What is the ACL and how does it tear?
The anterior cruciate ligament connects the thigh bone and the shin bone inside the knee and keeps the knee stable, especially in twisting. Most tears are non-contact injuries: a sudden stop, a change of direction or a bad landing.
A meniscus, cartilage or other ligament injury often comes with it, so the whole knee must be assessed.
Symptoms
- A pop or tearing feeling at the moment of injury, then swelling within hours
- The knee giving way, especially when turning
- Pain and restricted movement in the first days
Diagnosis
An experienced examination can largely assess the ligament; MRI confirms the diagnosis and shows associated injuries.
Treatment
Rehabilitation
For some patients who do not play cutting sports and whose knee does not give way, a strengthening programme without surgery is an option.
Arthroscopic reconstruction
For patients who want to return to sport or whose knee gives way, the torn ligament is rebuilt through keyhole surgery, usually with a graft from the patient's own tendon. The graft is chosen by age, sport and the state of the knee; additional procedures that support rotational stability can be planned when needed.
Recovery and return to play
Rehabilitation starts the day after surgery and continues for months. In the general literature return to play is usually planned for 9–12 months. Prof. Gürsoy has published a study showing that recovery after ACL reconstruction follows different patterns between patients — so the decision to return is based on strength, balance and hop tests rather than the calendar.
Common questions
Will a torn ACL heal on its own?
Complete ACL tears usually do not heal by themselves, although some patients achieve a stable knee without surgery.
When should I have surgery?
Usually once the initial swelling settles and the knee regains its range of motion; locking may require earlier surgery.
Can it tear again?
There is a risk of re-tear; full rehabilitation and a test-based return decision aim to reduce it.