Treating ACL Injuries

By Dr. Regina O. Hillsman

As a Connecticut-based private practice physician and orthopaedic surgeon with more than 30 years experience in the field, I offer specialized care for sports, work, and arthritis-related injuries. One type of injury I offer extensive professional experience repairing is torn anterior cruciate ligaments (ACL) of the knee.

As one of the four primary ligaments surrounding the knee joint, the ACL plays a critical role in ensuring unimpeded, proper movement of the knees. More than the other surrounding ligaments, the ACL acts as a knee stabilizer. ACL injuries range from small tears to severe cases where the ligament has been completely torn. They are particularly common in contact sports such as football, where a player may be planted in one direction and receive a side hit or tackle from another. Other sports such as skiing, martial arts, and basketball require short, sudden shifts in the knee position which commonly results in ACL injuries. ACL tears are often accompanied by a sharp popping sound and subsequent swelling and instability when standing on the affected leg. Interestingly, studies have found women to be more susceptible to ACL injuries due to a combination of differences in ligament strength, unique movement patterns, and hormone variations.

There are non-surgical healing options available for ACL injuries; by making lifestyle changes that minimize wear on the knee joints, many people allow the tendon to heal on its own. This “conservative management” strategy makes use of a knee brace and regular guided physical therapy sessions. ACL surgery is generally recommended for individuals who engage in athletic activities as a vocation or profession. While the other tendons and ligaments often compensate for a torn ACL to some degree, if the condition persists other knee injuries are much more likely.

For those requiring ACL surgery, I reconstruct the torn ACL either utilizing portions of the patient`s patellar tendon, hamstring tendon, or through donor grafts. While utilizing the patellar tendon allows for bone-to-bone healing, thus providing the highest-security graft, it often results in persistent knee pain. The hamstring tendon graft creates fewer disturbances and less resulting pain, but lacks stability to an extent. While donor tissue grafts are increasingly common, the sterilization process kills living cells of the graft, resulting in a longer and less predictable healing process.

For those who regularly engage in high-impact activities but have not yet developed significant ACL injuries, I recommend undertaking preventative neuromuscular training that improves muscle strength, balance, and instills proper movement habits. Visit my website at drhillsman.org to learn more about the orthopaedic services we offer children and active adults.