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Anterior cruciate ligament injury (ACL)
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Anterior cruciate ligament injury at HCA UK
Why choose us?
Our dedicated knee specialists provide tailored treatment for anterior cruciate ligament (ACL) injuries, drawing on expertise from across 10 orthopaedic fields. Using advanced imaging technology, we deliver rapid, precise diagnosis to guide the most effective care.
From your initial consultation to full recovery, our goal is to restore your knee's stability, strength and function. We aim to get you back to an active life. With 97% of orthopaedic patients recommending us, you can feel confident you're in trusted hands.
From your initial consultation to full recovery, our goal is to restore your knee's stability, strength and function. We aim to get you back to an active life. With 97% of orthopaedic patients recommending us, you can feel confident you're in trusted hands.
The anterior cruciate ligament (ACL) is a strong band of cord-like tissue that runs across and inside your knee to keep it stable. The ligament attaches the thigh bone (femur) to the top of your shin bone (tibia).
Your ACL sits in front of your posterior cruciate ligament. They form a cross inside the knee, which is why the term 'cruciate' is in the name. The ACL serves three key functions:
ACL injuries happen when the ligament is stretched beyond its normal range of motion. They are categorised from Grade 1 to Grade 3. At the point of injury, a torn ACL can often sound like a 'snap' or 'pop'. The amount of pain experienced can vary depending on the severity of the injury.
In some instances, people may only suffer slight discomfort, while a tear of the anterior cruciate ligament can be incredibly painful for others. The different grades of ACL are:
Grade 1: An ACL sprain occurs when ligament fibres remain mostly unbroken. This injury will generally respond to rest and pain relief. In most cases, an injury like this can heal in anywhere between two and four weeks.
Grade 2: A partial ACL tear where some fibres of the ligament break as a result of a sudden impact or twisting movement to your knee. Partial tears of the ACL are less common than complete tears. Physical therapy can help improve the knee's stability, with recovery often taking up to three months.
Grade 3: A full tear, also known as an ACL rupture, is when the ligament snaps completely or becomes detached from the bone. This is a significant injury that is more common among athletes. It often results in damage to other areas of the knee, such as the meniscus or other ligaments. The tear is highly unlikely to heal without surgical intervention. A full recovery typically takes up to a year.
In some instances, people may only suffer slight discomfort, while a tear of the anterior cruciate ligament can be incredibly painful for others. The different grades of ACL are:
Grade 1: An ACL sprain occurs when ligament fibres remain mostly unbroken. This injury will generally respond to rest and pain relief. In most cases, an injury like this can heal in anywhere between two and four weeks.
Grade 2: A partial ACL tear where some fibres of the ligament break as a result of a sudden impact or twisting movement to your knee. Partial tears of the ACL are less common than complete tears. Physical therapy can help improve the knee's stability, with recovery often taking up to three months.
Grade 3: A full tear, also known as an ACL rupture, is when the ligament snaps completely or becomes detached from the bone. This is a significant injury that is more common among athletes. It often results in damage to other areas of the knee, such as the meniscus or other ligaments. The tear is highly unlikely to heal without surgical intervention. A full recovery typically takes up to a year.
A torn ACL can happen during everyday activity, but is also a common sports injury that may happen during an awkward landing, impact or sudden change of direction that results in a twisting motion in the knee. Common causes include:
- Getting your feet stuck while twisting. For example, a football boot getting caught on turf
- Landing awkwardly from jumping, perhaps after a gymnastics manoeuvre or when dancing
- Direct impact to the area, such as a bad tackle in football or rugby
When you tear your ACL, you may experience some or all of these symptoms.
The symptoms of an ACL injury include:
The symptoms of an ACL injury include:
- A popping or snapping sensation and sound at the time of injury
- Pain that increases as you try to move your knee or put weight on it
- Rapid onset of swelling
- Feeling unstable or unsteady when weight-bearing after the injury
- A feeling of stiffness in your knee, or feeling as though the joint is moving or buckling
If you experience a combination of symptoms and self-care is not working, you’ll likely need urgent care. Untreated ACL injuries can put extra pressure on other areas of the knee, leading to further complications.
Our Urgent Care Centres provide swift treatment to anyone over 18 with a non-life-threatening condition, and we see 96% of people within 15 minutes of arrival. At HCA UK, your medical team will first take measures to reduce any swelling. They'll then diagnose the extent of your injury and tailor a treatment plan especially for you.
