How ACL tears/ruptures occur and Surgical treatment

Anterior Cruciate Ligament (or 'ACL') tears commonly occur with sudden twisting or turning movements, change in direction or sudden deceleration during running or sports. Partial ACL tears do not generally require surgical treatment, but in complete ACL ruptures, ACL reconstruction is required if you wish to return to sports or activities that require twisting or turning, as otherwise you may not be able to do so or worse, injure your knee further.

When you twist your knee or fall on it, you can tear a stabilising ligament that connects your thighbone to the shinbone. A complete anterior cruciate ligament injury does not heal on its own. Fortunately, reconstructive surgery can help many people recover their full function after an ACL injury.


Ligaments are tough, non-stretchable fibres that hold your bones together. The cruciate ligaments in your knee joints cross each other to provide rotational stability to the knee and is important in patients who enjoy sports which involve cutting and twisting movements such as football, rugby, skiing, netball and tennis. People often tear their ACL by changing direction rapidly, slowing down from running or landing from a jump. Young people (age 15-30) who participate in sports that require pivoting are especially vulnerable. You might hear a popping noise when your ACL tears. Your knee gives way and soon begins to hurt and swell.

Initial treatment includes rest, ice compression and elevation (RICE) plus a brace to immobilise the knee, crutches and pain tablets.


Initial tests may include X-rays and an MRI scan of the knee. People who have sedentary or less active requirements may be treated without surgery with physiotherapy or muscle strengthening exercises. However, in most instances, reconstructive surgery is required to restore previous full function. Surgery involves replacing the damaged ACL with a strong, healthy replacement ligament (graft) taken from the knee-cap or hamstring region.


Successful ACL reconstruction surgery restores stability to the knee. Restoring the strength in your thigh and calf muscles helps support the reconstructed structure and is crucial to the success of the procedure. Rehabilitation exercises are therefore crucial to gradually return your knee to full range of motion and stability. You may need to use a knee brace for awhile and will probably have to stay out of sports for about one year after the surgery.