An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL). This ligament is a strong band of tissue that connects the thigh bone (femur) to the shinbone (tibia) to provide stability of the knee. ACL injuries most commonly occur during sports that involve sudden stops or changes in direction, pivoting, and jumping.  High school female athletes have the highest risk for ACL injuries of all athletes.

What are the signs and symptoms of ACL injury?

  • Hearing a “pop” or feeling a popping sensation at the time of injury
  • Knee swelling
  • Knee gives out or buckles
  • Pain with weight-bearing

What causes an ACL injury?

  • Sports that involve cutting, pivoting, or quick starts and stops
  • Awkward landing from a jump (with knee buckling inward)
  • A direct hit to the knee or a collision

How is ACL Injury treated?

Non-Surgical

Initial treatment for ACL injuries is to reduce the swelling and regain range of motion that is often lost with acute immobilization following injury. Once swelling is normalized, begin to regain range of motion, especially knee extension, focusing on maintaining quadriceps (thigh) activation and strength.

Most often, ACL injuries are treated surgically. Conservative treatment for ACL injuries for young athletes is not commonly recommended due to the likelihood of recurrent injuries, further knee damage, such as meniscus tears, as well as an early onset of arthritis.

Surgical

Surgical treatment for ACL injuries is recommended to restore the normal function of the knee joint, for those athletes who wish to return to running, cutting, pivoting and twisting maneuvers. The surgery involves reconstructing/replacing the damaged ACL because it cannot heal on its own. There are numerous surgical options regarding graft type, which is often discussed with the surgeon who is performing the surgery. 

Here at Connecticut Children’s, we offer a range of graft options because we treat the full spectrum of patients, from young growing children to college athletes.  We often use the quadriceps tendon and have active on-going research on its use.  We also offer bone-patellar tendon-bone and hamstring grafts in certain cases. 

While ACL injuries in the very young child (more than 2 years of growth remaining) are rare, they require a different technique to protect their growth plates.  At Connecticut Children’s, we offer the IT band (iliotibial band) technique, which has had excellent long term results.

After Surgery

Following ACL reconstruction, the rehab and time away from organized athletics is about 9-12 months.  There is a lot of physical therapy, strengthening, and ACL injury prevention work done in order to successfully return to sports.

New Minimally Invasive BEAR Implant for ACL Tears

Connecticut Children’s is the first in Connecticut to use a breakthrough minimally invasive technology called the BEAR Implant for treatment of ACL tears. Unlike reconstruction, the BEAR Implant does not require a second surgical wound site to remove a healthy tendon from another part of the leg, or donor tendon. Instead, the implant acts as a bridge to help ends of the torn ACL heal together. Our Connecticut Children’s surgeon injects a small amount of your own blood into the implant and inserts it between the torn ends of your ACL. The combination of the BEAR Implant and your blood enables the body to heal the torn ends of the ACL back together while maintaining the ACL’s original attachments to the femur and tibia. As the ACL heals, the BEAR Implant is resorbed by the body, usually within eight weeks.