The Anterior Cruciate Ligament (ACL) is an important ligament located in the middle of your knee joint. Its role is to help keep you knee stable, especially when performing ‘cutting or pivoting’ movements like running from side to side or swift changes in direction.
An ACL injury is the tearing of the anterior cruciate ligament in your knee. It may make your knee feel unstable or loose, and your knee feels like it “gives way”.
Anterior cruciate ligament injuries are more common in sports such as football, netball, basketball and soccer.
ACL injuries usually occur when your foot is planted on the ground and your body rotates over your knee. Sometimes it is caused with a direct injury such as when another player falls onto the leg.
Many people report hearing or feeling a pop. The knee will then usually swell significantly, with the inability to continue playing.
ACL ruptures - Treatment options
Not all ruptures of the ACL need reconstructive surgery.
ACL ruptures can lead to instability if your sport, job or lifestyle requires pivoting. Many patients do very well without reconstruction, especially if their main exercise mainly involves jogging, cycling and swimming, rather than competitive ball sports such as football or netball that require pivoting movements..
If your knee feels unstable, than an ACL reconstruction is a very successful operation that can be performed with knee arthroscopy.
Diagnosis of ACL ruptures
If you have an injury to your knee that you suspect is an ACL rupture, it’s important that you seek immediate medical care. You knee is a complex structure involving many important ligaments, cartilage structures and tendons.
Immediate care with rest, ice, compression and elevation is important.
Xrays and MRI’s are often needed to fully access the injuries to the knee.
During an ACL reconstruction, the remnants of your ruptured ACL are first removed. This is usually achieved through key hole knee arthroscopy. The replacement ligament is then obtained, usually involving your hamstrings or patella tendon. this replacement ligament is called the ‘graft’.
The graft is then passed through tunnels that have been prepared in your tibia and femur. Then secured at each end with either screws or buttons.
Further Reading and References
Anterior cruciate ligament reconstruction: principles of treatment. EFORT Open Rev. 2017 Mar
Eighty-three per cent of elite athletes return to preinjury sport after anterior cruciate ligament reconstruction: a systematic review with meta-analysis of return to sport rates, graft rupture rates and performance outcomes. Br J Sports Med. 2017 Feb 21