What is an ACL injury?

The anterior cruciate ligament (ACL) is a very important stabiliser of the knee and the anterior-posterior direction. This is a ligament structure responsible for not only anterior-posterior stability, but also for rotational stability of that specific knee joint. Injury to the ACL occurs during sports that require pivoting manoeuvres.

What are the signs and symptoms?

The athlete often feels a ‘pop’ and has sudden swelling of the knee whilst playing sport. They will be unable to go back to the sport, or play any further sports, because they will have a sensation of instability and swelling in the knee.

What are the causes?

ACL injuries are sporting related injuries, and they are related to pivoting sports. Any athlete that must regularly perform pivoting manoeuvres will have a higher chance of rupturing their ACL. Athletes that play sports pivoting sports such as soccer, football, and basketball, are at higher risk for an ACL injury.

How is it diagnosed?

Typically, when diagnosing an ACL injury, the athlete story is really helpful, and they will usually describe feeling a ‘pop’ while doing a pivoting manoeuvre. An MRI can then help us diagnose more specifically where the damage has occurred: either meniscus tears, cartilage tears, or additional damage to other structures in the knee.

How is it treated?

The options for ACL injury include both conservative and surgical care. As most athletes wish to return to their pivoting sports we advise ACL repair. ACL reconstruction is a surgery that uses tendons from elsewhere, such as the hamstring, patella, or quad, to repair and reconstruct the ACL structure inside the knee. Rehabilitation after surgery is essential for a successful return to play.

How can it be prevented?

There are certainly factors that can be improved to decrease the risk for ACL injury. The FIFA 11+ Injury Prevention Program has clearly shown that you can reduce the incidence of ACL injuries based on a very specific training programme.