Medically Reviewed by Dr Wang Lushun
Senior Consultant Orthopaedic Surgeon
MBBS (S’pore), MRCS (Edinburgh), MMed (Ortho), FRCS (Ortho) (Edinburgh)
Knee injuries are common, especially among active individuals and those who participate in sports. One of the most well-known and serious knee injuries is an anterior cruciate ligament (ACL) tear.
The ACL plays a crucial role in stabilising your knee, particularly during movements that involve sudden stops, pivoting, or changes in direction. When this ligament is injured, it can significantly affect your mobility and ability to stay active.
Recognising the symptoms of an ACL tear early is important. Prompt diagnosis and treatment can help prevent further damage to the knee and improve long-term outcomes.
The anterior cruciate ligament (ACL) is one of the key ligaments in your knee joint. It connects the thigh bone (femur) to the shin bone (tibia) and helps keep the knee stable during movement. The ACL is particularly important for sudden changes in direction, pivoting or twisting movements, jumping and landing.
An ACL tear occurs when this ligament is overstretched or completely torn; and common causes include:
In particular, sports such as football, basketball, skiing, and tennis are frequently associated with ACL injuries.
An ACL tear often occurs suddenly and is usually associated with classic symptoms that develop almost immediately after the injury. Many patients can recall the exact moment it happened, especially during sports or physical activity. They include:
While many ACL injuries are painful, not all tears present with severe or disabling symptoms. In some cases, the initial pain may subside quickly, leading individuals to underestimate the severity of the injury. However, subtle signs can indicate a torn ACL and should be taken seriously.
In these situations, individuals may still be able to walk or carry out daily activities, but the knee often feels unreliable. This underlying instability suggests that the ligament may no longer be functioning properly. Continuing to stay active on an unstable knee can place excessive strain on other structures within the joint, increasing the risk of secondary injuries such as meniscus tears or cartilage damage.
Recognising these warning signs is important—but knowing when to seek medical attention is just as critical. Certain symptoms, especially following a sports injury or sudden twisting movement, may indicate a more serious knee injury that requires prompt evaluation.
You should see a doctor if you experience:
Even if the symptoms seem mild at first, ongoing instability or recurrent swelling should not be ignored. Early assessment allows for an accurate diagnosis and timely treatment, helping to prevent further damage and improve long-term outcomes.
If you suspect an ACL injury, consulting an orthopaedic specialist is an important next step towards getting an accurate diagnosis and appropriate care. Here’s what you can expect:
Your doctor will take note of details such as a sudden twist, a popping sensation, or rapid swelling can provide important clues that point towards an ACL tear.
This is followed by a physical examination to assess the stability of the knee, which may also include carefully and gently performing specific manoeuvres.
Lastly, an MRI scan will also be carried out as it can confirm the presence of an ACL tear and identify any associated injuries, such as meniscus damage or cartilage wear. In some cases, an X-ray may also be performed to rule out fractures.
Together, these assessments allow for an accurate diagnosis and a comprehensive understanding of the injury.
Treatment for an ACL tear depends on individual factors such as the severity of the tear, the patient’s lifestyle, activity level, and their expectations for recovery.
For some patients, particularly those with lower activity demands or partial tears, non-surgical treatment may be sufficient. This usually involves a tailored rehabilitation programme focused on strengthening the muscles around the knee and improving joint stability.
However, for those who wish to return to sports or experience ongoing instability, surgical treatment may be recommended. Depending on the nature of the injury, this may involve procedures such as ACL repair, where the existing ligament is preserved and reattached, or ACL reconstruction, where the torn ligament is replaced with a graft to restore stability to the knee.
Returning to sports after an ACL injury is a gradual process that requires patience and proper rehabilitation. The focus is not just on healing, but on ensuring that the knee is strong, stable, and ready to handle the demands of sport.
In the early stages of recovery, the priority is to reduce swelling and regain range of motion. As recovery advances, more sport-specific movements are introduced to prepare the body for a safe return to activity.
For patients who undergo ACL reconstruction, returning to sports typically takes several months. However, timelines can vary depending on individual progress, and it is important not to rush the process as returning too early increases the risk of re-injury.
At Arete Orthopaedic Centre, our orthopaedic specialist Dr Wang Lushun is experienced in the diagnosis and effective management of all ACL injuries, so that you can return to your daily life safely and with confidence.
MBBS (S’pore), MRCS (Edin), MMed (Ortho), FRCS (Ortho) (Edin)
With over 20 years of experience, Dr Wang Lushun is an orthopaedic surgeon who specialises in treating a wide range of sports injuries and musculoskeletal conditions. He has in-depth experience in minimally invasive surgery and advanced robotic surgery. Dr Wang provides orthopaedic care to athletes and everyday individuals throughout their journey to recovery.
