How is an ACL Injury Diagnosed?
During your orthopedic consultation with Dr. Mazzara, a physical examination of the injured knee will be performed. He will inquire about the events leading up to the injury, as well as checking range of motion, degree of swelling and extent of pain. Dr. Mazzara will often use an x-ray to check for bone involvement, which may include fractures or bone contusions, as well as an MRI to evaluate the ligaments, tendons and cartilage.
How is a Torn ACL Treated?
Depending on the severity and symptoms of the ACL injury, Dr. Mazzara may suggest either a surgical or non-surgical treatment. Not all ACL injuries require surgery; a minor sprain may heal on its own with proper rest and therapeutic knee exercises. Partial or complete tears however will often require surgery.
Does an ACL Injury Require Surgery?
If the ACL injury does not cause instability in the knee joint, or if the patient does not require use of their ACL for sports and daily activities, physical therapy may be enough to heal the joint. Dr. Mazzara suggests the well-known treatment called RICE; Rest, Ice, Compression and Elevation. He may also prescribe a non-steroidal anti-inflammatory medicine to reduce inflammation and pain from the injury, and promote healing.
What is the Surgical Treatment of an ACL?
More severe tears with knee instability require surgical treatment to restore normal knee function. Dr. Mazzara is skilled at performing ACL arthroscopic surgery, using a small camera called and arthroscope and small instruments to repair the damage inside the knee. An ACL reconstruction removes damaged fragments of the torn ACL and replaces it with a soft tissue called a graft. There are two types of graft options available for ACL reconstruction:
- Autograft uses a substitute ligament from the patient’s own body. Common grafts may include the patellar tendon and hamstring tendon. Dr. Mazzara will usually recommend using the quadriceps tendon to autograft because studies have shown that it is not associated with any of the disadvantages of other autografts such as knee weakness (as in the case of the hamstring tendon) or pain from softening of the cartilage on the patella called chondromalacia (as in the case of the patellar tendon).
- Allograft; tissue taken from a donor or cadaver. Allografts offer faster initial recovery and lower surgical morbidity. However, some clinical studies have shown a higher risk in re-rupture, especially in younger patients, but provide excellent results in most other patients.
What is the Recovery Time After ACL Reconstruction?
The goal of ACL treatment is to reduce swelling and restore motion to the knee joint. Patients are usually able to bear weight on the knee, while wearing a brace, immediately after surgery. Returning to work or school can happen in as little as 5-10 days post-surgery. Approximately 5 days after surgical reconstruction, physical therapy will be started with range of motion exercises, then strengthening, to build the supporting muscles. A return to sports activities can usually be accomplished around 5-8 months after surgery and based on individual progress.
If you have questions about treatment for an ACL injury or if you have a torn ACL, please contact the orthopedic offices of Dr. James Mazzara, knee specialist in Manchester, South Windsor, Enfield, Glastonbury and surrounding Hartford communities.