Torn ACL graft

[Thommo75]

Hi,
I tore my ACL and had a knee reconstruction about 5 years ago. Recently I had swelling and pain to the same knee and subsequently had a MRI. The scan showed a partial tear to the anterior fibres of the ACL graft. Does this mean another knee reconstruction?

Thanks
Neil.

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[physiobob]

Depends if you have lost the stability it was providing. Where was the original graft taken from? You have already lost the sensory part that the original ACL was providing with the initial injury, so the only reason for another one would be loss of rotation stability in your normal/vocational activities.

It is possible that the tear was already there and was not the cause of the swelling during this recent episode. They should check the meniscus carefully as well

[Thommo75]

Thank you for your quick reply. My understanding there is a anterior, posterior and mid fibres contained within the graft but don't understand what is mean by a tear in the anterior and the remifications. The knee stablility is still good. Does this mean the knee it back to where it was pre reconstruction. The scan did show damage to the articular cartildige to an extent that it suggests a possible loose fragment from this. The meniscus shows no tears. The graft was a hamstring one.

[physiobob]

There are only really anterior, posterior and mid fibers in the original ligament. The graft is just a cable and as such does not really have such distinct boundaries. Maybe the swelling was from the articular cartilage damage and not the graft itself. The fact that the knee stability is good in my book means no further intervention is needed at this time. Take it easy until the swelling is resolved though.

[Shravan nath yogi]

ACL: The Anterior Cruciate Ligament

The anterior cruciate ligament (ACL) is a ligament that connects the tibia to the femur. It serves to prevent the tibia (leg) from moving forward relative to the femur (thigh). The ACL is in the center of the knee. It crosses the PCL, hence the name, cruciate.
How does someone injure the ACL?
This ligament is frequently injured in contact sports (e.g., football) and pivoting sports (such as soccer and skiing), however there are many scenarios for injury to this ligament. Usually the patient complains of a sudden injury to the knee and the inability to walk right after the accident. Often, there is a significant amount of swelling that occurs relatively soon after the injury. In contact sports (e.g., football) the injury typically occurs when another player impacts the side of the knee. Non-contact ACL injuries are more common in women, such as a female soccer player who suddenly changes direction and feels a pop in her knee.

What are the symptoms of an ACL injury?

Initially, the symptoms are pain and fairly immediate swelling. Often patients will complain of hearing a loud "pop", which is the sound of the actual ligament tearing.
After the pain and swelling resolve, patients complain of episodes of instability, or giving-way. The knee feels loose. Some people liken this to walking on rollerskates. For some people, this looseness is predictable; other people live in fear of their knee giving out because they are unable to predict the motions that cause the instability.

What happens after the ACL injury?
It depends on the severity of the injury and whether there are any other associated injuries, such as a medial collateral ligament tear or a meniscal tear. Often the swelling resolves after a couple of weeks. Some patients will be able to function without any problems after they get over the initial injury, especially if they had only a partial tear. The majority, however, will notice "instability"; the feeling that their lower leg is shifting forward on their thigh bone. For some, this will be a minor nuisance; for others, it will be a significant disability.