Our Urgent Care Centres provide swift treatment to anyone over 18 with a non-life-threatening condition, and we see 96% of people within 15 minutes of arrival. At HCA UK, your medical team will first take measures to reduce any swelling. They'll then diagnose the extent of your injury and tailor a treatment plan especially for you.
No.1
in London for private orthopaedic care
10
specialist orthopaedic fields offering personalised treatment
97%
of our patients are likely to recommend us to family and friends
Fast access to specialists
appointments bookable online or by phone
Expert orthopaedic treatments
from specialist knee consultants
State-of-the-art diagnostics
with results in as little as 48 hours
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Anterior cruciate ligament tests and scans at HCA UK
Your knee specialist will assess you in detail. This will involve asking you a series of questions, examining your knee and typically undergoing an MRI scan. Your scan will be conducted by a consultant musculoskeletal radiologist. The MRI scan helps to confirm the diagnosis and uncover any damage to other parts of the joint. Your consultant will assess the severity of your injury and tailor a treatment plan for your onward care. Other types of tests may be necessary to ensure an accurate diagnosis, including:
- X-rays
- MRI scans
- Ultrasound scans
- Lachman test
- Pivot shift test
Anterior cruciate ligament treatments at HCA UK
Resting your knee is an important first step in recovery. Your consultant will guide you through the most suitable options based on how stable your knee feels, your daily activities and sporting goals.
Depending on your injury, you may not require surgery, but for more severe injuries, you may benefit from surgical repair. We offer both non-surgical and surgical treatments, supported by physiotherapy and rehabilitation , to help you regain movement and strength in your knee.
- RICE
- Pain relief
- Knee supports
- Modifying activity
- ACL reconstruction
Surgery to repair your ACL may be recommended if conservative treatment does not help your symptoms, you've suffered a serious ACL tear, or your job is physically strenuous. An operation might also be required if you've also damaged other ligaments, cartilage or bone.
Accessing private healthcare
Self-pay
You don’t need health insurance to be seen quickly. If you’re looking for a diagnosis or treatment and don’t want to wait, all our private healthcare services – from private GP appointments through to surgery and aftercare – can be paid for as and when you need them.
And to give you peace of mind from the start, we’ll offer you a clear and transparent quote outlining exactly what treatments you’re paying for.
Find out more
ACL FAQs
It's difficult to fully prevent ACL injuries as they often occur because of unexpected impacts or movements. However, there are some measures you can take to help prevent them:
Protective equipment: Knee braces can add support and protect your knees; they may potentially limit the damage or prevent an ACL tear in some instances.
Resting: Take time to fully recuperate after exercise or sport. When you push your body to its limits, it can exacerbate smaller injuries and result in an increased risk of an ACL injury.
Reduce risks: You could suffer a torn ACL from a fall at home or work. Clear away any trip hazards and use proper equipment if working at heights.
ACL prevention programmes: If you play high-risk sports or have a history of a partial tear, you might consider an ACL prevention programme. This involves exercises that aim to reduce the strain on the ACL and have been proven to reduce rates of injury.
Yes, they occur more often in sports with sudden stops, pivots or jumps, such as football, rugby, skiing and netball. Women face a higher risk due to their anatomy and hormones. Injury prevention training helps reduce this risk and keep you playing the sports you love.
It's unlikely that you'd be able to walk unaided straight away after suffering a complete ACL rupture. It may well become easier to walk on over time, but your knee could feel unstable or like it's 'locking' due to the joint's instability.
In the event of a partial tear or strain, you'll experience pain and discomfort when walking on the injured knee and doing so could increase your risk of exacerbating the injury.
In the event of a partial tear or strain, you'll experience pain and discomfort when walking on the injured knee and doing so could increase your risk of exacerbating the injury.
Untreated ACL tears can cause long-term knee instability, making it prone to giving way during activities. This can damage cartilage, the meniscus or other ligaments, and increase the risk of early arthritis. Without treatment, many people struggle to regain full strength, stability and confidence in their knee.
It typically takes over six months to return to physical activities after surgery for an ACL tear. Professional athletes are typically out of action for around eight to ten months after suffering an ACL injury.
Recovery times may be shorter in instances of partial ACL tears, while sprains to the ligament may heal in a matter of weeks with rest and the use of a knee brace.
