ACL and Meniscus Injuries

What is the Difference Between an ACL and a Meniscus?

The anterior cruciate ligament (ACL) and meniscus are both essential structures in the knee, but they play distinct roles and respond to injury in unique ways. The meniscus is a crescent-shaped piece of cartilage that cushions and stabilizes the joint by absorbing shock between the thighbone and shinbone. In contrast, the ACL is a strong ligament that provides rotational stability and prevents the shinbone from sliding forward. While both are frequently injured in sports, they differ in structure, function, symptoms, and treatment approaches. Understanding their differences is key to diagnosing and treating knee injuries.

How Do ACL and Meniscus Injuries Happen?

ACL and meniscus injuries often occur during high-impact activities or sudden movements. You may tear either structure while twisting your knee, landing awkwardly, or changing direction quickly. The mechanism of injury and the structure involved influence how each injury presents itself.

• ACL Tears: This injury usually occurs from a sudden pivot or awkward landing. Many people report hearing or feeling a “pop” at the time of injury. This is typically followed by immediate swelling and instability in the knee.
• Meniscus Tears: This often results from a twisting motion while the foot is planted. These may or may not involve a popping sound and tend to cause more localized pain, especially along the joint line. Swelling will develop gradually.

Meniscus injuries can also happen slowly over time due to degeneration, especially in older adults, while ACL tears are almost always acute and traumatic.

Shared and Unique Symptoms

Both ACL and meniscus injuries can result in pain, swelling, and limited range of motion, but there are key differences.

• Meniscus Tear: You will have pain on the sides or the backside of the knee. Swelling will develop over hours. Your knee may catch or lock, and you may have difficulty bending or straightening the knee.
• ACL Tear: Your pain will often be felt deep inside the knee. Swelling will be rapid and immediate, and your knee may feel unstable or give out while walking and weight bearing. If the ACL has been torn for a long period of time, you will often have more instability or giving way feelings, than pain.

 “ACL tears usually come with a story or mechanism of injury, often a meniscus tear can creep up without any noted injury.  MRI scans are vital in helping to determine pathology and plan for reconstruction or repair,” says Dr. Mark Ritter, an orthopedic surgeon specializing in sports medicine and trauma, including injuries to the knee and shoulder.

Meniscus Injury Treatment

Some acute or small tears can be monitored without surgery if the meniscus remains stable and asymptomatic, meaning the patient is not experiencing symptoms such as locking or significant swelling. Forté Sports Medicine and Orthopedics offers an orthobiologic treatment option called Platelet-Rich Plasma (PRP) injections, which is a nonsurgical procedure that promotes healing and has anti-inflammatory effects. To learn more about PRP and orthobiologics, click here.

Unstable meniscus tears, if left untreated, can cause further damage to the knee as well as pain, so surgical treatment is recommended. Surgical treatment options include a meniscectomy or an arthroscopic meniscal repair surgery. 

Meniscectomy - This surgery removes only the torn portion of the meniscus. This is like trimming a partially torn fingernail, so it does not catch on anything. The main goal is to preserve as much healthy tissue as possible to protect the knee from arthritis. Recovery can be fairly quick, and some athletes return to play within three weeks of their surgery.

Arthroscopic Meniscal Repair Surgery – This surgery repairs tears in the vascular area of the meniscus and can be performed for some patterns of tears. An arthroscopic repair of the meniscus involves stimulating the tear to promote healing and stabilizing the meniscus with suture repair to allow healing. Repairs of the meniscus require a longer rehabilitation, because of the slow healing of tissue. Athletes should expect to return to play after a five to six-month recovery. However, always ask for recommendations from your surgeon before returning to normal activities.

“ACL reconstructions and meniscus repairs require the patient to be willing to undergo the surgery, but also be dedicated to the rehabilitation to get the best outcome,” says

Dr. Ritter

ACL Injury Treatment

Depending on the severity of your ACL injury, treatment may include rest and rehabilitation exercises to help you regain strength and stability. Surgery may be necessary to replace the torn ligament, followed by physical rehab at our rehabilitation centers. A proper training program may help lower the risk of an ACL injury. Complete ruptures typically do not heal on their own. Reconstructive surgery is often recommended for active individuals, especially athletes, and involves rebuilding the ACL with a graft. After surgery, patients will undergo structured rehabilitation to regain strength and mobility. At Forté Sports Medicine and Orthopedics, our team is committed to helping patients return to play with confidence after injury.

“Tearing my ACL was one of the toughest challenges I have faced, but my experience at Forté made all the difference. Dr. Ritter was incredibly kind, supportive, and knowledgeable. He made me feel comfortable from day one. He checked in on me regularly and truly cared about my recovery. Thanks to his guidance and the amazing care I received, I was able to return to my sport fully, with confidence,” says Colleen McMaster, a collegiate athlete and ACL patient at Forté.

Contact Us Today!

If knee pain is slowing you down, Forté Sports Medicine and Orthopedics is here to help. Our specialists in Carmel, Greenwood, Mooresville, Noblesville, or Tipton, IN can pinpoint the cause and get you back to moving pain-free. Don’t ignore the pain! Take care of it now so it doesn’t turn into something worse. Contact us today.