Case history
Case history #1
A 20-year-old female basketball player lands awkwardly from a rebound, feels a sudden painful pop in her right knee, and falls to the ground. She is unable to return to play and feels that her knee keeps giving out when she tries to bear weight. She reports that her knee became very swollen within 1 or 2 hours after the injury.
Case history #2
A 30-year-old football player was injured when his left knee was rolled into accidentally by a teammate. The patient felt the knee hyperextend, bend inward, and pop. He was unable to keep playing and complained that his knee felt like it kept twisting. The knee swelled moderately over the next few hours.
Other presentations
ACL tears may also occur after slips and falls, twisting injuries to the knee, and high-energy injuries (e.g., motor vehicle accidents). The ACL may be injured alone (isolated) or as part of a more complex injury (multiple ligamentous injuries, meniscal tear, knee dislocation).
Complete, intrasubstance tears of the ligament are the most commonly seen injury. Many partial tears involve enough fibres to cause significant instability.[4][5] ACL bony avulsion (tibial eminence) injuries mainly occur in skeletally immature individuals.[6][7]
In children, falling off of a bike while trying to plant the ipsilateral foot is a common mechanism of ACL avulsion from the tibial eminence.[8]
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