Partial ACL Tear

A partial ACL (anterior cruciate ligament) tear occurs when the ligament in the knee is partially damaged, often leading to instability, pain, and limited range of motion. This injury typically results from sudden stops, pivots, or direct impacts, commonly seen in athletes. Early diagnosis and appropriate management are crucial to preventing further damage and ensuring optimal recovery.

What Is A Partially Torn ACL?

A partially torn ACL refers to an injury where only a portion of the ACL fibers are damaged, rather than a complete tear. The ACL is a vital ligament in the knee that provides stability by preventing the tibia (shinbone) from sliding out in front of the femur (thighbone). 

When partially torn, the ligament can still provide some level of stability, but the knee may feel unstable, particularly during activities that involve sudden changes in direction or high impact.

Symptoms of a partial ACL tear can include pain, swelling, a feeling of instability, and difficulty bearing weight on the affected leg. Unlike a complete tear, which often requires surgical intervention, a partial tear might be treated with physical therapy and rehabilitation to strengthen the surrounding muscles and restore knee function. 

However, the extent of the tear and the patient’s activity level will guide the treatment approach, with some cases requiring surgery to prevent further injury and ensure long-term knee stability.

Symptoms Of A Partially Torn ACL 

A partially torn ACL can manifest through a variety of symptoms, each indicating different aspects of the injury’s impact on knee function. Early recognition of these symptoms is important for proper diagnosis and treatment.

Popping Noise At The Time Of Injury

Many individuals with a partially torn ACL report hearing or feeling a “pop” at the moment of injury. This noise often occurs during activities involving sudden stops, twists, or impacts and is a key indicator that the ACL has been compromised.

Pain And Swelling In The Knee

Pain and swelling usually develop within a few hours of the injury. The pain can be sharp and intense initially, often making it difficult to bear weight on the affected leg. Swelling results from inflammation and can cause stiffness and a limited range of motion in the knee.

Knee Instability

A partially torn ACL may lead to a sensation of knee instability or “giving way,” especially during movements that require pivoting or sudden direction changes. This instability is a result of the ligament’s compromised ability to stabilize the knee joint, increasing the risk of further injury if left untreated.

Common Causes Of A Partial Tear in the ACL 

A partial tear in the ACL often results from specific movements or impacts that place excessive strain on the knee. These actions are typically sudden and forceful, leading to the overstretching or partial tearing of the ligament.

Slowing Down And Pivoting Or Sidestepping

Quick deceleration followed by a pivot or sidestep, common in sports like soccer or basketball, can create significant rotational forces on the knee. These sudden changes in direction place stress on the ACL, making it susceptible to partial tears.

Incorrect Landing From A Jump

Landing awkwardly from a jump, especially with the knee in a bent or twisted position, can lead to a partial ACL tear. The force generated by the jump, combined with improper landing mechanics, can cause the ligament to stretch beyond its normal capacity.

Strong Impact With Another Person Or Object

Direct collisions with another person or object, often seen in contact sports like football or rugby, can result in a partial ACL tear. The impact can force the knee into an unnatural position, overstretching the ACL and leading to partial damage.

How To Prevent A Partial Tear In The ACL 

Preventing a partial tear in the ACL involves taking proactive steps to strengthen the knee, improve flexibility, and practice safe movement techniques. Here are some effective tips to reduce the risk:

• Strengthen leg muscles: Focus on exercises that build strength in the quadriceps, hamstrings, and glutes. Stronger muscles help support the knee and reduce the strain on the ACL during physical activities.
• Improve flexibility: Regular stretching, especially of the hamstrings and calves, increases flexibility and reduces the likelihood of awkward movements that could lead to injury.
• Practice proper technique: Learn and consistently use correct techniques for jumping, landing, pivoting, and changing direction. Proper form minimizes stress on the ACL and other knee structures.
• Wear appropriate footwear: Use shoes that provide good support and are suitable for your sport or activity. Proper footwear can improve stability and prevent slips or missteps that might injure the knee.
• Warm up and cool down: Always warm up before and cool down after physical activities. This prepares the muscles and joints for exercise and reduces the risk of injury.
• Use braces or supports: If you’re recovering from a previous knee injury or engaging in high-risk activities, consider wearing a knee brace for additional support and to reduce the likelihood of a new injury.

