Anterior cruciate ligament injury

Anterior cruciate ligament injury / ACL tear / cruciate ligament rupture

In case of the anterior cruciate ligament injury or ACL tear, the anterior cruciate ligament tears. Cruciate ligament rupture is often used as synonym for the anterior cruciate ligament injury, but besides the anterior ligament it also encloses posterior ligament rupture. The anterior cruciate ligament tears more often than the posterior cruciate ligament. The function of the cruciate ligaments is to stabilize the knee joint. If a cruciate ligament ruptures, the menisci and cartilage are overloaded, which bears the risk of secondary damage (meniscus tear, cartilage damage, arthritis).

Symptoms anterior cruciate ligament injury / ACL tear / cruciate ligament rupture

Anterior cruciate ligament injury often causes a visible swelling of the knee and severe knee pain mostly deep inside the knee. In many cases, patients do hear a loud popping sound if the cruciate ligament tears. Since the cruciate ligaments stabilize the knee joint, knee instability may also occur. In addition to that, affected persons may be not able anymore to stretch or bend the knee and may take a relieve posture.

Symptoms of cruciate ligament rupture in short:

  • popping sound during ligament rupture
  • swelling of the knee
  • pain inside the knee
  • knee instability
  • stretching or bending a knee is not possible; instead of it relieve posture is taken

Causes anterior cruciate ligament injury / ACL tear / cruciate ligament rupture

Cruciate ligaments can tear with or without the influence of other knee injuries, and they can also make the emergence of other knee injuries more likely. Causes of ACL tear vary subject to the affected cruciate ligament. In both cases, the natural tearing strength has been exceeded.

The anterior cruciate ligament can rupture as a result of sudden, intensive changes of the direction, twists, bending or stretching movements. This can happen while executing daily life’s activities but also during sports activities necessitating quick changes of directions, stop-and-go movements or turns. Football, soccer or tennis players or skiers do suffer from cruciate ligament rupture most often.

The posterior cruciate ligament can tear if an external force damages it during an accident of sports activities like football or rugby. During this process, the lower leg is overstretched, so that the posterior cruciate ligament ruptures.

Diagnostics anterior cruciate ligament injury / ACL tear / cruciate ligament rupture

In case of assumed cruciate ligament rupture, a comprehensive orthopedic examination is carried out often accompanied by imaging procedures like MRI.

The best method to differentiate between different injuries is MRI. MRI enables us to visualize very different structures during one examination like muscles, ligaments, tendons, cartilage and bones. If it is necessary, we do also apply a well-tolerated contrast agent to improve the visibility of certain structures.

Therapy anterior cruciate ligament injury / ACL tear / cruciate ligament rupture

If there is only minor damage of the cruciate ligament, it can be treated conservatively with painkilling and anti-inflammatory drugs, physiotherapy and strengthening of leg muscles and wearing a stabilizing splint or orthesis. The conservative treatment makes sense for patients with ACL tear without damage of other knee structures and those who do not exercise much.

During minimally invasive knee arthroscopy, an endoscope is inserted through small skin incisions. With the help of the endoscope, the surgeon is able to see the damaged knee structures enlarged at a monitor. In addition to that, surgeons are also able to operate through the endoscope, and, thus, to stitch, repair, stabilize and relocate damaged tissue. The cartilage can be smoothed, and free cartilage particles can be removed.