What is the anterior cruciate ligament (ACL)?
The anterior cruciate ligament, often abbreviated as ACL, is a vital component of the knee joint. It connects the femur to the tibia, running diagonally across the center of the knee. Its role is to limit the forward sliding of the tibia relative to the femur and to control rotational movements. Along with the posterior cruciate ligament (PCL), it forms a cross in the center of the joint, giving them their name.
In the event of an ACL tear, knee stability is severely compromised. This can lead to loss of control of the joint, significant discomfort, and, in some cases, an inability to continue sports or professional activities.
What are the causes and risk factors for an ACL tear?
La rupture du ligament croisé antérieur survient généralement à la suite d’un traumatisme, souvent lors de la pratique d’un sport. Elle est particulièrement fréquente dans des disciplines comme le football, le ski, le basketball, le rugby ou encore le handball, où les changements rapides de direction, les pivots ou les réceptions de sauts sont nombreux. Cette blessure peut être causée par un mouvement de torsion brutal, un freinage soudain, une chute ou un contact direct sur le genou.
Certain factors increase the risk of rupture: a lack of physical preparation, poor perception of the movements performed, fatigue or muscular imbalance.
What are the symptoms of an ACL tear?
The clinical signs of an ACL tear are often immediate. The patient typically feels a cracking or tearing sensation at the time of injury, followed by sharp knee pain. Very quickly, the knee may swell, a sign of bleeding into the joint (hemarthrosis).
Subsequently, a feeling of instability is common, as if the knee were giving way, particularly during rotating movements or on uneven ground.
These symptoms should prompt you to consult a healthcare professional quickly to confirm the diagnosis.
Prevention of ACL tears
Preventing anterior cruciate ligament (ACL) injuries relies on rigorous physical preparation, particularly for those involved in high-risk sports. Dr. Coulin emphasizes the importance of targeted muscle strengthening—particularly of the quadriceps, hamstrings, glutes, and core—to ensure better control of joint movement and limit stress on the knee.
He also recommends movement awareness training, which is essential for improving balance, coordination, and neuromuscular responsiveness. Finally, a proper warm-up, mastered technique (particularly when jumping and changing direction), and a gradual return to training after an injury can significantly reduce the risk of an ACL tear.
What is the diagnosis to be established?
The diagnosis of an anterior cruciate ligament tear is initially based on a clinical examination performed by a doctor or orthopedic specialist. Specific tests are used to assess knee stability.
In case of suspicion, an MRI of the knee is generally prescribed. This medical imaging test allows visualization of the ACL and detection of any associated lesions (menisci, cartilage, etc.).
An X-ray may also be performed to rule out a fracture.
What are the possible treatments for an ACL tear?
Treatment for a torn ACL depends on several criteria, including age, activity level, patient expectations, and severity of instability.
- For sedentary people or those whose activities do not place intense strain on the knee, conservative treatment may be considered. It is based on rehabilitation, muscle strengthening, and adaptation of movements to avoid instability.
- In young, active, or athletic patients, or in cases of persistent instability, surgical treatment is generally recommended. The procedure involves reconstructing the ACL using a tendon graft, often taken from the patellar tendon or hamstrings.
After surgery, structured post-operative rehabilitation is essential. Returning to sport is gradual, generally between 6 and 12 months after surgery.
Do you think you may have torn your ACL?
Dr. Coulin welcomes you to Geneva to establish a precise diagnosis and, with you, develop a personalized treatment plan, adapted to your goals—whether they are athletic, professional, or related to your quality of daily life.
