Anterior cruciate ligament tears for the primary care sports physician: what to know on the field and in the office

Abstract

Anterior cruciate ligament (ACL) injuries are relatively common and can lead to knee dysfunction. The classic presentation is a non-contact twisting injury with an audible pop and the rapid onset of swelling. Prompt evaluation and diagnosis of ACL injuries are important. Acute treatment consists of cessation of the sporting activity, ice, compression, and elevation with evaluation by a physician familiar with ACL injuries and their management. The diagnosis is made with the use of patient history and physical examination as well as imaging studies. Radiographs may show evidence of a bony injury. MRI confirms the diagnosis and evaluates the knee for concomitant injuries to the cartilage, menisci and other knee ligaments. For active patients, operative treatment is often recommended while less-active patients may not require surgery. The goal of this review is to discuss the diagnosis of an ACL injury and provide clear management strategies for the primary-care sports medicine physician.

Keywords:

• Anterior cruciate ligament
• knee injury
• ligament tear
• knee instability

Acknowledgements

The authors would like to acknowledge Jessica Thompson, MPH (Tulane University School of Medicine, New Orleans, LA, USA) for her help in editing and preparing the manuscript.

Declaration of interest

WMR Heard has received research support from Zimmer. FH Savoie has been an unpaid consultant for Exactech Inc, Mitek, Rotation Medical and Smith & Nephew. He has also been a speaker for Mitek and Smith & Nephew, and received research support from Mitek. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.