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The Anterior Cruciate Ligament (ACL) is a tissue that connects the thigh bone to the shinbone and controls the front and back motion of the knee. It provides rotational control and stability by limiting forward movement of the thigh bone on the shin bone. Without an intact ACL, the knee may feel loose and wobbly.
An ACL tear is a common knee injury that occurs during sports with sudden twisting motions and changes in direction. When the ACL tears, the anterior cruciate ligament sprains or splits from the bone attachments.
When you tear your ACL, you may hear a popping sound. Other symptoms may follow, such as:
It is more common for ACL tears to occur during sports activities when the knee is vulnerable to injury. Certain movements can cause an ACL tear including:
Playing sports such as football, basketball and tennis have a higher risk of tearing the ACL.
Several risk factors can increase the likelihood of sustaining an ACL tear. Understanding these factors can help people take preventive measures and be more aware of their susceptibility to such injuries. The primary risk factors for an ACL tear include:
Women are more likely to suffer ACL tears than men. This increased risk is attributed to several anatomical and hormonal differences, including the following:
Engaging in sports that involve high-intensity movements such as jumping, pivoting, and sudden changes in direction can significantly increase the risk of ACL tears. High-risk sports include:
People who have previously sustained an ACL injury are at a higher risk of re-injury. This increased risk can be due to factors such as inadequate rehabilitation, persistent muscle weakness, or altered movement patterns.
Genetics may play a role in predisposing people to ACL injuries. Some people may have inherited anatomical characteristics or ligament properties that make them more prone to ACL tears.
Lack of proper conditioning and muscle strength can increase the risk of ACL injuries. Weak muscles around the knee can lead to instability and improper movement patterns, increasing the likelihood of ligament tears.
Using incorrect techniques during physical activities can place undue stress on the ACL. For instance, landing from a jump with knees caving inward or making abrupt changes in direction without proper body alignment can elevate the risk of injury.
Certain environmental conditions can also contribute to ACL injuries. Slippery or uneven playing surfaces, inappropriate footwear, and inadequate sports equipment can increase the likelihood of sustaining an ACL tear.
Even though ACL tears are common, they can be prevented through strength training and learning good exercise techniques. Some examples include:
If you suspect you have torn your ACL, stop all physical activities and keep weight off your leg by sitting down. Make an appointment immediately with your orthopaedic specialist. Keep your leg raised above chest level until then, and ice the area if you notice swelling. Refrain from putting pressure on your knees and take over-the-counter pain medication to manage the discomfort.
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An ACL tear is typically diagnosed through a combination of physical examination, patient history, and imaging tests. Initially, your orthopaedic specialist will assess the knee’s stability, swelling, and range of motion. They may perform specific maneuvers, such as the Lachman test, to check the integrity of the ACL.
Accessing how the injury occurred and the symptoms experienced are also crucial for a preliminary diagnosis. To confirm the extent of the tear and to rule out damage to other knee structures, magnetic resonance imaging (MRI) scans are often utilized. In some cases, X-rays might be ordered to exclude bone fractures. This comprehensive approach ensures an accurate diagnosis, which is essential for determining the most effective treatment plan.
An ACL injury is classified into a three-class grading system that signifies the severity of the injury. Grade 1 injuries are the least severe, while Grade 3 injuries are the most severe. Depending on the grade, treatment for the ACL tear may vary.
An ACL tear is a serious injury that can lead to a variety of complications if not properly managed. These complications can affect both short-term recovery and long-term knee function. Understanding the potential complications associated with an ACL tear can help people seek appropriate treatment and adhere to recommended rehabilitation protocols.
Not all ACL injuries require surgical treatment. Grade 1 ACL tears are usually treated with physical therapy and immobilisation.
However, if a torn ACL goes untreated, it may lead to:
It is important to make an appointment with an orthopaedic specialist to understand the best treatment plan for your ACL injury.
Physical therapy focuses on strengthening the muscles around the knee to improve stability and function. It often includes exercises to enhance flexibility, strength, and proprioception.
Knee braces can provide additional support and stability, helping to protect the knee during the healing process and during physical activities.
Non-steroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation associated with ACL injuries and aid in the overall recovery process.
When non-surgical treatments are insufficient, surgical intervention may be necessary to restore knee stability and function. The choice of surgical technique depends on various factors, including the patient’s activity level, age, and the severity of the injury.
Knee arthroscopy is a minimally invasive surgical procedure used to diagnose and treat various knee joint issues, including ACL tears. This procedure involves the following steps:
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Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
According to MOH’s fee guideline, knee arthroscopy ACL surgery costs an average of $30,000 at a private hospital. This fee is calculated before deducting your personal insurance plans (Integrated Shield Plans, Medishield Life) and MediSave payouts. The maximum MediSave payout you can obtain for a knee arthroscopy is $3,950.
Dr Kau (许医生) is on the panel for most major local insurers. Talk to our team and your insurance agent to understand the out-of-pocket fees required for a knee arthroscopy.
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If an ACL tear is not treated, it can lead to the loss of joint function in the future.
A complete ACL tear cannot heal on its own and requires surgery. If the ACL tear is less severe, it is still important to consult an orthopaedic specialist for a recommended non-surgical treatment plan.
After an ACL reconstruction surgery, recovery can take 9 months.
