Anterior Cruciate Ligament (ACL)

Is intra articular ligament of the knee which stabilizes and facilitate normal knee motion during general walking as well as during playing sports.

ACL injury usually occurs in sports related activities such as sudden twist and deceleration while playing football or jumping up to hit volleyball. It also occurs due to direct trauma to the knee from a fall or traffic accidents.

In acute ACL injury, there will be moderate to severe pain and usually swelling follows due to the bleeding in the joint. It is not possible to continue sports activities or even unable to put on weight on injured knee and walk.

In old ACL tear or chronic ACL insufficient knee, most of the cases are able to walk and run but will have more or less the sense of knee instability, pain or sudden weakness and fell down during pivot activities. i.e. loss balance and fall after sudden twist or turn while running or landing on ACL deficient knee.

Acute tear or chronic ACL insufficiency can be diagnosed by careful patient injury history taking and proper physical examination. The x-ray and MRI are the imaging studies done to confirm diagnosis as well as to look for associate injuries such as a tear of meniscus, chip fracture or cartilage injury.

In young active patient or person who lives active life style and wish to continue sports are advised to go for surgical treatment option. Surgery is also advised in ACL injury associated with unstable meniscus, cartilages and multiple ligament injury.

ACL repair is done when there is avulsion (a chip fracture where ACL attaches to the tibial bone) and ACL reconstruction is done when there is midsubstance tear or peel off the bony attachment. These procedures can be done arthroscopically (Keyhole operation seeing through the camera and working with small sophisticated instruments).

Without ACL reconstruction the knee remains unstable and with sports participation, activities that require twisting, cutting, jumping actions will put other structure of the knee at risk and most likely will damage it in near future and eventually ends up with osteoarthritis of the knee joint.

Dr. Harjeet Singh Bhatia

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Arthroplasty Center : 0 2282 1100 # 0