Anterior Cruciate Ligament (ACL) Surgery

Table of Contents

What is an Anterior Cruciate Ligament?

The anterior cruciate ligament (ACL) is one of the four major ligaments in the knee joint.

It is located in the center of the knee and helps to stabilize the knee joint by preventing the shinbone (tibia) from sliding forward on the thighbone (femur).

It helps to prevent the knee from wobbling or collapsing.

It also helps to control the rotation of the knee joint.

Watch Knee anatomy video

How do you injure your anterior cruciate ligament?

ACL injuries are common in sports that involve sudden stops and changes in direction, such as rugby, soccer and netball. They can also occur in non- athletic activities, such as a fall or a motor vehicle accident.

Associated injuries

When you injure your ACL, it is also common to injure other structures in your knee:

Meniscus tears
Other ligaments
Cartilage injury

These associated injuries will be taken into account when I am deciding on your overall management plan.

Reproduced with permission from OrthoInfo. © American Academy of Orthopaedic Surgeons.

Watch this video on Ligament Injuries

How is it diagnosed?

Firstly, I will take a thorough history and examination of your knee. If there is a clinical suspicion of an ACL injury, the diagnosis is confirmed by magnetic resonance imaging (MRI) scan.

Treatment

Physiotherapy

A dedicated physiotherapy program is very important following an ACL injury, whether or not you need surgery.

Physiotherapy addresses the most common issues after ACL injury – muscle weakness, decreased range of motion and instability. Treatment is tailored to your activity level, age, sporting demands, whether you have instability symptoms during day-to-day activities, and whether you have other associated injuries as mentioned above. Most importantly, it is worth noting that surgery is not always required and/or desired by the patient.

Anterior Cruciate Ligament (ACL) Surgery

If surgery is required, I will use key-hole (arthroscopic) surgery to reconstruct your torn ACL using a graft from another part of your body. This graft can be taken from your quadriceps tendon, patella tendon, or hamstrings tendon.

Graft choices are dictated by many factors, including

age
previous injury
specific activity/sporting demands

I will make a personalized recommendation based on these factors.

Watch an ACL reconstruction video

After surgery rehabilitation

Your post surgery rehabilitation will be mainly guided by your physiotherapist, with continued input from myself. In a nutshell, you will go through a graduated program where you will focus on achieving specific goals in each phase of the rehabilitation, before moving up to the next phase.

Returning to sport will be based on several performance indicators – generally speaking, the operated leg should perform at least 90% as well as the uninjured leg before you return to sports, and usually takes at least 9 months.