Acute proximal anterior cruciate ligament tears: outcomes after arthroscopic suture anchor repair versus anatomic single-bundle reconstruction. These data suggest that there may be greater potential application for ACL preservation techniques.Īnterior cruciate ligament primary repair proximal tears remnant preservation tear types.Īchtnich A, Herbst E, Forkel P, et al. Type I tears were seen in 16%, type II in 27%, and type III in 52% of patients in our cohort. This classification system was reliable in assessing tear location in acute ACL injuries. Type I tears were more common in patients older than 35 years compared with those younger than 35 years (23% vs 8% P <. Incidence of type I tears was 16%, type II tears 27%, type III tears 52%, type IV tears 1%, and type V tears 3% (2.5% with bony avulsion). Interobserver reliability was 0.670 (95% confidence interval, 0.505-0.836), and intraobserver reliability ranged from 0.741 to 0.934. Inter- and intraobserver reliability were measured using kappa statistics.Ī total of 353 patients (57% male mean age, 37.1 years range, 18.1-81.2 years) were included. An orthopaedic surgeon, a radiologist, and a research fellow graded the tear type on 30 MRIs to determine reliability, and the research fellow graded all MRIs. Tear types were graded as proximal avulsion (distal remnant length >90% of total ligament length, type I), proximal (75%-90%, type II), midsubstance (25%-75%, type III), distal (10%-25%, type IV), and distal avulsion (<10%, type V). Patients younger than 18 years and those with reports of chronic tears, partial tears, multiligamentous injuries, were excluded. To propose a magnetic resonance imaging (MRI) classification system for different tear types based on clinical relevance and to assess the distribution of these different ACL tear types.Ī retrospective search in an institutional radiographic database was performed for patients who underwent knee MRI at our institution between June 2014 and June 2016. Currently, the incidence of these different tear types is unknown. Proximal and distal avulsion tears have been treated with arthroscopic primary repair, while augmented repair, remnant tensioning, primary repair with biological scaffold, and remnant preservation have been proposed for different types of midsubstance tears. If you need help with an ACL injury or knee pain, call Nevada Orthopedic & Spine Center, or schedule an appointment online today.Over the past decade, there has been a resurgence of interest in anterior cruciate ligament (ACL) preservation. During your recovery, your provider develops a sport-specific rehabilitation program to strengthen your ACL and get you back in the game. Your provider uses a piece of tendon to build a new ligament. If you have joint instability or you want to return to athletic activities or competitive sports, you will need surgery to regain optimum ACL strength and function.ĪCL surgery involves reconstructing the ligament with a graft. Nonsurgical treatment such as a brace, anti-inflammatory medications, and physical therapy may be enough if your knee is stable and you don’t plan to return to intensive activities. The treatment that’s best for your knee depends on the severity of the tear (partial versus complete), whether the joint is still stable, and your activity goals.
Resting prevents further injury, while icing, compressing the knee with an elastic bandage, and elevating your leg above your heart reduce swelling. You can immediately treat an ACL tear using the RICE protocol: rest, ice, compression, and elevation. You may also sustain other injuries because the force that causes your ACL to tear frequently damages other parts of your knee. The pain and swelling appear within six hours of your ACL injury. You also experience one or more of the following symptoms: Many people hear a popping sound when the ACL tears. What symptoms occur if I have an ACL tear? You can also end up with an ACL tear by taking a hit to the side of the knee during a football tackle.
Most ACL tears occur due to movements that are common in sports such as basketball, football, and soccer, including: The ligament also gives your knee rotational stability. The ACL holds the shinbone in place, preventing it from sliding away from the thigh bone. The ACL runs diagonally through the joint, connecting the thigh bone (femur) with the shinbone (tibia). Your knee joint is supported by four ligaments that stabilize the bones.