Anterior Cruciate Ligament [ACL] Tear

FAQS about ACL

Dear patient the information provided to you is based on the evidence-based literature available with the intention of providing insights into the ACL tear, its symptoms and treatment available.

What is ACL?

ACL [anterior cruciate ligament] is an important knee joint stabilizing structure which bridges the thigh bone and shin bone.

How does ACL tear?

It is basically a sports related injury which happens in contact sports like football, basketball, kabaddi and also it is commonly seen in bike related accidents.

Why is ACL important?

ACL along with providing stability to the knee, protects menisci and articular cartilage from damages thereby preventing osteoarthritis.

Can ACL heal on its own?

ACL does not heal by itself because of lack of blood supply.

What are the symptoms of ACL tear?

Knee instability, occasional pain, loss of quadriceps strength.

What is treatment for ACL tear?

In an ideal situation like young and active patients, arthroscopic ACL reconstruction surgery is the answer. But in middle aged individual with less active lifestyle and with preexisting arthritis of knee joint it can be managed conservatively

Does an active middle-aged adult require ACL surgery?

Obviously yes, of course age is just a number, studies have shown successful results are even achieved in older patients.

What happens in untreated ACL tears?

Untreated and symptomatic ACL tears lead to secondary meniscal tears and cartilage damages which will progress to osteoarthritis.

Do partial tears require surgery?

It depends on the percentage of ligament involved and the kind of physical demand the patient has.

What is the ideal timing for ACL surgery?

There are conflicting debates, in our hands early ACL reconstructions have given good results. Also, in coexisting pathologies like meniscus tears, cartilage injuries, multi ligament knee injuries earlier the better.

What is the duration of hospitalization?

Approximately 24-36 hrs. of stay required for antibiotic prophylaxis and general care.

Is physiotherapy required after ACL surgery?

All the patients will be guided through a customized physiotherapy program to achieve excellent results which will be started at the earliest.

When can you walk after ACL surgery?

Generally, the following day after surgery with crutch assistance for up to 3 weeks. Beyond 3 weeks patient can walk without assistance.

What is done in ACL reconstruction surgery?

After diagnostic arthroscopy, torn ACL is debrided, anatomical tunnels are created in femur [thigh bone] and tibia [shin bone] to receive the prepared graft tissue and will be secured in the bony tunnels with implant devices in both the ends of femur and tibia

What are the graft choices for ACL reconstruction?

Commonly hamstring tendon and bone patellar tendon is used, also quadriceps tendon, peroneus longus tendon can be used depending on the co-existing ligament injuries.

What are latest trends in ACL reconstruction?

Anatomical single bundle ACL reconstruction, Double bundle ACL reconstruction, All-Inside ACL reconstruction are possibilities as of today.

Is ACL repair possible instead of reconstruction?

ACL repair is a revived concept of earlier times. With improved technology and proper case selection as in young patients, femoral peel offs and bony avulsion if done in 3 weeks of time we can expect good results.

When can I resume to attending office?

In case of sitting job – 2 weeks, Jobs which demands walking – 4 to 6 weeks.

When can I return to play?

For a non-contact sport like badminton, table tennis it is about 4 months.

Jogging in 4 months,

Contact sports like football, basketball, cricket in 6 months.

Can ACL tear be prevented?

Yes, with adequate conditioning programs, sports specific approach.