Anterior Cruciate Ligament (ACL) Rupture

What is a rupture of the Anterior Cruciate Ligament (ACL)?

The Anterior Cruciate Ligament (ACL) is one of the major ligaments in your knee providing stability and support during movement. An ACL rupture occurs when the knee is pushed into an abnormal movement that results in it being stretched or torn, often through sudden twisting motions or direct impact. It's a common injury in athletes, particularly those involved in sports with start-stopping or person-to-person impact like basketball, soccer, netball, and football.

How is a ruptured ACL diagnosed?

Symptoms of ACL ruptures include:

Sudden Pain: You may experience an immediate, sharp pain in your knee at the time of injury.
Swelling: Swelling and inflammation usually follow soon after the injury.
Instability: Many individuals report feelings of instability or a sensation that their knee may give way.
Limited Range of Motion: You may find it difficult to fully straighten or bend your knee.

If you suspect you've ruptured your ACL, it's crucial to seek medical attention promptly. It is common for the knee to be painful and moderately swollen after the injury. Over the next few days the swelling should start to reside and the range of motion should start to increase again along with the ability to weight bear without pain.

Diagnosis is usually after a history of the mechanism of injury, and a clinical examination from a trained physiotherapist, doctor or surgeon. An MRI scan is usually done to confirm the diagnosis as well as look for other associated structures injured such as meniscal tears.

How is a ruptured ACL treated?

The treatment approach for ACL ruptures depends on various factors, including the severity of the injury, your activity level, and your overall health. Not all ACL ruptures require surgery and, in some cases, conservative treatments such as physiotherapy rehabilitation and bracing may be sufficient, particularly for individuals who are less physically active, have degenerative change or who have partial tears.

Dr Eardley-Harris has been extensively trained and has experience in both ACL reconstruction in children, adolescents and adults including both non-operative and operative intervention and will discuss with you further details specific to your knee injury and recovery after setting your tailored management pathway.

ACL Reconstruction Surgery to Treat a Ruptured ACL:

For many active individuals, especially athletes, ACL reconstruction surgery may be recommended. During this procedure, the damaged ACL is replaced with a graft, typically taken from the patient's own hamstring, patellar tendon, or quadriceps. This surgery aims to restore stability to the knee and reduce the risk of further injury, especially when put through pivoting motions or heavy impact sport.

Occasionally further surgery besides the ACL reconstruction needs to happen to the knee at the same time. This can include surgery on the meniscus, graft harvest or extra tightening procedures such as the lateral extra-articular tenodesis (LET). This can mean extra incisions and length to your surgery time. A lateral extra-articular tenodesis (LET) is where a small piece of the iliotibial band is refashioned for additional stabilisation to the knee along with the reconstruction.

Recovery from your ACL reconstruction surgery requires time and dedication to rehabilitation. The rehabilitation may change depending on your injury but generally involves a time and goal-based program that strengthens the muscles around your knee as well as guidance on gradually returning to activities and sport by a trained physiotherapist. The ability to return to sport is usually around the 12-month mark.

ACL reconstruction in children and adolescents who are still growing may be different as any surgery needs to respect the size of the child and the growth plates. The rehabilitation program can also be different with a focus on neuromuscular activation and minimising pressure to the growth plates which can alter the timing and exercises expected for children compared to adults.

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Note: The information on this page is for educational purposes only and should not replace consultation with a qualified healthcare provider. Always seek professional medical advice for you, and your child's specific condition.

Meet Nathan

Adult & Paediatric Hip and Knee Surgeon

Dr Nathan Eardley-Harris has experience in providing care for patients throughout the entire spectrum of life

As an Australian-trained Orthopaedic Surgeon based in Adelaide, South Australia specialising in hip and knee surgery covering very young children to the elderly and everyone in-between, Nathan offers personalised care to help patients find the best outcomes in every unique condition.

He has subspecialty, post-fellowship training in hip preservation surgery and joint replacement, including robotic & technology-assisted surgery across all approaches, including the direct anterior approach. Through compassion, communication, collaboration & competence, Nathan aims to build patient-surgeon trust, helping you understand your condition and the options available to empower you to make better treatment decisions toward your personal recovery goals. With stronger, better-informed patient-surgeon relationships, evidence-based surgical techniques and the latest assistive technology, Nathan aims to provide patients with the best possible care.

My Approach

Personalised Care

Your condition, goals and challenges are unique to you, and your management should reflect that. There is no one-size-fits-all method for treatment - your care is tailored to your situation.

Evidence-based, Modern Technology

With the latest technology including robotics and 3D personalised planning to support evidence-proven surgical techniques, you get accurate, precise results. If surgery is necessary, it’s customised to your situation.

Collaboration With Professionals

See the right team of elite health professionals, hand-selected to provide you with the best outcomes given your condition, rehabilitation & goals.

Comprehensive Surgical Care

Decision for Surgery

Together we have made the decision that surgery is the best pathway forward. Our team will discuss with you the timing and the location of your surgery, including the expected length of stay in hospital.

Personalised Surgical Planning

Dr Eardley-Harris will sit down and plan your specific surgery to best achieve your goals. This may involve further tests needed for the planning, as well as any unique circumstances to your condition or injury.

Preparation

Prior to surgery, you will be given specific instructions to be ready for the operation. This may include certain tests, medication management, and pre-surgery & aftercare information.

Day of Surgery

On the day of surgery, Dr Eardley-Harris will visit you in the pre-operative room, and answer any other questions that you have, and ensure that you are ready for your procedure. During your surgery, our team will ensure you are comfortable and well-informed.

Recovery

Following surgery you will enter the recovery room, with specialised nursing care. Here, you and your family will be informed of the findings, allowing you to be confident in the outcome. You will follow your pre-planned aftercare procedures to allow your body to recover.

Questions

Choosing surgery is a significant decision that often involves careful consideration of various factors. If you have any questions throughout your process, feel free to ask Dr Eardley-Harris' team for further clarity.

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