How Doctors Examine A Partially Torn ACL

When examining a patient for a partially torn ACL, physicians follow a systematic approach to assess the knee’s stability, range of motion, and overall condition. The process typically includes the following steps:

• Medical history and symptom review: The doctor will ask about the patient’s medical history, including any previous knee injuries and the specific circumstances surrounding the current injury. They will also inquire about symptoms such as pain, swelling, instability, and any sensations experienced at the time of injury, like a popping sound.
• Physical examination: The physician will conduct a thorough physical examination of the knee. This includes inspecting for swelling, bruising, and any visible deformities. They may also palpate the knee to identify areas of tenderness and assess the overall stability of the joint.
• Range of motion tests: The doctor will assess the knee’s range of motion by asking the patient to bend and straighten their knee. A reduced range of motion, often due to pain or swelling, can indicate ligament damage.
• Specialized ligament tests: Several specific tests may be performed to evaluate the integrity of the ACL. The most common ones include:
  • Lachman test: The doctor will hold the thigh with one hand and pull the shin forward with the other to check for excessive forward movement, which can indicate ACL damage.
  • Anterior drawer test: Similar to the Lachman test, this involves pulling the shin forward while the knee is bent at a 90-degree angle to assess the ACL’s stability.
  • Pivot shift test: This test is used to detect knee instability by rotating the knee inward while applying pressure, observing for a sudden shift or “giving way” sensation.
• Imaging studies: If a partial tear is suspected, the physician may order imaging studies to confirm the diagnosis and assess the extent of the injury.
• MRI (magnetic resonance imaging): An MRI is the most common imaging tool used to visualize soft tissues such as ligaments. It can provide detailed images of the ACL, helping to distinguish between a partial and complete tear.
• X-rays: X-rays might also be used to rule out any bone fractures or other structural damage, although they cannot directly visualize the ACL.
• Comparison with the uninjured knee: To better understand the extent of the injury, the doctor may compare the injured knee with the uninjured one, checking for differences in stability, movement, and physical appearance.

Common Treatments For A Partially Torn ACL 

Treatment for a partially torn ACL varies depending on the severity of the injury, the patient’s activity level, and their overall health. The goal of treatment is to reduce pain and swelling, restore knee function, and prevent further injury. Below are common treatment options, along with their benefits and potential side effects.

Rest, Icing, and Elevating the Leg

Resting the injured knee, applying ice, and elevating the leg are initial steps to reduce pain and swelling.

• Benefits: These methods help control inflammation, minimize further injury, and promote healing in the early stages.
• Side effects: There are no direct side effects, but prolonged inactivity can lead to muscle weakness and stiffness if not followed by appropriate rehabilitation.

Anti-inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are often used to manage pain and reduce swelling.

• Benefits: NSAIDs can effectively reduce pain and inflammation, making it easier for the patient to participate in physical therapy and daily activities.
• Side effects: Common side effects include stomach irritation, ulcers, and an increased risk of bleeding. Long-term use should be monitored by a healthcare provider.

Physical Therapy

Physical therapy is a crucial part of the recovery process, focusing on strengthening the muscles around the knee, improving flexibility, and restoring range of motion.

• Benefits: Physical therapy helps restore knee stability, prevents further injury, and may eliminate the need for surgery. It also improves overall knee function and promotes a faster return to normal activities.
• Side effects: While generally safe, some patients may experience discomfort or pain during exercises, particularly in the early stages of therapy. Overexertion can also lead to further injury if not properly supervised.

Reconstruction Surgery

In cases where the knee remains unstable or if the patient is highly active, ACL reconstruction surgery may be recommended. This procedure involves replacing the torn portion of the ACL with a graft from another part of the body or a donor.

• Benefits: Surgery can restore full stability to the knee, allowing patients to return to high-level activities and sports. It also reduces the risk of developing osteoarthritis due to knee instability.
• Side effects: As with any surgery, there are risks of infection, blood clots, and complications related to anesthesia. Post-surgery, patients may experience pain and stiffness and require a long rehabilitation period. As well, longterm puts patients at risk for
  • Post-traumatic arthritis
  • Meniscus tears
  • Prolonged recovery

Regenexx

Regenexx is a regenerative medicine treatment that uses a patient’s own Bone Marrow Concentrate (BMC) and platelet-rich plasma (PRP) to promote healing of the partially torn ACL.

