ACL Tear

Dr. James - Orthopaedic Surgeon in Singapore

Written by Dr James Tan

Contents

    What Is an ACL Tear?

    The ACL, or anterior cruciate ligament, is a ligament in the knee that joins the thigh bone (femur) to the shin bone (tibia). Its main function is to prevent the shin bone from moving forward excessively below the thigh bone. The ACL also acts as the main stabiliser in the knee.

    When the ACL is injured, it is called an ACL tear injury. Research shows that almost half of the knee injuries are because of ACL tears. These tears may be quite painful and can get aggravated if not properly evaluated and treated by a doctor. Read along further to find out about the causes and types of ACL tears, diagnosis, and ACL tear injury treatment in Singapore.

    Causes of ACL Tear Injuries

    acl tear diagram

    Image Credit: Cleveland Clinic

    There are several causes of ACL tears including:

    • Changing direction suddenly while walking or running
    • Abruptly stopping while running, for example, in soccer.
    • Slowing down your speed abruptly while running
    • Jumping and landing from a jump in the wrong posture
    • Collision with another person that puts strain on the legs and knees.

    Types of ACL Tears

    ACL tears can primarily be divided into two main types:

    Partial ACL Tears

    • Happens when the ACL is only partially torn.
    • Partial ACL tear symptoms include mild to moderate knee pain, swelling, and instability.
    • Associated with a good prognosis.
    • Often rare.

    Complete ACL Tears

    • The majority of ACL tears are complete tears when the ligament is completely torn.
    • Symptoms include severe pain and instability in the knee that can cause it to buckle or give away.
    • Recovery from an ACL complete tear without surgery is almost impossible without surgery.

    ACL and meniscus tears are often confused with each other. To confirm your diagnosis of a particular grade of sprain and see if you have any other types of knee pain or injury, your doctor might call for an X-ray or MRI of your knee and provide a customised treatment plan for you.

    Visit our meniscus tear treatment page for more information on the causes, diagnosis and treatment options at Ray of Health.

    ACL Tear Symptoms

    Typical signs and symptoms of an ACL tear include:

    • You can hear the popping sound of the ligament rupturing when the injury occurs.
    • Pain starts immediately after the injury.
    • The knee starts to swell within hours.
    • It becomes difficult or almost impossible to walk.
    • You feel pain in the knee while standing or putting weight on the leg.
    • Your knee may feel unstable or loose at the joint making daily activities difficult
    • You may lose your range of motion in the knee.

    ACL Tear Diagnosis

    To diagnose an ACL tear, the qualified orthopaedic specialist will carry out a physical exam to check the knee for any inflammation and other signs of injury. The doctor may move the leg in certain positions to assess the location and extent of the injury. He may order additional imaging tests to view the internal structure of the knee and confirm the diagnosis. These imaging tests include:

    • X-rays: X-rays visualise the bony structures in your body. An x-ray of the knee will not specifically show the tear but it can help the doctor see if the knee pain is associated with a broken bone.
    • MRIs: MRIs are a good way to see the soft tissues of the knee and can help the doctor diagnose it effectively.

    Related Articles

    meniscus tear surgery

    Meniscus Tear Surgery and Prevention

    The meniscus is a crucial piece of cartilage in the knee that acts as a shock absorber between your thigh…

    acl tear

    How To Know If You Have An ACL Tear

    If you play some sports like football, basketball, tennis, or volleyball, chances are that you or someone you know has…

    acl tear

    Will An ACL Tear Heal on Its Own?

    Full ACL tears are not self-healing. These tears almost always require surgical intervention, usually through the minimally invasive procedure called…

    knee health

    Maintaining Strong and Healthy Knees: All You Need to Know About Knee Health

    Knee health is fundamental to enjoying an active and healthy life. From athletes to office workers, everyone can benefit from…

    knee injury

    Common Knee Injuries (and What You Need To Know to Prevent Them)

    Knee injuries can result from various activities, including sports and exercise. Some common injuries that require sports injury treatment and knee pain treatment include…

    Find ACL Tear Treatment in Singapore

    Whether you are a serious athlete or just happened to move the wrong way one day, you might have torn or sprained your ACL. As soon as you start dealing with knee pain, it is advised to visit a knee doctor and get examined properly so the ACL tear treatment can commence. If left untreated, it can lead to other complications, stressing the need to seek knee pain treatment as soon as possible.

    Looking to get treated for cruciate ligament ACL injuries in Singapore? We are ready to help! The orthopaedic knee specialist here at Ray of Health will diagnose your issue and create a customised treatment plan for you. We also offer other orthopaedic treatment plans for heel pain and rotator cuff tears.

    Why suffer in pain for another day? Reach out to us online, call +65 6235 8781, or chat with us on WhatsApp at +65 8028 4572. You can also talk to us by clicking the button below.

