You knew the moment it happened — you could feel your knee twist or torque — and you also knew it wouldn’t be long until the swelling set in. Sure enough, your knee started to puff up and you dutifully applied ice and rested the joint.
It’s now been days, weeks, or even months, and the swelling has become an ongoing issue, which means it’s time to come see us.
At William Schell, MD, Dr. Schell specializes in major joints like your knees, and he can help you get to the bottom of your ongoing knee swelling. While it’s impossible to diagnose you with any accuracy here, we want to explore one possibility — an ACL tear, which is a common driver of persistent swelling.
The role of your ACL
Each of your knees has four ligaments (tissues that attach bone to bone) that stabilize these large joints. The four ligaments include:
- Anterior cruciate ligament (ACL)
- Posterior cruciate ligament (PCL)
- Medial collateral ligament
- Lateral collateral ligament
Your ACL and PCL form an X that criss-crosses your knee and, as the name implies, your ACL is located at the front of your knee, with your PCL toward the back. These two ligaments control the back-and-forth motion in your knee.
More specifically, your ACL keeps your tibia (shinbone) from slipping out in front of your femur (thighbone) and it also allows for rotational stability. This connective tissue is not as strong as your PCL, which is one of the reasons why it’s injured far more often.
The makings of an ACL tear
Most ACL tears occur when you land badly after jumping, you turn suddenly, you stop short, or you get hit in the knee. ACL tears are essentially sprains, and we grade them as such:
- Grade 1 — the ACL is stretched
- Grade 2 — the ligament is torn
- Grade 3 — a complete rupture of the ACL
Each year in the United States, between 100,000 and 200,000 people develop complete tears in their ACLs, to say nothing of the scores more who are left with partial tears.
Symptoms of an ACL tear
Now, let’s get to your knee swelling. When you tear or rupture your ACL, you can expect the following symptoms:
- Pain in your knee, especially when you bear weight
- Weakness in your knee
- A sensation that your knee is giving out
In many cases, you might feel or hear a pop in your knee, which is a hard-to-miss indicator of ligament damage.
Taking action for ACL tears
If it’s a grade 1 or 2 ACL sprain, there’s a good chance that we can treat the problem conservatively with:
- Physical therapy
- Crutches for a time, if it’s a meaningful tear
- A brace
Over time, the ligament should heal and your swelling should go down.
If it’s a bad grade 2 sprain or a grade 3, conservative measures may not be enough. It’s not uncommon for us to see patients who have tried to rest their knees in the hopes they would heal on their own. This can work, but just as often these patients encounter ongoing issues with weak knees and swelling, which indicate that the tear isn’t likely to heal without some help.
Your knees are important joints, so we urge you to come see us at the first signs of trouble. This way we can quickly assess the extent of the damage and come up with a treatment plan that will help you move forward.
If you’ve tried to go it alone, but symptoms like knee swelling aren’t going away, it’s not too late for us to help. If we confirm a significant ACL tear, we can correct the problem surgically and get you on the road to a functioning knee that doesn’t swell up.
For expert diagnosis and care of your swollen knee, please contact our New York City office to schedule an appointment with Dr. Schell. Our office is located on Columbus Circle on the Upper West Side.