ACL Injury

Jeff Wang, MD, MPH and J. Herbert Stevenson, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

  • The anterior cruciate ligament (ACL) is a primary knee stabilizer that serves to prevent excessive anterior translation and internal rotation of the tibia on the femur.

    • During dynam...

DIAGNOSIS

HISTORY

Describe mechanism 
  • Noncontact

    • Sudden deceleration

    • Cutting, sudden change in direction

    • Landing from a jump with the knee in extension

  • Contact with player, object

  • May recall sudden pop or ...

TREATMENT

GENERAL MEASURES

  • Acute injury: protection, relative rest, ice, compression, elevation, medications, modalities (PRICEMM) therapy

  • Crutches may be useful until patient is able to ambulate withou...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

  • ROM exercises to regain full flexion and extension

  • Advance activity as tolerated

MONITORING

Assess functional status, rehabilitative exercise compliance, and pain con...

REFERENCES

Beynnon B, Vacek PM, Newell MK et al. The effects of level of competition, sport, and sex on the incidence of first-time noncontact anterior cruciate ligament injury. Am J Sports Med. ...

ADDITIONAL READING

  • Christiansen BA, Anderson MJ, Lee CA et al. Musculoskeletal changes following non-invasive knee injury using a novel mouse model of post-traumatic osteoarthritis. Osteoarthr Cartil....

SEE ALSO

Algorithm: Knee pain 

CODES

ICD10

  • S83.519A Sprain of anterior cruciate ligament of unsp knee, init

  • M23.619 Oth spon disrupt of anterior cruciate ligament of unsp knee

  • S83.511A Sprain of anterior cruciate ligament of right kne...

PEARLS

  • Lachman test is the most sensitive and specific physical examination maneuver for diagnosing acute ACL injury.

  • Bone contusion of the anterior femoral condyle and/or posterior tibial plateau on M...

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