Torn ACL

A torn cruciate ligament is very painful and is caused by a sudden twisting of the knee, for example during sports or an accident. Slipping or a misstep can also be the cause. In addition to pain, symptoms also include swelling and overextension of the knee or the inability to straighten. Sagging at the knee is also common. Before treatment, the doctor must first conduct a thorough examination.

What are the cruciate ligaments?

Cruciate ligaments are two knee ligaments that ensure that the knee is stable and that the lower leg does not move in a strange way compared to the upper leg. There are two cruciate ligaments on each knee: the anterior and posterior cruciate ligaments. When one or both ligaments are torn, the knee loses its stability. For example, the leg can be overextended: bent forward too much.


Very often the cause of a torn cruciate ligament is an accident or during sports. If the knee is suddenly twisted, the cruciate ligament can tear. We see this more often in sports that involve jumping up and turning, where the knee makes a rotating movement and can no longer absorb this. Stepping or slipping can also be the cause, where the upper leg rotates differently than the lower leg. The foot is often stuck on the ground or stuck somewhere, causing the knee to twist. It is often the anterior cruciate ligament that has to absorb the blows and becomes damaged. Less commonly, the posterior cruciate ligament is damaged. The cruciate ligament may be strained or torn. There is a big difference in terms of treatment.


Both a strained and torn cruciate ligament cause pain. The knee becomes swollen and very painful. It is often not possible to bend or straighten the knee due to the pain. The knee can often be overextended because it is less stable, but the knee can also be locked. This depends on the type of cruciate ligament that is damaged. Sometimes there is a sinking of the knee and an unstable feeling of the knee. When the cruciate ligament tears, a tearing or snapping sound can often be heard, but not everyone notices this.


The knee should be examined by a doctor. Sometimes the swelling is very large because blood has entered the joint. The swelling can be reduced by draining the blood using a needle. This must always be done by a doctor: never puncture the knee yourself! Reducing the swelling is necessary for a proper examination. The doctor will examine whether the kneecap is still in place and whether there is a fracture of the knee joint. The doctor checks whether the knee joint has become unstable. The foot is placed on the table and the knee is slightly bent. The doctor will slide the foot forward and simultaneously scan the knee joint. If the joint feels unstable, there is a good chance that there is a torn cruciate ligament. If the injury is unclear, an X-ray can be taken. It may also be decided to make a scan of the knee. The examination can be quite painful, but it is necessary. If necessary, take paracetamol beforehand.


A strained cruciate ligament will go away on its own without treatment after two to three weeks of rest. This is different when it turns out that the cruciate ligament is torn. A pressure bandage or plaster cast will be applied and left in place for several weeks. In addition, the knee must be relieved. Walking on crutches is sometimes necessary. The muscles around the knee can be trained with the help of physiotherapy. Strong muscles make the knee joint more stable. If it appears that the above treatment does not help, you may consider undergoing cruciate ligament surgery. Often it is the anterior cruciate ligament that is torn and when this requires surgery we also call it an anterior cruciate ligament operation.
The old cruciate ligament is removed under anesthesia and replaced by a cruciate ligament made from the hamstring tendon or the patellar tendon. The tendon of the hamstring is often taken for this purpose. Two tendons are removed. The doctor will size and prepare these tendons to replace the cruciate ligament. The new cruciate ligament is attached to the bone using dissolvable screws. Sometimes they are made of titanium. In any case, the screws do not have to be removed later: a new operation is therefore not necessary unless the operation was unsuccessful. Afterwards, the knee will be bandaged and the knee will have to be relieved for some time. then you can slowly start loading the knee. Physiotherapy is recommended.

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