ACL Tear Treatment in New Jersey
What Is the ACL?
An anterior cruciate ligament injury, commonly known as an ACL injury, is an orthopedic condition often referenced in sports, but it is something that can happen to athletes and nonathletes alike.
Located in the middle of the knee joint, the ACL makes a cross formation with the posterior cruciate ligament, also known as the PCL. Together, they fulfill the vital role of providing stability and maintaining bone alignment in your legs.
Specifically, the job of the ACL is to keep the tibia, or shin bone, from sliding out from the femur, also known as the thigh bone. Similarly, the PCL’s job is to keep the shin bone in place and control the front and back motion of your knee.
A torn ACL is a painful orthopedic condition. Our facilities offer some of the latest, innovative, and minimallyy invasive treatments and procedures aimed at restoring mobility and quality of life. If you have suffered an injury and suspect you may have a torn ACL, visit an orthopedist right away.
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What Causes an ACL Injury?
Due to the ACL’s location and the roles it fulfills, it is prone to injury, especially among athletes and those who engage in vigorous activities that involve intense ranges of motion. PCL injuries can also occur, but they happen less frequently. The most common form of ACL injury is a tear to the ligament. Actions that cause an ACL tear include:
- Stopping suddenly
- Rapidly changing direction
- Landing from a jump incorrectly
- Sustaining impact from direct contact or collision
What Are the Symptoms of an ACL Tear?
If you believe you have sustained a tear to your ACL, it is best to get screening and ACL tear treatment before further damage can occur. Common ACL tear symptoms include:
- A popping sensation at the time of injury
- Pain and swelling on and around the knee
- Tenderness along the knee joint
- Feeling unstable on your feet
- Difficulty in bearing weight
Diagnosing an ACL Tear
If you suspect you have an ACL tear, schedule an appointment with an orthopedic specialist to obtain a proper diagnosis. After you have discussed your symptoms and medical history, your orthopedist will perform a physical examination of your knee to look for signs of injury as well as to rule out other conditions before proceeding with ACL tear treatment.
ACL Screening Tests
Physical tests for ACL injuries may include:
- Lachman test. This test is performed with your knee bent at 20 to 30 degrees of flexion. The shin bone is pulled forward to assess the stability of the knee joint. You might see this test conducted as a football game when a player is being evaluated for injury.
- Anterior drawer test. When lying down with your knee bent at 90 degrees, your doctor will apply pressure behind the knee. If your lower leg moves out of place, it could indicate an ACL injury or tear.
- Pivot shift test. Your doctor will grasp your lower leg (tibia) and rotate it to determine your range of motion and look for signs of instability in the joint. This can be an uncomfortable process if you do have an ACL tear, so this procedure is sometimes performed under general anesthesia at the time of your surgery.
If you exhibit pain, swelling, instability or irregular movements during your physical exam, you may have a torn ACL or other injury. Your doctor may then order imaging tests to confirm the diagnosis before proceeding with ACL tear treatment.
Diagnostic Tests
Diagnostic imaging tests include:
- X-ray imaging. Although an X-ray image cannot show soft tissue tears, it may help rule out other conditions that could be causing knee pain, such as a broken bone or osteoarthritis.
- Ultrasound technology. This imaging technology provides more detailed images than those from an X-ray, yet not as detailed as those captured from an MRI. Using soundwaves to visualize internal structures, ultrasound is useful in identifying injuries to the tendons, muscles and ligaments, which can aid in the treatment for ACL tears.
- Magnetic resonance imaging (MRI). Magnetic wave technology can produce detailed images of soft tissue inflammations, swelling, cartilage degradation and ACL tears.
What Are the Types of ACL Tears?
Roughly half of all ACL tears coincide with damage to the meniscus, cartilage or other surrounding ligaments. Classified as sprains, ACL tears are graded according to severity, from Grade 1, which is a mild sprain in which the ligament has been slightly overstretched, but it is still capable of providing stability to the knee joint, to Grade 3, a complete ligament tear, which happens when the ligament is either pulled away from the bone or torn in half.
ACL Treatment
The type, location and severity of your ACL tear, combined with your age, health condition and lifestyle will help your doctor determine your path of ACL tear treatment.
Minor or partial ACL tears may heal with nonsurgical treatments and restorative therapies, however, major tears or injuries sustained by athletes or weekend warriors will likely require reconstructive surgery.
