ACL tear — assessment and treatment

The knee relies on ligaments for stability because bony congruity is limited. The ACL is the most frequently torn knee ligament in many athletic populations.

Typical injury mechanisms include a twisting deceleration with the tibia shifting forward; associated meniscus or cartilage injury is possible.

After the acute painful swollen phase, many patients notice instability—especially with cutting, uneven ground, or returning to pivoting sports—even if day-to-day walking feels acceptable.

Repeated instability episodes can increase long-term risk to knee cartilage; that is why plans are adapted to age, activity demands, and exam findings.

Non-operative care focuses on strengthening and neuromuscular control; some patients adapt well, while others—often younger pivoting athletes—may proceed to ACL reconstruction when instability persists.

Reconstruction uses a graft (commonly hamstrings, patellar/quadriceps tendon, or allograft) placed in bone tunnels to restore anterior stability.

Rehabilitation is prolonged; return to high-demand pivoting sports often requires many months of structured progression.