ACL Tears

Anterior Cruciate Ligament Tear (ACL Tears):

 

One of the most common knee ailments is an ACL tear. Players who participate in sports like football, basketball, soccer, and volleyball, as well as persons who participate in physically demanding occupations, may get this condition. Surgical and noninvasive therapies are available. An ACL injury usually heals in six to nine months for most people.

What is an ACL Tear? What Does it Feel Like?

An ACL tear occurs when the anterior cruciate ligament (ACL) in the core of the knee is torn. The tear might be partial (just a small portion of the ligament is ripped) or complete (the ligament is completely destroyed) (the ligament is torn into two pieces). If your child ruptures their ACL, the pain will occur. The child may hear or feel a pop when the knee “gives out” (collapses or buckles). Typically, the knee will begin to swell right away.

The tough bands of tissue that link bones or hold organs in place are referred to as “ligaments” in medicine. “Towards the front of the body” is what the word “anterior” signifies. Cruciate refers to the two ligaments in the knee that create a cross shape: the anterior cruciate ligament (ACL) in the front and the posterior cruciate ligament (PCL) in the rear.

What is the Anterior Cruciate Ligament (ACL)?

Bones, ligaments, tendons, and cartilage make up the structure of the knee. The anterior cruciate ligament (ACL) links the thigh bone to the shin bone. It is positioned in the front center of the knee (tibia). It’s one of four major ligaments in the knee:

• An anterior cruciate ligament (ACL).
• Medial collateral ligament (MCL).
• Lateral collateral ligament (LCL).
• A posterior cruciate ligament (PCL).

The ACL’s primary role is to prevent the shinbone from moving forward and rotating on the thigh bone.

What are the Types of ACL Tears?

When a child injures a ligament, your doctor may grade it on a scale of one to three, with three being the most serious:

• Grade One: Although the ligament has been stretched, it continues to stabilize the knee joint.
• Grade Two: The ligament has been relaxed and stretched. It’s ripped in half. (This is an unusual grade.)
• Grade Three: The ligament has been ripped and is now in two parts. This is a serious injury.

The collateral ligaments, joint capsule, articular cartilage, and menisci are frequently injured in conjunction with ACL rupture (cartilage pads).

How Common Are ACL Tears? Who is at Risk?

Tears of the anterior cruciate ligament (ACL) are a common knee injury. Every year, between 100,000 and 200,000 occurrences occur in the United States. They’re prevalent among athletes, especially those who participate in sports that require a quick change of direction, such as football, basketball, soccer, and volleyball. Playing a physically demanding game that includes climbing, turning, or leaping puts your child at a higher risk.

An ACL tear can occur at any age, although girls are four times more likely than males to get one. Experts are divided on why women are more vulnerable. Some speculate that this is due to a lack of physical training, neuromuscular control, or muscle strength. Others believe it’s due to differences in pelvic and lower leg alignment, looser ligaments, or estrogen’s effect on a woman’s ligaments. Differences in how men and women leap and land may possibly have a role.

Can your Child Walk with a Torn ACL?

Some people believe they are steady enough to walk if they do it slowly and cautiously. Others opt for crutches in the event that their knee “gives out” (collapses or buckles).

Do ACL Tears Hurt?

Yes. When the damage occurs, your child will experience discomfort and maybe hear or feel a pop.

What Happens if a child’s ACL is torn?

Adolescents and children are still developing. Reconstructing an ACL might result in growth plate damage, which can cause bone development issues. The surgeon may wait until the kid is older and their bones have matured before operating on the ACL, or they may utilize sophisticated procedures to avoid damaging the growth plate.

What Causes ACL Tears?

Non-contact ACL rips account for the majority of ACL tears. This implies they aren’t caused by another player kicking the knee, for example. They can happen in a variety of ways, including when a child:

• Suddenly come to a halt.
• When your child is running.
• From a leap, landing awkwardly.
• The knee twists when your child abruptly changes direction.
• Collide with another person, as in a football tackle.

Roughly half of the time another injury can occur in conjunction with ACL rupture. Other elements of the knee, such as the ligaments and/or cartilage (a gel-like connective tissue) can get damaged. 70% of people who suffer an ACL tear will have damage to one or both of their menisci (the cushions in the knee that help to protect the cartilage).

How can You Learn if Your Child has an ACL Tear?

You may feel or hear a snap in your child’s knee when the ACL rips or your child may feel like his or her knee has “given out.” Other signs and symptoms include:

• Swelling begins right after (but can begin four to six hours after the accident) and lasts two to four weeks.
• Your child’s knee’s range of motion has been reduced.
• Anxiety when your child walks.

What Tests are Performed to Diagnose an ACL Tear?