Recovery times may be shorter in instances of partial ACL tears, while sprains to the ligament may heal in a matter of weeks with rest and the use of a knee brace.
Partially torn ACLs may heal naturally, but a lack of blood flow to the area generally means the process is slow and complete tears almost never heal.
These terms are sometimes used interchangeably but can have subtly different meanings. A ruptured ACL is when the ligament is completely torn or pulled away from the bone. Ligament tears can be partial when some of the ligament remains intact. A full ACL tear is the same as an ACL rupture.
The procedure typically lasts between one and two hours and is performed under general anaesthetic. Surgery to fix a torn ACL is typically done via arthroscopy (keyhole surgery).
Small incisions will be made in your knee so that your surgeon can use a camera and specialised tools to operate within the knee joint. As this type of surgery does not 'open' your knee, you can benefit from a faster recovery and less post-operative pain.
Your surgeon will create a new ligament using a graft. Tissue from the patellar tendon or hamstring tendon is most commonly used in ACL restoration, although in some cases, an artificial graft may be required. The graft will be held in place permanently by screws, buttons or staples that will remain in the joint.
Once your surgeon is happy that the repair is complete, your incisions will be closed with stitches or surgical tape, and your knee will be bandaged.
Small incisions will be made in your knee so that your surgeon can use a camera and specialised tools to operate within the knee joint. As this type of surgery does not 'open' your knee, you can benefit from a faster recovery and less post-operative pain.
Your surgeon will create a new ligament using a graft. Tissue from the patellar tendon or hamstring tendon is most commonly used in ACL restoration, although in some cases, an artificial graft may be required. The graft will be held in place permanently by screws, buttons or staples that will remain in the joint.
Once your surgeon is happy that the repair is complete, your incisions will be closed with stitches or surgical tape, and your knee will be bandaged.
You won't experience pain during the surgery as you'll be under anaesthetic, but the surgery site may feel sore when you come around, and your knee will likely feel stiff. This is usually manageable with pain relief medication.
Your costs will depend on your circumstances, including what diagnostic tests you require and the particulars of your surgery. Find out more about how you can pay for your treatment.
You can usually drive once you can confidently control the pedals without pain or hesitation. Always follow your consultant's advice and ensure your knee feels strong and stable before returning to driving.
You'll typically be sent home with crutches to use for a few weeks after undergoing surgery. Physiotherapy exercises will help strengthen the muscles around your knee. People are generally able to walk unaided around a month after surgery.
Yes, you can. With the right treatment and physiotherapy, many people return to their chosen sport. Most need six to twelve months to rebuild strength and stability. Following a gradual, guided programme helps you return confidently and safely, while reducing the risk of repeat injury.
You may be able to return to light duties or a sedentary job within a few weeks of surgery. However, if your job involves a lot of physical labour, it may be months before your knee is strong enough to support you at work.
Professional athletes often require a much longer period to undergo a rehabilitation programme to return to full strength. ACL injuries typically keep sportsmen and women out of action for up to a year.
Professional athletes often require a much longer period to undergo a rehabilitation programme to return to full strength. ACL injuries typically keep sportsmen and women out of action for up to a year.
Rehabilitation helps you regain strength, stability and full movement. You start with gentle exercises to control swelling and improve flexibility, then progress to balance and sport-specific training. With a commitment to physiotherapy, you can typically return to daily activities and sport within 12 months.
Our patient stories
Decades of pain, resolved in weeks
Now 46, Mike had been struggling with knee problems since he tore his right ACL during a football match at the age of 19.
Hana's recovery: Roaring back from a serious knee injury
Hana was a fearsome player on the pitch, but her commitment came at a price. In 2018 she tore her ACL (anterior cruciate ligament) and was seen by Mr Simon Thompson. He helped her get back to playing at a competitive level and Hana got to wear the England jersey she’d dreamed of. So, when she then suffered a meniscal tear in 2020, she knew who she was going to see.
Kriti’s story
As Kriti Singh stepped off the dance floor at her thirtieth birthday party in Varanasi, India, she felt a sharp pain in her right knee. With a ten-year history of knee trouble, this didn’t bode well.
“With hindsight, I should have dealt with my knee problems a long time ago. I'd say to anyone else in my position that if you're not sure about anything, you should seek the help of a specialist.”
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.