For a torn anterior cruciate ligament — one of the knee's main stabilising ligaments.
The anterior cruciate ligament (ACL) runs through the centre of the knee and stops the shin bone sliding forward and twisting. It is most often torn during sports that involve pivoting, sudden stops, jumping and landing — football, basketball, badminton and kabaddi among them.
A torn ACL does not heal back together on its own. Whether it needs reconstruction depends on your activity level, how unstable the knee feels, and whether other structures such as the meniscus are also injured.
A structured physiotherapy programme may be suitable for people with lower physical demands who do not experience the knee giving way.
ACL reconstruction is usually advised for active people, those who play pivoting sports, and knees that keep giving way or have other repairable injuries.
ACL reconstruction is keyhole (arthroscopic) surgery. The torn ligament is replaced with a graft — most commonly taken from the patient's own hamstring or patellar tendon — fixed in tunnels in the thigh and shin bones.
Any associated meniscus tear is usually treated during the same operation.
Rehabilitation is structured and progresses in stages over several months, guided by a physiotherapist. Return to sport is decided on the basis of strength, control and confidence in the knee, rather than on time alone.
It is worth an assessment after any twisting knee injury with a 'pop', rapid swelling, or a knee that feels unstable afterwards. An examination and MRI usually confirm the diagnosis.
Consultations at Sahyadri (Deccan), Bharati Vidyapeeth (Katraj) and Apollo (Swargate).
