Anterior cruciate ligament (ACL) tear
Understanding this condition
The anterior cruciate ligament (ACL) is one of two ligaments at the centre of the knee. It plays an essential role in stability: it prevents the tibia from sliding forward under the femur during changes of direction and pivoting movements.
ACL rupture most often occurs during a sports injury: pivoting of the knee with the foot planted on the ground (skiing, football, rugby, handball) or a direct blow. The ligament tears completely or partially.
Symptoms
At the time of injury, the patient often feels a snap or pop, followed by acute pain and rapid knee swelling (within a few hours). At this stage, the diagnosis is often made.
Once the acute phase has passed, instability dominates: a sensation of the "knee giving way" during changes of direction, descending stairs, or pivoting. Straight-line walking is generally possible, but pivoting sport becomes impossible without apprehension.
How can it progress?
A torn ACL never heals spontaneously. Chronic knee instability leads to repeated sprains, which eventually damage the menisci (secondary lesions) and then the cartilage. In the medium to long term, the risk is early-onset osteoarthritis.
For sedentary patients willing to give up pivoting sports, physiotherapy alone may be sufficient. For young, athletic, or active patients, reconstruction is generally recommended.
Treatment options
In the acute phase: rest, ice, analgesics, physiotherapy to recover mobility and muscle bulk. This phase lasts several weeks.
Then, the indication for surgical reconstruction depends on lifestyle: pivoting sport, age, perceived instability, associated lesions. Reconstruction is performed arthroscopically using one of your own tendons as a graft. A consultation allows discussion of the indication and technical choices.