ACL tear treatments without surgery include the following at-home and physician-assisted therapies:
- Rest. Take a break from exercise or strenuous activities and keep weight off of your injured knee.
- Ice. Apply cold packs to your injured knee several times per day, for up to 20 minutes at a time. Avoid applying ice directly to your skin.
- Compression. Your doctor may wrap a compression bandage around your injured knee to minimize swelling.
- Elevation. Rest in a reclined position, with your knee elevated higher than your heart.
- Anti-inflammatories. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen may be helpful in reducing pain and swelling from your torn ACL.
- Bracing or crutches. A fitted knee brace may help provide stability to an injured ACL, allowing for healing.
- Physical therapy and rehabilitation. After an initial period of rest, physical therapy can be a beneficial ACL tear treatment without surgery by helping to improve the knee’s range of motion, strengthen the muscles surrounding the knee, and to help reduce pain and swelling.
- Platelet-rich plasma (PRP). This emerging ACL tear treatment involves injections made from the patient’s blood platelets to accelerate healing in deep ACL tears.
Torn ACL Surgery
Some types of ACL tears do not heal sufficiently with nonsurgical ACL tear treatment options alone. In those cases, surgery is necessary to restabilize the knee and allow you to achieve a full range of motion.
Athletes and young to middle-aged patients who sustain an ACL injury generally have to have ACL surgery as there is a high probability of further injury due to their high level of physical activity with frequent twists, turns, jumps, landings and bearing weight.
ACL surgery is performed under regional or general anesthesia, most often arthroscopically. This minimally invasive surgical method allows a surgeon to view the affected area and remove and replace the damaged tissue at once.
Through the use of fiber optic lighting directed through a thin tube, this type of ACL surgery facilitates the use of smaller incisions, which allows for quicker recovery times than in traditional open surgeries. Common ACL surgeries include:
- Autograft. An orthopedic surgeon replaces the damaged tendon with one from elsewhere in your body, such as your other knee, hamstring or thigh.
- Allograft. Tissue from a cadaveric donor is used to replace the damaged ACL ligament.
- Synthetic graft. Uses artificial tendon to replace the torn ligament.
Bridge-Enhanced ACL Restoration (BEAR) Implant Surgery
A new procedure offers a less invasive alternative to traditional ACL surgery
A pioneering new surgery at RWJBarnabas Health enables the body to heal itself. The Bridge-Enhanced ACL Restoration (BEAR) uses a recently FDA-approved device to “bridge” the gap in the repair and enhance healing by promoting healing through the use of the patients own blood and growth factors. The implant is made of protein, and provides a scaffold for repair. This minimally invasive procedure can make recovery faster and less painful for patients.
Learn about how the innovative BEAR implant surgery helps our patients:
Read Thomas K.'s Patient Testimonial
Watch NBC4 New York's News Video: New ACL Tear Treatment Helps Young Athletes Get Back on Field Faster
ACL Surgery Recovery
Post- ACL surgery recovery times vary according to the patient’s health, lifestyle and type of procedure.
You can expect to be limited to reduced physical activities and use crutches to assist with weight-bearing for about 7 to 10 days following your surgery. You will also be assigned exercises and physical therapy to regain your strength, endurance and range of motion.
Most patients can expect to do light walking within a few weeks following the ACL surgery, with most full activities possible within 3 to 6 months.
Due to the high physical demands of a sports regimen, it may take 9 to 12 months for an athlete to achieve a full recovery following ACL surgery.
The RWJBarnabas Health Difference
At RWJBarnabas Health, we aim to help our patients achieve a better quality of life by getting you back to your everyday activities with ease. As the largest health care network in New Jersey, RWJBarnabas Health's leading-edge orthopedics department is led by highly skilled medical professionals who will guide you through your torn ACL treatment process with care and compassion.
Our team includes:
- Sports medicine physicians
- Orthopedic surgeons
- Physician assistants
- Registered nurses
- Physical therapists
With access to the latest technologies to diagnose a wide array of orthopedic conditions, we can administer therapies and treatment for ACL tears that:
- Promote enhanced healing
- Aid in pain management
- Encourage better patient outcomes for you and your family
Have you suffered from an ACL injury? We can help.