Medically reviewed by Dr. L. Bharath , Consultant Orthopaedic Surgeon, Bharath Orthopaedics
A knee injury can affect much more than your ability to play sports. It may make walking, climbing stairs, getting up from a chair or even standing for long periods uncomfortable. If your knee feels unstable after an injury, an anterior cruciate ligament (ACL) tear could be one possible reason.
At Bharath Orthopaedics, Chennai, patients with suspected ACL injuries can undergo an orthopaedic assessment to understand the nature of the injury and the available treatment options. Depending on the severity of the tear, knee stability, activity level and overall health, treatment may involve physiotherapy or surgical reconstruction.
ACL surgery in Chennai is generally considered when a torn ligament causes persistent knee instability or when a patient wishes to return to activities that involve running, jumping and sudden changes in direction. The decision should always be based on an individual clinical assessment rather than the MRI report alone.
What is an ACL Injury?
The anterior cruciate ligament (ACL) is one of the important ligaments inside your knee joint. It connects the thigh bone (femur) to the shin bone (tibia) and helps maintain knee stability.
The ACL plays an important role when you:
- Run or change direction suddenly.
- Jump and land on your feet.
- Turn or twist your knee.
- Participate in sports such as football, cricket, basketball and badminton.
- Perform activities that involve sudden stopping or acceleration.
When this ligament is stretched or torn, the knee may lose some of its normal stability. The injury can be partial or complete, and the symptoms vary from one person to another.
What Causes an ACL Tear?
An ACL injury can happen during sports, exercise or everyday activities. It does not always require a direct blow to the knee.
Some common causes include:
1. Sudden change in direction: Turning quickly while running can place excessive rotational stress on the knee.
2. Incorrect landing: Landing awkwardly after a jump may cause the knee to twist or move inward.
3. Sports injuries: Football, cricket, basketball and badminton involve movements that can increase the risk of ligament injuries.
4. Direct impact: A collision or tackle that forces the knee into an unnatural position can damage the ACL.
5. Road accidents and falls: Sudden trauma can also result in ligament injuries.
Not every knee injury is an ACL tear. Meniscus injuries, collateral ligament injuries and other knee conditions can produce similar symptoms. A proper assessment is therefore important.
What are the Symptoms of an ACL Tear?
Some people notice symptoms immediately after the injury, while others experience instability during certain movements.
Look out for the following signs:
- A popping sound or sensation at the time of injury.
- Sudden pain in the knee.
- Swelling that develops within a few hours.
- Difficulty putting weight on the affected leg.
- A feeling that the knee is slipping or giving way.
- Difficulty bending or fully straightening the knee.
- Reduced confidence while walking, running or climbing stairs.
One important point is that pain may decrease after the initial injury, even when the ligament remains damaged. Therefore, improvement in pain does not necessarily mean that the ACL has healed.
If you experience severe pain, significant swelling, inability to bear weight or a visibly deformed knee, seek prompt medical attention.
How is an ACL Tear Diagnosed?
An ACL injury cannot be confirmed by symptoms alone. An orthopaedic evaluation helps determine whether the ligament is damaged and whether other structures inside the knee are affected.
The assessment generally involves the following:
- Clinical examination: The doctor will ask how the injury occurred, when the symptoms started and whether your knee feels unstable. Physical tests such as the Lachman test, anterior drawer test and pivot-shift test may be performed when appropriate.
- MRI scan: An MRI scan is commonly used to assess the ACL and identify associated injuries involving the meniscus, cartilage and other ligaments.
- X-ray: An X-ray may be recommended to check for fractures or other bony abnormalities. It does not directly show the ACL.
The diagnosis is based on the patient’s history, physical examination and relevant imaging findings.
Does Every ACL Tear Require Surgery?
No. Not every ACL injury requires an operation.
The treatment depends on the extent of the ligament injury, the patient’s age, physical activity, knee stability and associated damage.
Non-surgical treatment may be considered when:
- The tear is partial and the knee remains functionally stable.
- The patient does not participate in activities requiring frequent pivoting.
- Knee stability can be maintained with rehabilitation.
- The patient’s symptoms improve with appropriate physiotherapy and activity modification.
Treatment may include:
- Physiotherapy to strengthen the muscles surrounding the knee.
- Exercises to improve balance and coordination.
- Temporary activity modification.
- A knee brace in selected cases.
- Medication for pain management when medically appropriate.
When might ACL surgery be recommended?
ACL reconstruction may be considered when:
- The knee repeatedly gives way during daily activities.
- The patient wants to return to sports involving pivoting and sudden movements.
- Knee instability continues despite rehabilitation.
- Associated meniscus injuries require surgical management.
- The patient’s functional requirements cannot be met with non-surgical treatment.
The decision should be made after discussing the expected benefits, limitations, risks and alternatives.
What is ACL Reconstruction Surgery?
ACL reconstruction is a surgical procedure in which the damaged ligament is replaced with a graft to help restore knee stability.
It is commonly performed using arthroscopic (keyhole) techniques. A small camera and specialised instruments are inserted through small incisions around the knee.
The procedure generally involves:
- Anaesthesia: Appropriate anaesthesia is administered based on the patient’s medical condition and anaesthetic assessment.
- Arthroscopic examination: A camera is used to examine the inside of the knee and assess associated injuries.
- Graft preparation: The selected graft tissue is prepared for reconstruction.
- Graft placement: Small tunnels are created in the thigh and shin bones to position the graft at the anatomical location of the original ACL.
