Causes

Most ACL injuries during sports. Football, rugby, netball and basketball are all associated with ACL injuries. Often there is forced rotation of the knee on a planted foot. ACL ruptures also occur in about 15% of all skiing injuries, and can occur even with slow speed falls.

 

In severe injuries, other structures can be damaged as well, including the meniscii and medial collateral ligament.

 

Symptoms

Patients will often feel the knee come out of position, and may hear a "pop". Swelling usually occurs quickly, within an hour. Patients are not usually able to walk on the leg immediately after the injury and certainly are unable to continue with the sport.

 

It can often take several weeks before you can walk on the leg normally without a limp, and the knee may be unstable to a variable degree. Some patients will have instability with day to day normal activities, and some only with sports. Instability often occurs with twisting movements.

 

Treatment

As with most injuries the immediate treatment is rest, ice, compression and elevation (RICE). 

 

ACL injuries are commonly under diagnosed by GPs and in A&E, often being put down to a strain and are picked up later when instability is a problem. Late diagnosis and instability can sometimes lead to other injuries in the meniscus.

 

Not all ACL injuries need surgical treatment. This will often depend upon the degree of instability and the wish to return to sport. It is important to discuss your aims and expectations with your surgeon. 

 

Surgery

The ruptured ACL will often require reconstruction, and this will involve replacing the injured ligament with a graft. This is often either some of
the hamstring tendons, or a portion of the patella tendon.