ACL tears can sometimes be confused with other injuries, especailly when it happens to a younger athletes. Even though increased number of ACL injuries in younger athletes are seen, it is still rare compared to older population. Since, in those younger athletes, the weak link is their growth plate instead of the ligament itself, an injury to open growth plate (physis) becomes more common. The ligament can pull a piece of bone off of tibial plateau, which can happen by the same mechanisms of injury as an ACL tear. This can be detected by plain films. This injury is also different from ACL tears in that this can be repaired surgicaly not having to have it reconstructed.
Another injury that can be confused with ACL tears is petalla subluxation. This is due to similarities of both injuries. They both happen from similiar mechanisms of injury. Clinical presentations are similiar, such as immediate swelling, loss of motion, etc. Another reason for this is that medical professionals have to a tendency to think "knee injury = ligament injury?!" Those medical professionals need to do a thourough evaluation of the injury to avoid misdiagnosis.
A key to a quick recovery from an injury that has happended is to find out what the injury is and have it taken care of early and appropriately.
With patellar subluxation, the patella (knee cap) dislocates and it goes back in place by itself. So, there is no need for reduction. It may need to be immobilized, however. Most of the times, the patella dislocates/subluxes lateraly.
Sometimes, unfortunately, injuries do happen. Injuries like ACL tears usually require surgery. However, it is not easy to make a decision and have a surgical procedure done, psychologically and timing-wise. Sometimes, it is wise to have it done right away. Sometimes, the athlete can wait. This decision making should be done considering the severity of the injury, recovery time, etc.
Rehab after ACL reconstruction takes about 5-6 months. This means, for some sports, the end of a season. Let's say the injured athlete is a professional baseball player and gets injured during spring training. This means that he will be more than likey miss the entire season. And his goal will become returning to the field the next season. If he gets surgery done by June, he will have enough time to get ready for the following season. However, he has about 3 months to make his mind up. In his case, he has an option to try to rehab his knee until then. If it works, he may be able to play. If not, he can go ahead and get a procedure done.
On the other hand, let's say the injured athlete is a 16 year-old soccer player who plays for a club team and for high school. In this case, her soccer season is pretty much all year around. It will probably better for her to have surgery done sooner because the longer she waits the longer her return to play will be.
Some cases are more complicated than these cases. But final decision should be made by the injured athlete (and parents if the athlete is a minor), not the surgeon or coach.
