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ACL Injuries

The anterior cruciate ligament controls forward shift and rotation of the knee. When it tears, the knee tends to “give way” — but with a well-planned treatment, returning to an active life and to sport is realistic.

01What is it?

The anterior cruciate ligament (ACL) connects the thigh bone to the shin bone, crossing through the centre of the knee. It can tear partially or completely during sudden changes of direction, awkward landings or when the knee collapses inwards.

It is common in football, basketball, volleyball and skiing, but it can also happen with a simple misstep in everyday life.

02Symptoms

A ‘pop’ felt or heard at the moment of injury, followed by swelling within a few hours, is typical. Once the acute phase settles, the main complaint is a knee that feels unstable.

  • A ‘pop’ at the time of injury
  • Swelling within hours
  • Giving way on stairs or when turning
  • A feeling of instability

03Diagnosis

A careful clinical examination is the most valuable step; tests such as Lachman and pivot-shift assess how the ligament works. MRI confirms the tear and reveals any associated meniscus or cartilage damage.

04Treatment Options

The decision is not based on the MRI alone — age, activity level, sporting goals and episodes of giving way all matter. For some less active patients, a strengthening programme may be enough.

For athletes and patients with instability, the ligament is reconstructed arthroscopically (keyhole surgery) using a graft prepared from the patient’s own tendons. Associated meniscus tears are treated in the same session.

  • Rehabilitation and strengthening
  • Arthroscopic ACL reconstruction
  • Associated meniscus repair
  • Athlete-specific return protocol

05Recovery & Return to Sport

Physiotherapy starts within the first days after surgery. Walking is regained quickly; running and contact sports are planned once strength, balance and hop tests are passed — usually between 6 and 9 months.

Return to sport is guided by measurable criteria rather than the calendar, which lowers the risk of re-injury.

?Frequently Asked Questions

Does every ACL tear need surgery?+

No. Some patients with lower activity demands and no instability can be managed with rehabilitation. The decision is made together, based on examination and goals.

What happens if I don’t have surgery?+

Repeated episodes of giving way in an unstable knee can damage the meniscus and cartilage over time, so regular follow-up matters for active people.

When can I return to sport?+

For most athletes between 6 and 9 months; the exact timing is set by strength and functional testing.

This page provides general information. The right treatment for you is decided with your doctor after examination and tests.

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