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ACL Injury Updated 3/2011

J. Herbert Stevenson, MD
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BASICS

  • Description
  • Epidemiology
  • Risk Factors
  • General Prevention
  • Etiology
  • Associated Conditions

DIAGNOSIS

  • Signs and Symptoms
  • Tests
  • Differential Diagnosis

TREATMENT

  • Medication (Drugs)
  • Additional Treatment
  • Surgery
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
  • Prognosis
  • Complications
The following is an excerpt....
BASICS
Description
  • The anterior cruciate ligament (ACL) is one of the major stabilizers of the knee. It prevents excessive anterior translation and internal rotation of the tibia on the femur. During dynamic movement, the ACL and PCL work together to stabilize the knee.
  • ACL injuries are common and can occur through noncontact or contact mechanisms. >70% of ACL injuries are caused by noncontact forces (1,2).
  • Partial tears of the ACL can occur, but complete tears are far more common.
  • Female athletes are at 2–5 times higher risk of ACL tear, particularly in soccer, basketball, and skiing (2).
  • ACL injury is associated with early onset of knee osteoarthritis, regardless of surgical or nonsurgical treatment (3,4)[B].
Epidemiology
Incidence ...

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Figure 6-110 ANTERIOR CRUCIATE LIGAMENT TEAR. A. Proton Density-Weighted MRI, Sagittal Knee. Note the normal low signal intensity anterior cruciate ligament (ACL) in this pediatric patient (arrow). B. Proton Density-Weighted MRI, Sagittal Knee. Observe that the ACL has been avulsed from its proximal femoral attachment (arrow) Note the retraction of the ligament and surrounding hemorrhagic edema. COMMENT: The ACL originates on the lateral femoral condyle posteriorly and courses caudally in an anteroinferior direction to insert on the lateral portion of the intercondylar area of the tibia. Anterior translation of the tibia and posterior translation of the femur are limited by this ligament.Credit: Terry R. Yochum, Lindsay J. Rowe, Yochum And Rowe's Essentials of Skeletal Radiology, Third Edition. Philadelphia: Lippincott Williams & Wilkins, 2004.
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