ACL Rupture

Anterior Cruciate Ligament (ACL) Anatomy

The ACL is a strong rope like structure located in the center of the knee. It crosses from the back of your femur (thighbone) and runs down to the front of your tibia (shinbone).

The function of the ACL is to provide stability to the knee.

Causes of ACL injuries

ACL injuries are one of the most common ligament injuries that occur. Once the ACL is torn it has a poor ability to heal and typically will not heal if untreated.

Causes of ACL injuries are usually when a patient either

twists the knee too far, or
there is a sudden change in direction or speed

Symptoms of an ACL injury

Patients report the following associated symptoms of anterior cruciate ligament injuries:

an audible ‘pop’ sound from the knee
a sensation of something tearing inside the knee.
a feeling as if the knee has momentarily ‘come out of its joint’.

These symptoms are usually followed by:

swelling of the knee
difficulty walking and
pain.

ACL injuries typically cause instability of the knee:

on uneven ground or
during sport when a patient attempts a ‘sidestep’ or ‘twist’ manoeuvre.

ACL injury diagnosis

Dr Edward Graham will need to diagnose the specific nature of the ACL Injury or the extent of any associated injury in the knee joint.

Often, an ACL Injury can be identified during a physical exam by a medical professional. By manipulating the knee and leg bones the cause of symptoms can be pinpointed.

During this consultation Dr Edward Graham will:

take a medical history
perform a physical examination
assess the joint’s range of motion

Imaging tests

X-rays do not show cartilage and ligaments. They can help rule out other problems with the knee that may have similar symptoms like fractures (broken bone) .
MRI can create detailed images of both hard and soft tissues within your knee. An MRI can produce cross-sectional images of internal structures required if the diagnosis is unclear or if other soft tissue injuries are suspected such meniscal or articular cartilage injuries.

While not all of these tests are required to confirm the diagnosis, this diagnostic process will also allow Dr Edward Graham to review any possible risks or existing conditions that could interfere with the surgery or its outcome.

Untreated Anterior Cruciate Ligament injuries

When this ligament tears, unfortunately it doesn't heal and often leads to a feeling of instability in the knee.

If untreated, additional ligament problems are more likely to develop for both active adults and children. A significant number of patients with an untreated (unreconstructed) ACL tear have recurrent:

knee instability
buckling of the knee
giving-way of the knee

These recurrences must be avoided as these episodes cause further problems like cartilage tears and premature wear and tear resulting in arthritis of the knee.

Giving up sport option

Where a patient is considering giving up sport to avoid an ACL Reconstruction operation, a physiotherapy programme may provide sufficient stability for daily living.