The anterior cruciate ligament (ACL) is one of four important ligaments in the knee, and its main function is to stabilise the knee
An ACL tear is a common knee injury (especially in sports like soccer, rugby and netball), but can also occur with injuries unrelated to sporting activities
There are often associated injuries, such as a tear of the supporting cartilage in the knee (the meniscus)
At the time of injury, a “pop” or “snap” is sometimes felt, and usually there is immediate swelling
An ACL tear usually results in an unstable knee, and symptoms include “giving way”
Knee instability can result in further damage to the cartilage in the knee, and could eventually result in painful osteoarthritis (OA)
For various biological reasons the ACL does not heal very well. Surgery is usually indicated, especially if you are young or active or if there is an associated cartilage injury
Surgery is performed arthroscopically (“keyhole” or minimally invasive surgery) – this is associated with a faster recovery time and minimal scarring
The operation is done under general anaesthetic and usually involves an overnight stay in hospital
The procedure involves removal of the torn ligament, and replacement using a “graft”. The graft is usually made using your own hamstring tendons although other tendons may be used if necessary. The graft is inserted through tunnels created in the bone (the femur and tibia) and fixed with either metal buttons, screws or a combination of both.
At the time of surgery, other injuries can be addressed as well (e.g. fixing a torn cartilage)
Crutches are usually needed for between 4 to 6 weeks afterward, and often a brace is used as well
An essential component of a successful ACL reconstruction is rehabilitation, and physiotherapy is started soon after surgery
It usually takes at least 9 months to return to sports like soccer, rugby and netball