What is an ACL Tear?
It is a tear of the anterior cruciate ligament (ACL), one of the strong bands of tissue that connect your femur (thigh bone) to your tibia (shinbone). The ACL runs diagonally in the middle section of the knee. It prevents the tibia from sliding out in front of the femur and allows for rotational stability to the knee. ACL tears typically occur in sports that involve abrupt stops or changes in direction, jumping and landing.
What are the Different Types of ACL Tears?
- Grade 1: The ACL has sustained mild damage but still provides sufficient stability to the knee
- Grade 2: The ACL has been stretched and partially torn
- Grade 3: The ACL has been torn completely and is unable to provide stability to the knee
What are the Symptoms of an ACL Tear?
- A “popping” sensation in the knee
- Intense pain
- Rapid swelling
- Loss of range of motion
- Instability of the knee
- Knee giving way when bearing weight
What are the Common Causes of an ACL Tear in Singapore?
- Abruptly slowing down and changing direction
- Pivoting with your foot
- Landing awkwardly from jumping
- Stopping suddenly
- Receiving a direct blow to the knee
What are the Risk Factors of an ACL Tear?
- Being female: This may be related to differences in anatomy, muscle strength and control as females tend to have greater thigh muscle imbalances as a result of weaker hamstrings.
- Participation in certain sports: Sports like soccer and basketball require frequent and abrupt deceleration.
- Poor conditioning: Not being adequately prepared in terms of conditioning and technique to participate safely in certain sports.
- Using poorly maintained equipment: Using sports equipment that are not properly maintained or properly used, will increase one’s risk of injury.
- Wearing ill-fitting footwear: Wearing shoes of the wrong size can increase pressure on the knee, reduce support of the knee, and result in poor alignment of the knee.
What are the Complications of an ACL Tear?
People who have experienced an ACL tear have a greater likelihood of developing chronic knee instability, secondary knee injuries, knee arthritis, restricted mobility and muscle weakness around the knee. Hence, this makes timely and targeted treatment all the more important, so that the risk of complications may be minimised.
How are ACL Tears Diagnosed?
Your Singapore orthopaedic surgeon will first conduct a physical examination to check for swelling, deformity and tenderness. The doctor may carefully adjust your leg or have you move your leg in certain ways, so as to assess the location, extent and type of injury.
Other imaging tests may also be recommended in order to get a clearer look at the internal structures of the knee to confirm the diagnosis. These tests include X-rays, magnetic resonance imaging (MRI) scans and ultrasound scans.
What are the Treatment Options for an ACL Tear?
For mild ACL tears, your doctor may recommend non-surgical treatment, which includes:
- Wearing a brace: This provides stability and minimises side-to-side knee movement.
- Physiotherapy: Through the series of exercises prescribed, patients are able to restore their knee’s range of motion and increase knee strength.
- RICE (Rest, Ice, Compression, Elevation): Rest the affected leg and apply ice packs appropriately to the injured knee to reduce pain and swelling. Some patients may also be asked to wrap a tight, elastic bandage around the injured knee and elevate the knee to help reducing swelling.
In cases where ACL surgery in Singapore is recommended, however, then it may involve:
- ACL reconstruction: The most common type of surgery for ACL tears, it involves removing the damaged ACL and replacing it with a graft made of tissue from another part of the patient’s body (such as the hamstring or patellar tendon) or a donor.
- ACL repair: This is only done for certain types of partial ACL tears whereby the ACL can still be stitched back together.
How Long is the Recovery Time after ACL Tear Surgery?
Depending on the extent of the ACL injury and the type of surgery performed, recovery time can vary. In general, patients take at least several months to fully recover from an ACL surgery.
In the weeks following surgery, patients may need crutches and a knee brace; on top of physiotherapy for months in order to strengthen and condition their knee properly. It is important to attend follow-up checks with your doctor and get their clearance before resuming any sports activity.
Can an ACL Tear Heal Without Surgery?
Complete ACL tears cannot be healed without surgery, and only some minor ACL tears may be able to heal on its own through the help of physiotherapy. It is important to seek the advice of an orthopaedic doctor to attain the right diagnosis and treatment.
Can You Still Walk with a Torn ACL?
Yes, walking is possible but it is difficult and painful. If you suspect an ACL injury, it is best to rest the area immediately and seek medical treatment. Walking on a torn ACL may worsen the condition and increase the risk of complications.
Is ACL Surgery Painful?
ACL surgery is painless as general anaesthesia is administered and patients will be asleep throughout the surgery. A few days following the surgery will be the most painful, but it will be managed by adequate pain relief medication and rehabilitation. Subsequently, the pain will gradually subside the course of a few weeks.
Can I Make a Full Recovery after ACL Surgery?
Many people do make a full recovery and return to full activity following ACL surgery, especially if they have been actively participating in the rehabilitation process. Other contributing factors include the extent of the injury and the type of procedure performed.