What is anterior cruciate ligament (ACL) separation and its grades with treatment?

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From the Guidelines

Anterior cruciate ligament (ACL) separation is a serious knee injury that requires prompt and proper treatment to prevent long-term morbidity and mortality, and the most recent and highest quality study recommends early reconstruction for acute isolated ACL tears to minimize the risk of additional cartilage and meniscal injury 1.

Overview of ACL Separation

ACL separation, or anterior cruciate ligament injury, is a common knee injury that occurs when the ACL, which connects the femur (thigh bone) to the tibia (shin bone), is stretched or torn. The severity of the injury can vary, and treatment depends on the grade of the injury.

Grades of ACL Separation

The grades of ACL separation are:

  • Grade I: Mild ligament stretching without joint displacement
  • Grade II: Partial ligament tears with minimal displacement
  • Grade III: Complete ligament tears with visible deformity

Treatment of ACL Separation

Treatment of ACL separation depends on the grade of the injury and the individual's overall health and activity level. The American Academy of Orthopaedic Surgeons recommends early reconstruction for acute isolated ACL tears to minimize the risk of additional cartilage and meniscal injury 1.

  • Grade I and II injuries are typically treated with conservative management, including rest, ice, pain medication, and physical therapy.
  • Grade III injuries may require surgical reconstruction, especially for active individuals who want to return to sports or high-level activities.

Rehabilitation after ACL Reconstruction

Rehabilitation after ACL reconstruction is crucial to restore knee function and prevent long-term morbidity. The British Journal of Sports Medicine recommends immediate knee mobilization and strength/neuromuscular training during ACL postoperative rehabilitation 1.

  • Rehabilitation typically includes a combination of physical therapy, strength training, and neuromuscular training.
  • The goal of rehabilitation is to restore range of motion, strength, and function to the knee, and to prevent long-term complications such as chronic pain or arthritis.

Key Takeaways

  • Early reconstruction is recommended for acute isolated ACL tears to minimize the risk of additional cartilage and meniscal injury 1.
  • Rehabilitation after ACL reconstruction should include immediate knee mobilization and strength/neuromuscular training 1.
  • Treatment of ACL separation depends on the grade of the injury and the individual's overall health and activity level.

From the Research

Anterior Cruciate Ligament (ACL) Separation

There are no research papers to assist in answering this question as the provided studies are related to acromioclavicular joint separations, not anterior cruciate ligament (ACL) separations.

Acromioclavicular Joint Separation Grades and Treatment

  • The grades of acromioclavicular joint separation range from grade I (mild sprain) to grade VI (severe dislocation with displacement) 2
  • Grade I-III acromioclavicular joint separations are typically managed conservatively, while grades IV-VI are managed surgically 2, 3
  • Conservative management of grade I-III acromioclavicular joint separations includes early functional rehabilitation and may involve the use of a brace to restore joint integrity 4
  • Surgical treatment may be considered for patients with grade III or higher injuries, especially if there is significant displacement or instability 5, 6
  • The choice of treatment depends on various factors, including the severity of the injury, patient age, and activity level 5, 6

Treatment Outcomes

  • Nonoperative treatment has been shown to be effective in managing grade III acromioclavicular joint separations, with outcomes similar to those of surgical treatment 3, 6
  • Early functional rehabilitation and bracing have been shown to be effective in improving clinical and radiological outcomes in patients with high-grade acromioclavicular joint injuries 4
  • Surgical treatment may provide better radiological outcomes, but may also be associated with longer recovery times and higher complication rates 5, 6

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

Treatment of grade III acromioclavicular joint injuries: a systematic review.

Clinical orthopaedics and related research, 2007

6
Research

Treatment of grade III acromioclavicular separations. Operative versus nonoperative management.

Bulletin (Hospital for Joint Diseases (New York, N.Y.)), 1997

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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