Anterior cruciate ligament (ACL) tears are one of the most common knee injuries seen in running, cutting and pivoting sports such as AFL, soccer, netball, basketball and skiing. The ACL is a key stabiliser of the knee, helping control rotation and forward movement of the shin bone, so an injury can significantly impact confidence and performance.
Most ACL tears occur without direct contact, often when the foot is planted and the body twists, or with sudden deceleration and change of direction. Patients commonly report a popping sensation, rapid swelling and the feeling that the knee might give way, especially on uneven ground or when turning.
Diagnosis usually involves a careful clinical examination and an MRI scan to confirm the extent of ligament and associated cartilage or meniscus damage. Not every ACL tear needs surgery, but active patients involved in pivoting sports or those with instability are often advised to consider reconstruction or repair.
Treatment options include non-operative rehabilitation, ACL reconstruction using a tendon graft, or ACL repair in selected tear patterns. The best approach depends on factors such as age, sport, knee stability, associated injuries and personal goals, and should be discussed with a specialist knee surgeon.
Rehabilitation is critical to success and focuses on regaining range of motion, strength, balance and sport-specific control. Return to sport is usually guided by strength and functional testing rather than time alone, but for many patients this occurs around 9–12 months after surgery to minimise re-injury risk.