- Graft fixation: The graft is secured using suitable fixation devices.
- Post-operative assessment: The knee is examined, and an individual rehabilitation plan is initiated.
The exact surgical approach depends on the injury pattern and the surgeon’s assessment.
What are the Different Graft Options for ACL Surgery?
During ACL reconstruction, the torn ligament is replaced using graft tissue. The choice of graft depends on the patient’s age, activity level, anatomy, sporting requirements and medical history.
This graft uses tendons from the back of the thigh. It is one of the commonly used options for ACL reconstruction.
2. Patellar tendon graft
A section of the patellar tendon is used to reconstruct the ACL. It may be considered for patients requiring particular graft characteristics. Some patients may experience discomfort at the front of the knee or while kneeling.
3. Quadriceps tendon graft
This graft is taken from the quadriceps tendon above the kneecap. It is another option that may be suitable for selected patients.
4. Allograft
An allograft uses donor tissue. It may be considered in selected situations, depending on the patient’s age, activity level and surgical requirements.
There is no single graft option that is suitable for everyone. The advantages and limitations of each option should be discussed before surgery.
How Long Does It Take to Recover After ACL Surgery?
Recovery after ACL reconstruction takes time and requires a structured rehabilitation programme. Patients should understand that returning to normal walking and returning to competitive sports are two different stages of recovery.
The recovery timeline varies according to the type of reconstruction, associated injuries, muscle strength and individual progress.
| Recovery stage | General rehabilitation goals |
| First 1–2 weeks | Pain and swelling management, gentle knee movement and muscle activation |
| Weeks 2–6 | Improving knee movement, walking and muscle strength |
| Weeks 6–12 | Progressive strengthening, balance and coordination |
| Months 3–6 | Advanced strengthening and gradual functional exercises |
| Months 6–9 | Sport-specific rehabilitation when appropriate |
| Months 9–12 or longer | Consideration of return to competitive sports after functional assessment |
These are broad rehabilitation stages, not guaranteed recovery deadlines. Patients who undergo additional meniscus or cartilage procedures may need a modified rehabilitation programme.
When can you return to sports?
Returning to sports should not depend on the number of months since surgery alone. The knee should demonstrate adequate strength, stability, movement control and psychological readiness.
A specialist and physiotherapist may use strength measurements, hop tests and functional assessments before allowing a patient to return to high-demand sports.
Returning too early can increase the risk of another ACL injury.
What are the Possible Risks of ACL Surgery?
Like other surgical procedures, ACL reconstruction has potential risks. Patients should understand these before making a treatment decision.
Possible complications include:
- Infection.
- Bleeding or blood clots.
- Persistent pain or swelling.
- Knee stiffness or restricted movement.
- Reduced muscle strength.
- Graft stretching or failure.
- Injury to nearby structures.
- Persistent instability or reinjury.
The likelihood of complications varies between patients. Following the recommended rehabilitation programme and attending follow-up appointments are important parts of post-operative care.
What is the Cost of ACL Surgery in Chennai?
The cost of ACL surgery in Chennai can vary depending on several factors.
These include:
- The type of ACL injury.
- Whether it is a partial or complete tear.
- The graft was selected for reconstruction.
- Whether meniscus repair or another procedure is required.
- Hospital and operation theatre charges.
- Anaesthesia and diagnostic investigations.
- Physiotherapy and rehabilitation requirements.
For this reason, an exact estimate should be provided only after reviewing the patient’s condition and proposed treatment plan.
Patients should ask for a clear explanation of the estimated expenses, including hospitalisation, surgery, investigations and rehabilitation.
Why is Rehabilitation Important After ACL Surgery?
Surgery is only one part of ACL treatment. Rehabilitation plays an equally important role in restoring knee function.
After reconstruction, the graft needs time to heal and undergo biological remodelling. Physiotherapy helps patients gradually regain movement, muscle strength, balance and coordination.
A rehabilitation programme may include:
- Knee range-of-motion exercises.
- Quadriceps and hamstring strengthening.
- Balance and proprioception training.
- Progressive weight-bearing exercises.
- Functional movement training.
- Sport-specific exercises when appropriate.
The exercises and their intensity should be adjusted according to the patient’s recovery and the surgeon’s instructions. Patients should not independently increase exercise intensity or return to sports without clearance.
When Should You Consult an Orthopaedic Doctor for an ACL Injury?
Do not ignore repeated knee instability after a sports injury or accident.
Consider an orthopaedic assessment if:
- Your knee repeatedly gives way while walking.
- You experience swelling after physical activity.
- You have difficulty returning to sports.
- Your knee feels unstable while climbing stairs.
- You have persistent symptoms despite physiotherapy.
- An MRI report suggests an ACL injury.
Early evaluation can help identify the extent of the injury and determine whether surgical or non-surgical treatment is appropriate.
ACL Surgery in Chennai at Bharath Orthopaedics
An ACL injury can affect your work, sports participation and everyday routine. Understanding the injury and available treatment options can help you make an informed decision.
At Bharath Orthopaedics, Chennai, patients can consult an orthopaedic surgeon for the assessment and management of knee injuries, including ACL-related conditions.
Treatment planning considers the patient’s symptoms, clinical examination, imaging findings and activity requirements. Where surgery is indicated, the treatment discussion includes the proposed procedure, graft options, possible risks and expected rehabilitation.
The focus is on providing clear medical information and an appropriate treatment plan based on each patient’s condition.
For consultation details, visit Bharath Orthopaedics
Read also: Recovery from Hip Replacement.