Conditions / Ligament injuries
An ACL tear is a rotation problem, not just a torn rope.
The anterior cruciate ligament stops the shin bone sliding forward and, just as importantly, stops it rotating under the thigh bone when you cut, land or pivot. When it tears, the knee gives way in exactly those moments. Most tears happen without contact.
Interactive procedure guide
Ligament stability, explained.
You can still switch views and read every explanation.
01 / Torn ACL
A break in the restraint
The separated ends show a torn ACL. Move the slider to see an exaggerated illustration of the forward movement and rotation that can occur when the ligament is deficient.
Look for the gap in the highlighted ligament.
Explore the anatomy
Illustrative anatomy. Colours, movement and implants are simplified to explain the principle; they do not show a specific patient or predict an outcome.
Signs
- A pop at the moment of injury
- Swelling within the first few hours
- The knee giving way when turning
- Difficulty trusting the knee on stairs or uneven ground
When surgery is, and is not, the answer
Reconstruction is usually recommended for people who want to return to pivoting sport, for knees that give way in daily life, and where the meniscus is also torn and needs protecting.
Non-operative management with structured rehabilitation is a reasonable choice for lower-demand knees that stay stable, and it is discussed as a real option rather than a fallback.
How it is done
The graft is taken from your own hamstring, quadriceps or patellar tendon, chosen according to your sport, age and anatomy.
In patients at higher risk of re-tearing, typically younger athletes returning to pivoting sports, a lateral procedure on the outside of the knee is added. This addresses the rotational control the ACL alone does not fully restore. Dr Catteeuw trained in this technique with the group that published the evidence for it.
Multi-ligament injuries, where two or more ligaments are torn, are planned as a single reconstruction wherever possible.
What recovery looks like
- Walking without crutches: about two weeks
- Cycling and straight-line running: around three months
- Change of direction and sport-specific training: six to nine months
- Return to competitive pivoting sport: nine to twelve months, based on strength testing rather than the calendar
Timelines are typical ranges and are individualised. Progress is judged on strength and function, not dates.
Talk it through
If this sounds like your knee, contact Mediclinic to arrange a consultation with Dr Catteeuw. Bring any existing scans and reports so you can discuss the options together.