What is ACL?

ACL or the Anterior Cruciate Ligament is one among the many ligaments that connect the knee bones (femur or the thigh bone and tibia or the leg bone) together. A ligament is a structure that connects the bones.


Why are the ligaments important? What is its function?

The ligaments around knee joint connects the bones together like a hinge connects the door to the wall.(muscles crossing the knee also have a similar role)


As there is usually more than 1 hinge for a door, there are many ligaments in the knee. Though there are many hinges, if one of them is damaged the door will shake when opening and closing and later it will cause damage to the door itself. Likewise, damage to just one ligament can cause uneasiness in the movements of knee and will cause damage to the knee in the long run.

Why is ACL particularly important than other ligaments of knee?

 Among all the ligaments, ACL is the one which is most commonly injured. Actually, ACL reconstruction (Surgery for the ACL tear) is the most commonly performed sports surgery.

All ligaments are important. But as ACL is most commonly injured, it just stays in the limelight. That’s all.

What is the difference between ACL tear and ACL injury?

Both are the same.

What is the treatment for an ACL tear?

Let me bring the analogy of door hinge here also.

When a hinge is damaged it can be managed in two ways

1)          Replacing the damaged hinge with a new one.

2)          Replacing the other normal hinges with more stronger ones.

Likewise, an ACL tear can be managed in two ways

1)          Replacing the damaged ACL with a new one – ACL reconstruction surgery.

2)          Making the other normal hinges of the knee more stronger ones – Muscle strengthening exercises.


Among the two treatment options, which is the best one?

As the muscle strengthening training needs much perseverance and motivation, the results of muscle strengthening are not so predictable.

The results of ACL reconstruction surgery is more predictable and so it has the upper hand.

But if the patient is motivated enough, and is ready to do surgery if the muscle strengthening doesn’t work for him/her, the muscle strengthening protocol is a good (though not the best) option to consider.


Are there any situations where the muscle strengthening option can’t be considered?

Yes, there is. Many of the ACL injuries came along with an injury to the meniscus also. (Meniscus are “washer” like tissues in between the knee bones).  Most of the meniscus injuries need surgery- either repair or balancing (removal of the torn part). In such cases ACL reconstruction is usually done along with the meniscus surgery as we can avoid a second surgery for ACL if needed.

What will be done to an injured meniscus?

All the injuries to the meniscus can't be repaired and it depends on, where on the meniscus the tear occored and how was it torn. If the meniscus tear is repairable, its better to get it repaired. When the tear is non-repairable we will trim the edges of the torn meniscus(balancing) to make it clean and to prevent the tear to progress.

When can I leave the hospital after surgery?

Usually you can leave the hospital within 1 or 2 days after surgery.

Do,s and Don'ts after surgery

You have to follow a rehabilitation plan following surgery which tipically consists of some form of support and some excercises which will be taught by your doctor before leaving hospital. The rehabilitation period usually lasts up to 9 months following surgery. 

Provided you have followed the rehabilitation plan following the surgery properly, there are not much "don's" after surgery. Once the rehabilitation is over you can do anything and everything you want as if there was no injury or surgery.

Care After Surgery

The immediate care after surgery differs depending on what(if anything) was done to the meniscus. 

If nothing was done to the meniscus or if the meniscus was trimmed into shape(balancing), you will be made to walk on the next day after surgery with a belt around your operated knee and with the help of a support.  If the meniscus is repaired, you need to give time for it to heal before weight bearing. Then you should avoid bearing weight on the operated leg for a month. Even then you can move around using your other leg and a walker support.

The wounds will be cleaned and stiches will be removed in between. 

The care after one month is almost the same for both cases. And it consists of some form of support and some excercises that you need to do which will be taught by your doctor in detail.

By about 9 months after surgery, you will be free to do anything and everything you were doing before the injury. You could play professional food ball or badminton, go for a hiking and anything you want......