Extension Block from ACL Tear

Patients with acute ACL tears can sometimes present with missing terminal extension (inability to fully straighten the knee). One must always suspect a bucket-handle meniscus tear in this situation, but sometimes it is due to “stump entrapment” where a portion of the torn ACL flips forward and gets pinched between the femur and tibia, acting as a mechanical obstruction that limits full extension of the knee.

1️⃣ + 2️⃣ Arthroscopy views of the ACL fragment caught in the intercondylar notch.
3️⃣ + 4️⃣ Sagittal and coronal MRI views of the ACL fragment flipped forward.

Do I need to have ACL surgery?

Do I need to have ACL surgery?

Not everyone who has an ACL tear needs to have ACL surgery; so, before signing up for surgery to reconstruct your ACL, think about your activity level, current level of function and comfort, activity goals, etc and decide with your surgeon what the best treatment option is for you and your knee.

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