The anterior cruciate ligament (ACL) is an important ligament for proper movement. It is one of two ligaments that cross in the middle of the knee, connects your thighbone (femur) to your shinbone (tibia) and helps stabilize your knee joint.ACL injury more commonly causes knee instability than injury to other knee ligaments.


Anterior cruciate ligament tear can be from mild to completely torn:

ACL Anatomy


Most ACL injuries happen during sports and fitness activities. The ligament may tear when you:

–   Slow down suddenly to change direction or pivot with your foot firmly planted

–  Twisting

–  Hyper extending your knee.

–  Landing awkwardly from a jump

–  Falls during downhill skiing

–  A football tackle

–  Motor vehicle accident

Signs and symptoms

–  Hearing a sudden popping sound

–  Swelling

–  Instability of the knee

–  Pain


  1. Clinical Examination:

–  The pivot-shift test

–  The anterior drawer test

–  The anterior drawer test

–  The Lachman test

  1. MRI


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  1. Physiotherapist:

a)      If the tear is mild then patient need to seek for physiotherapy intervention:

–  Ice /cryocuff

–  Rest

–  Raise injured leg

–  Ultrasound therapy

–  TENS (transcutaneous nerve stimulation)

–  Strengthening exercise (static quads)

–  Swimming

–  Wearing a knee brace/knee support

b)      Post-Surgery:

–  Phase 1: management of pain and swelling while regaining movement

–  Phase 2: In weeks 3 and 4, when the swollen knee and the pain reduce. The patient will be able to start going exercises such as mini wall sits and riding stationary bikes. The aim is to be able to bend the knee 100 degrees.

–  Phase 3: Weeks 4 and 6 are the controlled ambulation phase. The patient will try to get their knee to bend 130 degrees during this stage. The aim during this period is to focus heavily on improving balance.

–  Phase 4: This is the moderate protection phase, covering weeks 6 to 8. In this period the patient will try to obtain full range of motion as well as increase resistance for the workouts.

–  Phase 5: This is the light activity phase, covering weeks 8 to 10. Rehabilitation during period places particular emphasis on strengthening exercises, with increased concentration on balance and mobility.

–  Phase 6: This is the return to activity phase, lasting from week 10 until the target activity level is reached. At this point the patient will be able to start jogging and performing moderately intense agility drills. Somewhere between month 3 and month 6 the surgeon will probably request that the patient perform physical tests to monitor the activity level.

  1. Doctor: Surgery to rebuild the ACL

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–  Do NOT move your knee if you have had a serious injury.

–  Use a splint to keep the knee straight until you see a doctor.

–  Do NOT return to play or other activities until you have been treated.

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