tear. People have gotten hurt, not realized it, felt fine and continued with the game. It has happened.
Other symptoms include the giving out that was mentioned earlier and swelling and pain in the knee.

Surgery?
People can get surgery done to reconstruct their ACL, however it might not be necessary. If you don't do a sport routinely that requires the use of your knee, and you don't have knee instability, then you probably won't need to have surgery to reconstruct the ACL. There is also a debate over whether to perform surgery on a partial tear. Some say that you can, but others say that it's better not to do it. Most people start feeling better after a few weeks, but problems with instability might continue.

At Ithaca High this year, we've had three ACL tears. Two guys and one girl tore their ACLs this year. One was in soccer, one in football, and one in lacrosse. ACL injuries are also more common in younger people. There is a debate in the health professions about what to do when the ACL injury happens to somebody who is not only younger, but a child. Some people say that it is better to repair the ACL before skeletal maturity, however, the other side says that problems that arise may lead to growth plate closure or alignment deformities. Who knows what's going to happen?