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ACL Injury

Caitlin G. Waters, MD and J. Herbert Stevenson, MD Reviewed 06/2019
 


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.

  • The ACL and po...

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

FOLLOW-UP RECOMMENDATIONS

  • ROM exercises to regain full flexion and extension

  • Advance activity as tolerated

Patient Monitoring

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

REFERENCES

1
Beynnon BD, 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

  • Dufka FL, Lansdown DA, Zhang AL, et al. Accuracy of MRI evaluation of meniscus tears in the setting of ACL injuries. Knee.  2016;23(3):460–464. [View Abstract on OvidMedline]

  • Fr...

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...

CLINICAL 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 pla...

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