Anterior Cruciate Ligament Tear

By | June 10, 2022

The function of the anterior cruciate ligament is to stabilize the knee joint. It supports rotational movements and forward movement. If the anterior cruciate ligament is torn, the knee becomes unstable. Consequential damage to the cartilage and menisci can also occur.

What is an anterior cruciate ligament tear?

Force can tear the cruciate ligament. It can be cracked or completely torn. An anterior cruciate ligament tear occurs separately or is part of a larger knee injury.

The knee is painfully swollen due to the tear and its mobility is restricted. A feeling of instability and insecurity develops. The damaged cruciate ligament can lead to buckling events. Typically, thighs and lower legs move against each other in an uncontrolled manner. For coronary heart disease (chd), please visit

For some of those affected, the symptoms only appear later, with permanent stress. Typically, the ACL tear is often a sports injury . Exercise-intensive sports with many changes of direction can lead to a cruciate ligament rupture.


The most common cause of a cruciate ligament tear is extreme twisting trauma to the knee joint. This rotation in the joint when the lower leg is stationary can cause several knee injuries.

In addition to the anterior cruciate ligament tear, damage to the collateral ligaments and other accompanying injuries to cartilage and menisci can occur. An anterior cruciate ligament tear is always caused by an unusual overload and force on the knee joint. It was then stretched, flexed, or twisted excessively. An anterior cruciate ligament tear does not require any external influences. It can already occur when the femur is forcibly overstretched.

Since very strong forces are required, previous damage can often play a role. The cruciate ligament may have been slightly torn for a long time, or cartilage may only be present in a degenerated form. A blow from the front can also tear the anterior cruciate ligament. Football, skiing or martial arts are known to cause such injuries.

The “unhappy triad”, an unfortunate combination of three types of injury, often occurs. Then, in addition to the anterior cruciate ligament, the inner side ligament and inner meniscus of the knee are also affected.

Symptoms, Ailments & Signs

An anterior cruciate ligament tear is normally associated with significant and long-lasting pain, which persists even at rest. In most cases, those affected can diagnose a cruciate ligament rupture themselves, since normal movement is no longer possible. Even the smallest movements cause a lot of pain, so a visit to the doctor should not be put off.

An existing cruciate ligament tear can only be restored with appropriate treatment and care. In many cases, surgery is even possible to ensure a full and timely recovery. However, if you do not visit the doctor at this point, you must expect the course of the disease to be significantly more difficult.

Under certain circumstances, permanent consequential damage can occur that can no longer be eliminated afterwards. In many cases there is severe swelling in the area of ​​the affected knee. These swellings can be seen with the human eye without any problems.

At the latest when such a swelling occurs, an appropriate doctor should be consulted immediately. The following therefore applies: A tear in the front cruciate ligament always requires medical, medicinal or even inpatient treatment. Otherwise, there will be significant complications that cannot be resolved so quickly.

Diagnosis & History

A thorough clinical examination is very important for the exact diagnosis of the anterior cruciate ligament tear. An experienced doctor should not only identify the tear. Furthermore, the degree of instability is also very important.

An initial suspected diagnosis can be made with movement tests. However, since the knee joint often cannot be moved completely in the event of a tear in the anterior cruciate ligament, the examination is made more difficult. The doctor is dependent on the patient describing the accident as precisely as possible. To get a more accurate picture, the doctor can perform a puncture of the knee joint.

To do this, he pricks a bent knee with a needle. The withdrawn liquid is then examined in detail. It is determined whether there are indications of a ligament injury. Magnetic resonance imaging ( MRI ) offers certainty as to whether it really is a case of a tear in the anterior cruciate ligament. It makes the anterior cruciate ligament visible and also reveals concomitant injuries.

The course of the disease is influenced by the patient’s age, physical activity and the time of diagnosis or the start of appropriate therapy. If the anterior cruciate ligament tear is consistently treated conservatively or surgically, there are good prospects of regaining full functionality. However, the leg muscles must be trained well over the long term.


If an anterior cruciate ligament tear is treated promptly, there are usually no major complications. However, with insufficient physical therapy and in older patients, a rupture can lead to premature joint wear. Osteoarthritis results in chronic pain, restricted mobility and other secondary problems.

Problems can also arise during cruciate ligament surgery. In some cases, bleeding, joint infections, thrombosis or injuries to the nerves, muscles or vessels occur, for example. Postoperative complications cannot be ruled out either. Occasionally, after cruciate ligament surgery, movement is restricted or the transplant loosens.

In individual cases, meniscus damage or a fracture of the kneecap occurs. Permanent instability only remains in exceptional cases. When the patient takes painkillers, there are always certain risks and side effects associated with it.