• Benefits: This minimally invasive procedure can accelerate healing, reduce pain, and potentially avoid the need for surgery. It also carries a lower risk of complications compared to surgical options.
• Side effects: While generally safe, there can be some discomfort at the injection site, and there is a risk of infection, though rare. The effectiveness of Regenexx varies, and not all patients may experience significant improvement.

Regenexx treatment, developed by the Centeno-Schultz Clinic, is a non-surgical approach to treating a partially torn ACL using regenerative medicine techniques. This treatment leverages the body’s natural healing mechanisms, particularly through the use of stem cells or PRP, to repair and strengthen the damaged ligament.

Understanding Regenexx Treatment

Regenexx is a proprietary procedure that involves the use of stem cells or PRP to promote the healing of damaged tissues, including partially torn ACLs. This approach is designed to be a minimally invasive alternative to surgery, focusing on regenerating the ligament rather than removing and replacing it.

1. Procedure Overview

• Bone Marrow Concentrate (BMC): The procedure begins with the extraction of the patient’s own bone marrow. These cells are processed and concentrated in a lab. After this concentration, it is injected directly into the injured ACL under precise imaging guidance (such as ultrasound or fluoroscopy). 

** This procedure was invented and perfected at the Centeno-Schultz Clinic over the last 20+ years!

• PRP treatment: Alternatively, or in conjunction with BMC, PRP can be used. Blood is drawn from the patient, and the platelet-rich portion is separated and concentrated. This PRP, rich in growth factors, is then injected into the partially torn ACL to accelerate healing.

2. Here’s How Regenexx Works

Your ACL CAN HEAL with the help from the Regenexx process!

The injected BMC and PRP release growth factors and other signaling molecules that promote tissue repair, reduce inflammation, and encourage the regeneration of collagen fibers within the ACL. Over time, this can lead to the strengthening and restoration of the ligament’s structure and function.

Centeno-Schultz Clinic pioneered the non-surgical treatment of ACL tears with biologics to allow healing of your native ACL without invasive surgery! 

Below, see our published case series along with a multi-year follow up RCT (randomized control trial):

• Symptomatic anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow concentrate and platelet products: a non-controlled registry study
• Anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow nucleated cells: a case series
• Image Guided Injection of Anterior Cruciate Ligament Tears with Autologous Bone Marrow Concentrate and Platelets: Midterm Analysis from A Randomized Controlled Trial

<

3. Benefits Of Regenexx For Partial ACL Tears

• Minimally invasive: Unlike ACL reconstruction surgery, Regenexx does not require large incisions or general anesthesia, reducing the risk of complications and shortening recovery time.
• Promotes natural healing: By utilizing the body’s own cells, Regenexx aims to repair the existing ACL tissue rather than replace it, preserving the natural structure of the knee.
• Reduced recovery time: Patients undergoing Regenexx treatment generally experience a faster recovery period compared to surgical options, allowing for a quicker return to daily activities.
• Lower risk of complications: Since Regenexx is less invasive, the risk of infection, blood clots, or other surgical complications is significantly reduced.

Clinical Considerations And FDA Guidelines

• Good Clinical Practice (GCP) Guidelines

The Centeno-Schultz Clinic adheres to Good Clinical Practice (GCP) guidelines, ensuring that Regenexx procedures are performed ethically, with patient safety as the primary concern. GCP guidelines encompass proper patient consent, accurate documentation, and adherence to established medical protocols.

• FDA Compliance

Regenexx treatments are carefully designed to comply with FDA regulations, particularly concerning stem cells and PRP use. The FDA permits the use of autologous (from the patient) bone marrow cells and PRP as long as they are minimally manipulated and intended for homologous use (used for the same purpose as they naturally fulfill). 

The Centeno-Schultz Clinic follows these regulations to ensure that treatments are both safe and effective.

• Risks And Considerations

While Regenexx offers many benefits, it is important to note that outcomes can vary. Some patients may not experience significant improvement, and there is always a risk of infection or pain at the injection site, though these are generally rare. 

Additionally, Regenexx may not be suitable for all cases, particularly in patients with severe or complete ACL tears, where surgery might be the more appropriate option.

Get A Non-surgical Treatment For A Partially Torn ACL

Regenexx treatment from the Centeno-Schultz Clinic represents a promising non-surgical option for individuals with partially torn ACLs. By adhering to GCP guidelines and FDA regulations, the clinic ensures that patients receive a safe and effective treatment to harness the body’s natural ability to heal, potentially avoiding the need for more invasive surgical procedures.