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At Wake Orthopaedics, we offer superior orthopedic care, including treatment for ACL injuries, that restores our patients’ quality of life.

Whether you’re an athlete who’s ready to get back in the game or you’re just wanting to walk and run normally again, our progressive treatment options can make a difference.

What is the Anterior Cruciate Ligament (ACL)?

The ACL is one of the four main ligaments in the knee that connect the thigh bone (femur) to the leg bone (tibia). The ACL runs diagonally down the middle of the knee joint. It prevents the tibia from sliding too far forward on the femur and also provides rotational stability to the knee.

Common Causes of an ACL Tear

The ACL is the most injured knee ligament in the United States. ACL tears can occur in several ways, including a twisting injury of the knee, a sudden change in direction, landing from a jump incorrectly or after a collision. This can occur in a number of settings but most often occurs during sports.

There are several recognized risk factors for ACL injury including female gender, participation in certain sports such as soccer, football, basketball, and downhill skiing, and anatomic factors such as variations in the geometry of the thigh and leg bone.

Symptoms of an ACL tear

Symptoms of an ACL tear may include a pop in the knee, severe knee pain after an injury, or associated swelling of the knee. When an ACL tear has been going on for a long period of time, patients may feel a "shift" or a sensation of giving way in the knee while cutting or pivoting.

Treating an ACL Tear

Treatment of ACL injury ranges from rehabilitation without surgery to ACL reconstruction. How patients do after ACL injury ranges from patient to patient and depends on a number of factors, such as patient age, activity level, and degree of injury.

Partial ACL tears or ACL strains often respond well to conservative treatment without surgery. Rehabilitation focuses on core and quadriceps strengthening and often takes several months. However, some patients may continue to have feelings of shifting or instability even after rehabilitation.

In cases of a complete ACL injury or rupture, surgical reconstruction is often performed for individuals who wish to continue with sports that involve cutting or pivoting, or in individuals with continued instability even after rehabilitation alone. In these cases, continued rehabilitation without reconstruction of the ACL can lead to other associated injuries, such as injuries to the meniscus, cartilage or other ligaments. Surgical repair of the ACL using suture to sew the two ends together is generally not successful. Surgical treatment of ACL ruptures involves reconstruction of the ligament using either cadaver tissue or the patient's own tissue. This can come from the patellar tendon, hamstring tendon or the quadricep tendon. A new ligament is built from this tissue. Bone sockets are created in both the femur and the tibia, and the new ligament is fixed on both sides.

After ACL reconstruction

Overall, ACL reconstruction is a very successful operation, and a majority of individuals are able to return to high-level cutting and pivoting sports. ACL reconstruction provides a durable result at 10 and even 20 years after surgery. Rehabilitation after ACL reconstruction starts immediately after surgery to work on strengthening of the quadriceps and hamstring muscles and regaining range of motion. Therapy progresses to exercises to improve neuromuscular control and exercises designed to restore function and endurance. Typically, six to nine months after surgery, a majority of patients are able to return to sports.

Dependable Orthopaedic Surgeons 

Whether you’re concerned with an ACL tear, or are in search of other orthopaedic services, schedule an appointment with one of our orthopaedic specialists at one of our seven convenient locations throughout the Triangle.

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