In addition to typical symptoms such as headaches or skin irritation, an allergic reaction to the drug can rarely occur. If the drug is taken over a longer period of time, the internal organs, especially the kidneys, liver and heart, are increasingly stressed. Sometimes addictive behavior develops or the patient experiences withdrawal symptoms after stopping.

When should you go to the doctor?

If health irregularities occur after a rotational movement, an accident or a force on the knee, a doctor should be consulted. If there are complaints in the knee area after severe overloading, it is also advisable to clarify the complaints. A doctor is not needed if the symptoms are already alleviated within a few minutes or within half an hour. In these cases, sufficient relief and protection should take place. If a symptom-free status is achieved after a short time, there is no further need for action.

However, if the knee can no longer be loaded as usual despite a sufficient rest period, if swelling develops or if the joint movement can no longer be carried out as usual, a doctor’s consultation is necessary. Irregularities in movement or the inability to move need to be investigated and treated. Pain, discolouration of the skin and a feeling of discomfort when performing only small movements indicate a disorder of the joint. To clarify the extent, a doctor must be consulted. If the appearance of the foot is already associated with symptoms, the person concerned needs medical care. The symptoms are to be understood as warning signals from the organism.

Treatment & Therapy

The first therapeutic measure for a tear in the anterior cruciate ligament is to stabilize the joint. Immediately after the accident, the leg must be rested and elevated. Furthermore, cooling makes sense and applying a pressure bandage. A doctor can prescribe various painkillers and anti- inflammatories for the pain or inject them directly.

Cold therapy and physiotherapy are used as conservative therapy methods. The exact form of therapy depends on the extent of the clinical and subjectively experienced instability. If the patient has only a low level of stress and little instability, a non-surgical treatment method may be sufficient. Special strength and coordination training for the affected knee is recommended.

An anterior cruciate ligament replacement, a surgical procedure, is recommended for very active patients, children and adolescents. In this way, recurring buckling events and consequential damage can be avoided. An operation can only be carried out after a rest phase, when the knee has completely gone down again.

During an operation, the torn anterior cruciate ligament is replaced with the body’s own tendon transplant. The inner thigh flexor tendons are often used for this. General surgical risks occur, but are very rare with this method.


In order to prevent a cruciate ligament rupture, it makes sense to thoroughly warm up the muscles before any sporting activity. Coordination exercises are also recommended. Other preventative measures include well-trained leg muscles, prudent sporting behavior and suitable sports equipment.

If the anterior cruciate ligament is treated surgically, the inserted transplant needs several months until it has grown firmly into the bone. Athletes therefore have to wait around six months before they are allowed to put full weight on the affected knee again.


The follow-up treatment of an operated cruciate ligament begins immediately after the operation. The patient protects and cools the knee to counteract swelling and pain. Stretching the knee is also important, which is why a motor splint is usually used. It passively moves and stretches the joint.

Wearing a knee brace for up to six weeks is also recommended. It ensures that the knee cannot be bent more than 90 degrees during this period. In the first weeks of rehabilitation, the load and scope of the exercises are adjusted to the current condition of the knee. First and foremost, the strengthening of the thigh muscles such as knee extensors and squatters, which are extremely important for the stability of the knee.

At first, the patient is only allowed to tense and relax the muscles. He also does squats later on. The use of a bicycle ergometer, a leg press or aqua jogging are considered sensible training measures. The patient learns from the physiotherapist which measures are best suited to him or her individually.

You can do that yourself

If there is a suspicion of an anterior cruciate ligament tear, the affected leg must first be immobilized and rested. Cold packs or ice spray help against the pain and any swelling. The affected leg must then be stabilized with a bandage. A doctor’s appointment must also be made at the same time.

Cooling and protection apply immediately after the operation. The passive stretching of the joint is achieved by means of a motor splint. The most important self-help measure is regular physiotherapy. A physiotherapist must accompany the entire follow-up treatment so that the intensity of the training can be adapted to the current condition of the knee.

As soon as the anterior cruciate ligament rupture has largely healed, gentle exercise, such as swimming or aqua jogging, can be started. Excessive loads should be avoided. To promote muscle coordination, coordination exercises are also available 15 to 25 days after the operation, which can be carried out independently after a medical introduction. The blood circulation in the affected joint is stimulated by cold/warm showers and relaxed movements.

Finally, it is important to avoid uncontrolled movements. At the same time, an anti-inflammatory diet must be followed. Fresh vegetables, fish and saturated fat are on the menu, while wheat should be replaced with millet or oats.

Anterior Cruciate Ligament Tear