MANUAL MINORS
An ACL tear is a serious knee injury that typically occurs due to sudden movements, rapid changes in direction, or direct impacts. It is common in contact sports and activities involving jumps or quick pivots. The tear can be partial or complete, causing joint instability, pain, swelling, and difficulty bearing weight on the affected leg.
Diagnosis
Diagnosis is based on the patient’s medical history, physical examination, and specific tests like the Lachman test, anterior drawer test, and pivot shift maneuver. Magnetic resonance imaging (MRI) is used to confirm the extent of the injury and assess damage to other knee structures, such as the menisci.
Differential Diagnosis
Condition | Key Differentiation |
|---|---|
Collateral Ligament Sprain | Pain and lateral knee stability without rotational instability. |
Meniscal Injury | Knee locking or clicking with localized joint line pain. |
Tibial Plateau Fracture | Severe pain with inability to bear weight, confirmed by X-ray. |
Patellar Tendinitis | Anterior knee pain that worsens with activity, especially around the patella. |
Prepatellar Bursitis | Visible swelling in the front of the knee without joint instability. |
Emergency Management
Initial management in the emergency department focuses on controlling pain and swelling, as well as stabilising the joint. Temporary immobilisation with a splint or hinged knee brace is recommended, along with ice application, elevation of the limb, and analgesics, including NSAIDs. Referral to an orthopaedic specialist for further evaluation is crucial.
Definitive Treatment
Definitive treatment depends on the severity of the injury, the patient’s functional needs, and their level of physical activity. For young individuals and athletes, ACL reconstruction surgery is the treatment of choice, followed by an intensive rehabilitation program. In older patients or those with a lower activity level, conservative treatment, including physiotherapy, may be sufficient to restore stability and function.
Comments