Other probable causes of knee discomfort are ruled out as part of the diagnosing procedure. An x-ray will need to be taken by your doctor to ensure that no bones have been shattered. He or she will take a medical history and inquire about the knee discomfort in particular. They’ll look at your child’s damaged knee and compare it to the other one. This test is quite effective at diagnosing ACL injuries. Magnetic resonance imaging (MRI) will almost certainly take place. The ligaments are visible on MRIs, and a doctor will determine if there is a torn ACL.

What is the Treatment for an ACL Injury?

R.I.C.E. treatment should take place as soon as possible following an injury:

• R: Rest.
• I: Ice.
• C: Compression.
• E: Elevation.

You have complete control over the treatment your child receives. Many people who have torn their ACL opt for surgery so that they can resume their previous activities. You may decide that your child will not undergo surgery; however, keep in mind that a ruptured ACL will not mend on its own.

What Surgical options do you have? What kind of surgery is it, and how is it carried out?

A tendon transplant, such as a hamstring (from the back of the thigh) or the kneecap/patellar tendon, is used to rebuild a ruptured ACL (from the front of the knee). In elderly people who are still quite active, a cadaver tendon (a tendon from someone who died and gave his or her corpse to science) may be utilized. Because of the greater risks of re-tear, cadaver tendons are normally avoided in young athletes. The procedure is minimally invasive, which means the surgeon uses an arthroscope, thin wand-like equipment, instead of a knife to make a huge incision. The arthroscope and working tools are inserted into the knee through tiny incisions.

What Non-surgical Options Are There?

Bracing and physical therapy are two nonsurgical options:

• Bracing: Using a brace to keep the knee stable is a good idea. Your child will need crutches to avoid putting any weight on that leg.
• Physical therapy: Exercises will improve the function of your child’s knee and develop the leg muscles that support it.

Keep in mind that if your child does not get surgery to repair the damaged ACL, a re-injury may occur.

What are the Risks Associated with Surgery?

• Infection is rare, although each type of surgery has the risk of infection.
• After surgery, knee stiffness is common, but physical therapy can help. This may be avoided by receiving treatment prior to surgery to regain the full range of motion.
• The spread of a virus. Receiving a cadaveric transplant increases the risk of contracting diseases like HIV and Hepatitis C. Receiving an HIV-infected organ transplant is a one-in-a-million possibility.
• A clot has developed in my blood. Although it is uncommon, a blood clot can turn deadly. If the clot breaks off in the circulation, it might cause a pulmonary embolism or a stroke in the brain.
• Kneecap soreness. This is a typical issue when using patellar tendon transplants.
• The growth plate has been injured. In a child or adolescent, this is a danger of early ACL repair. If at all possible, the surgeon will delay treatment until the skeleton has fully matured, or will utilize special treatments to avoid damaging the growth plate.

Is it Feasible to Keep an ACL Injury at Bay?

For child athletes, preventing an ACL injury is difficult, but there are a few training tactics parents can do to lower the risks of injuring an ACL. If your child plays soccer, basketball, or volleyball, two activities should catch parent’s attention: how to take hard, quick steps to speed in a new direction (or “cut”), and how to land upright after a leap or step (or “plant”). Cutting and planting actions account for around 70% of all ACL injuries. Jumping, landing, and twisting all exert strain on the ACL in the knee, especially in female athletes. The ACL’s ability to withstand rotational pressures might be jeopardized when starting a cut (or landing after a jump). When your child plants incorrectly, the ACL’s ability to move the knee in the proper manner can become compromised.

Why Choose the Doctors and Surgeons at Medical City Children’s Orthopedics and Spine Specialists?

There are many reasons why parents should choose Medical City Children’s Orthopedics and Spine Specialists for their child when he or she is diagnosed with an ACL injury.

• Experienced and skilled surgeons. The surgeons at Medical City Children’s Orthopedics and Spine Specialists are highly experienced and skilled in the treatment of ACL injuries in children. They have performed thousands of successful ACL surgeries on children of all ages.
• State-of-the-art technology. The Doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists use the latest state-of-the-art technology in the treatment of ACL injuries. This includes robotic-assisted surgery, which can help to improve accuracy and precision.
• A team approach. The surgeons at Medical City Children’s Orthopedics and Spine Specialists work closely with a team of other healthcare professionals, including physical therapists, athletic trainers, and child life specialists. This team approach ensures that your child receives the best possible care.
• A focus on patient satisfaction. Medical City Children’s Orthopedics and Spine Specialists is committed to providing the highest quality care and a positive patient experience. The staff is compassionate and understanding, and they will work with you to answer all of your questions and concerns.

If your child has been diagnosed with an ACL injury, I encourage you to schedule a consultation with the surgeons at Medical City Children’s Orthopedics and Spine Specialists at one of their offices in Dallas, Plano, Frisco, and McKinney, Texas. They will be able to discuss your child’s individual case and develop a treatment plan that is right for them.

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American Academy of Orthopaedic Surgeons:  ACL Tear