ACL Tears

The anterior cruciate ligament is one of four main ligaments within the knee that connects your thigh bone (femur) to your shin bone (tibia) helping to stabilise the knee. Injuries to the anterior cruciate ligament often occur during athletic activity and are caused by sudden changes in direction, pivoting movements, landing awkwardly, stopping suddenly or after receiving a direct blow to the knee. ACL tears can be partial or complete and most commonly occur after significant stretching of the ligament. The knee will typically swell significantly after an ACL tear and walking on it will be painful.

The immediate treatment of an ACL tear involves the RICER protocol (rest, ice, compression, elevation and referral). The knee should be rested in an elevated position and an ice pack applied every two hours for twenty minutes at a time. A compression bandage should be applied around the knee to limit swelling and bleeding. Taking Panadol and over the counter anti-inflammatory tablets such as Nurofen or Voltaren can reduce the pain and swelling. You should see your GP if the knee feels unstable or significantly symptomatic. After excluding a fracture with an X-ray, weight bearing will usually benefit the knee and encourage recovery. Seeing a physiotherapist early will also help you to regain movement and prepare you for either surgery or non-surgical treatment. Your GP may then refer you to an Orthopaedic Surgeon for further management and advice.

Early surgery is often not necessary except when more than one ligament is torn. Ongoing treatment will depend on your symptoms and lifestyle. Non-operative management involves physical therapy +/- bracing and may be appropriate if the knee is stable and minimally symptomatic and/or for those living a less active lifestyle. Operative management involves reconstruction of the anterior cruciate ligament.