ACL Injuries in San Antonio

FAQs

I’ve heard that women are at higher risk for ACL injury. Why is this? 

Women are definitely at higher risk of tearing their ACL. There is no one single reason why women are at greater risk. However, most surgeons agree that there are multiple factors that play a role. There are important differences in the anatomy or structure of the knee between men and women. The intercondylar notch, or the space where the ACL is located, is narrower in women than in men. Female athletes also put greater stress on their ACL during athletics. Their knees are more “turned in” and frequently less bent when jumping and landing. Female athletes often land on their heels with the knees “locked out”. This places more stress on the ACL than if they land with bent knees and a wider stance. 

I didn’t feel a pop when I hurt my knee. Could my ACL still be torn?

Yes. While many athletes who tear ACL felt a pop, the ligament can still be injured even if you didn’t. In fact, only about 70% of patients with a torn ACL felt a pop during their injury.

Do I need an MRI?

If your doctor is concerned about an ACL tear, they will usually recommend an MRI. Ligaments, like the ACL or MCL, cannot be seen on x-rays. Many surgeons and orthopedic doctors can diagnose an ACL tear with physical examination. The MRI, however, can confirm the diagnose and also evaluate other structures that may be injured like the meniscus or the cartilage.

I tore my ACL, but my knee feels much better after a few weeks. The swelling has gone, and I can walk and bend it without any problems. Why do I still need surgery?

It is very common for patients to feel much better once the swelling goes down. This usually occurs in 2 to 3 weeks. Patients will usually be able to walk without much difficulty and their range of motion also improves. Often, their knee will feel “fine” until they try to run or pivot or return to sports. It is important to follow the advice of your doctor. When the ACL is completely torn, the knee is “unstable.” If your child return to sports and twists the knee again, they could tear the meniscus or cartilage or damage other structures.

I’m worried my child injured their ACL. What can we do while we are waiting for the appointment with the surgeon or for the MRI?

First and foremost, it is important not to injure the knee further. If your child has a large amount of swelling, they should not return to sports until evaluated by a doctor. It is also important to reduce the swelling and control the pain with RICE. This stands Rest, Ice, Compression (with an ACE wrap or elastic bandage), and Elevation (raising the knee). 

My son is 13 years old. How is his surgery different from the surgery an adult would need?

The growth plates or growth cartilage in your son are most likely still open. This means he still has potential for more growth. Special techniques are needed in patients with open growth plates. For example, some types of grafts that include pieces of bone or “bone blocks” are not good options in young athletes. Your surgeon may recommend hamstring or quadriceps tendon or IT band. Also, your surgeon may use special techniques to avoid drilling into the growth plate.

What “graft” should my child have for the ACL reconstruction?

There are three main graft choices in young athletes – patellar tendon, hamstring tendon, and quadriceps tendon. There are pros and cons to each option. It is important to talk to your child’s surgeon about their sport and previous knee problems. For example, your surgeon may not recommend patellar tendon graft if your child has a history of pain at the front of the knee since this graft has a higher risk of anterior knee pain. On the other hand, patellar tendon may be a great option for older teenage football or soccer players, and some studies have shown a lower failure rate with this graft.

How long will my child need crutches after surgery?

Many surgeons only recommend crutches for a few days to a couple of weeks after an ACL reconstruction. They may, however, recommend crutches for 6 to 8 weeks if they have to repair a meniscus tear.

How long is the surgery? Will my child need to stay in the hospital?

Surgery is usually between an hour and a half and two hours. Most ACL reconstructions are performed as an outpatient surgery.

Does my son or daughter have to do physical therapy after surgery?

Yes! Physical therapy is incredibly important. The goals of PT are to reduce swelling, regain range of motion and flexibility, regain strength in the muscles around the knee, improve balance, and ultimately prevent further injuries.

When can my child return to sports?

This can vary based upon the sport, the ACL technique used, and the recommendations of the individual surgeon. Most children return to sports at between 8 and 12 months though.