What is an Anterior Cruciate Ligament (ACL)?

The knee joint is held up by four ligaments - structures in the knee that connects the thigh and shin bones and helps to control joint movement. There are two ligaments deep inside the knee, namely the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL); and one on each side of the knee (the collateral ligaments).

What is the function of the ACL?

The ACL controls how far forward the tibia (shinbone) can "slide" forward relative to the femur (thigh bone) and essentially prevents excessive anterior movement. While some degree of motion or sliding is normal and required for knee function, excessive motion may damage other structures in the knee, resulting in long-term problems in certain patients.

The ACL also provides stability to the knee when it is subjected to torsional and rotatory movements.

What is an ACL injury?

An ACL injury is caused by the overstretching or tearing of the ligament in the knee. The tear may be partial or complete. It is a common injury among athletes who subject their knees to intense stresses due to the physical demands of their respective sport.

What causes ACL injury?

An ACL injury is common in athletes who play sports such as basketball, football, sepak takraw or downhill skiing. It can occur when:

• The knee sustains an injury from the side for instance during a football tackle.
• The knee joint is over extended, such as when kicking the ball over the net insepak takraw.
• The knee experiences an abrupt change of direction; including stopping while running, landing from a jump or sudden turning.

What are the symptoms of an ACL injury?

Early symptoms of an ACL injury may include:

• Swelling
• Pain
• Locking
• Difficulty when weight-bearing
• Inability to continue playing

Late signs/symptoms of an ACL injury may include:

• Instability (knees “giving way”)
• Meniscal tears
• Locking
• Stiffness

If left untreated, an ACL injury may lead to cartilage degeneration or arthritis.

How is an ACL injury diagnosed?

To properly diagnose an ACL injury and to obtain the right treatment, our experienced doctors in REHABCENTRIC at Ara Damansara Medical Centre will assess you by conducting a medical history and a comprehensive physical examination in order to determine if your ACL is torn and to assess your mobility.

Your physician will also check other structures in the knee such as the meniscus and collateral ligaments which may be involved in an ACL injury.

An MRI of the knee is frequently required for an accurate diagnosis prior to proceeding with definitive management.

What are the treatments available for an ACL injury?

There are several treatments your physician may suggest depending on the severity of the injury.

For immediate symptom relief following an ACL tear, your physician may utilise the RICE method, which is:

• Rest
• Ice
• Compression
• Elevation

These simple strategies may allow you to manage the early symptoms prior to obtaining definitive management

Rehabilitation (Physiotherapy) is offered at ADMC for ACL injuries as it:

• Helps restore range of movement
• Strengthens the muscles around the knee
• Allows you to return to normal gait (walking)
• Improves coordination and proprioception
• Is important prior to undergoing surgery
• Rehabilitation following ACL reconstructive surgery

Why would you need surgery for an ACL injury?

Your physician may suggest surgery for your ACL injury based on factors which take the individual patient as a whole. These include: Type of sporting activity

• Function/occupation
• Age
• Associated injuries (i.e Meniscus)
• Degree of instability
• Multi-ligament injuries

An ideal candidate for ACL reconstructive surgery would be an individual who is:

• Young
• Active in sports
• Professional athletes
• In a physically demanding job (i.e army, heavy lifting)
• Having other ligament injuries (PCL, MCL, PLC)
• The need for revision surgery (having failed previous ACL surgery)

Our physicians and surgeons at REHABCENTRIC at Ara Damansara Medical Centre (ADMC) have years of experience and will provide you with the best treatment while guiding you through this journey.