    Locations

    Camden Medical

    1 Orchard Boulevard, #09-06

    Singapore 248649

    Mount Alvernia Hospital

    820 Thomson Road

    Medical Centre D #05-60

    Singapore 574623

    Book an Appointment

    Please enable JavaScript in your browser to complete this form.

    ACL Tear Treatment With Dr James Tan

    Dr James Tan, our ACL tear specialist at Ray of Health, deals with various orthopaedic conditions of the body. He advises his patients to consult him in case of any pain or injury at the earliest so that the condition can be assessed and diagnosed properly.

    1. Registration: Firstly, register with Dr James' team and book an appointment here.
    2. First appointment: At the first appointment, Dr James Tan will carry out a thorough physical exam for your ACL tear, evaluate your medical history.
    3. Diagnosis: Typically, additional diagnostic tests are required to access the causes of the problems accurately. This usually comes in the form of MRI or X-ray scans.
    4. Personalised Treatment Plan: Dr James will then create a personalised treatment plan based on your specific condition and needs, which could include undergoing surgery, and recommend the necessary treatment modalities to you.
    5. Follow-up sessions: Dr James will schedule additional follow-up sessions to monitor the recovery process until you fully recover.

    Disclaimer: Treatment plans may differ for different patients. Please contact Dr James for more information.

    dr james tan

    Medisave & Insurance Shield Plan Approved

    If you are a Singaporean or a Permanent Resident of Singapore, some of our orthopaedic procedures can be claimed under Medisave. The claimable amount will vary based on the procedure's complexity.

    For other situations, please consult our friendly clinic staff regarding the use of your Integrated Shield Plan insurance.

    ACL Tear Treatment in Singapore

    An ACL tear can be a painful condition that may cause instability in the knees and difficulty in doing daily activities. The treatment for an ACL tear will depend on several factors such as the patient’s symptoms, age, lifestyle, kind of tear, and other related factors. Depending on each individual case, your knee specialist will determine whether it is to be treated through conservative options or through surgical intervention.

    ACL Tear Treatment Without Surgery

    Non-surgical treatment options for an ACL tear in Singapore are chosen for patients who have a minor tear, are older, or who lead a less active lifestyle. These conservative treatment options can include:

    Medication

    • Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen for a few days.
    • Help in reducing swelling associated with the injury.

    Joint Aspiration

    • The orthopaedic specialist may remove some fluid from the knee to relieve pressure from the area
    • This can improve the range of motion, and reduce pain and swelling.
    • This procedure is done under local anaesthesia where the doctor inserts a needle into the knee joint and removes the fluid.

    Lifestyle Modification

    • Avoid activities that put additional strain on the knees.
    • Give the knee enough rest to heal.
    • Applying ice to the affected area several times a day can also help with the pain and swelling.

    Injections

    Injections, on their own, are not considered a treatment option for a torn ACL. However, they may be used for symptomatic relief or as part of a combined treatment approach. The types of injections that may be used in case of ACL tear injury include:

    • Corticosteroid Injections: Steroid injections are primarily used to reduce inflammation and pain in the knee with the tear.
    • Platelet-Rich Plasma (PRP) Injections: Platelet-rich plasma (PRP) injections involve taking platelets from the blood of the same patient and injecting this plasma into the injury site to promote healing.
    • Stem Cell Injections: Stem cell injections involve injecting the injured site with stem cells obtained either from the same patient or from some other donor. These injections facilitate the regenerating process and may help in regenerating the torn ligament in the knee.

    Physical and Occupational Therapy

    • Physical therapy is also an important modality in the treatment of ACL tears.
    • The first goal of physiotherapy for ACL tear is to reduce swelling and inflammation by doing specific exercises and therapies, such as heat therapy.
    • Once the swelling has subsided, the therapist will focus on strengthening the knee muscles by doing specific exercises and stretches.

    Bracing

    A specialised knee brace can help support your knee after an ACL injury and go a long way in facilitating recovery. Such a brace can also help prevent future injuries.

    Surgical ACL Tear Treatment Options

    Your Singapore orthopaedic surgeon may recommend surgical intervention for your anterior cruciate ligament tear especially if you are a sportsman or a person who wishes to return to a high level of activity. A torn ACL is not usually repaired as that involves repairing it with sutures. However, this procedure has been shown to fail over time. Therefore, surgical treatment for a torn ACL involves reconstructing the ACL.

    ACL Reconstruction Surgery

    The ACL reconstruction surgery involves replacing the torn ligament with a graft. The surgery is carried out arthroscopically in which the surgeon makes very small incisions on the knee. An arthroscope, which is a narrow tube that has a fibre-optic video camera attached to its end, is inserted through one of the incisions. The camera guides the surgeon to carry out the procedure in a much less invasive manner. The surgeon inserts thin surgical instruments through the other incisions to reconstruct the ligament. The process comprises the following steps:

    • First of all, the surgeon cleans the knee joint area and removes the torn ACL.
    • After that, the surgeon prepares the graft according to the size of the torn ligament where it is to be placed.
    • To attach the graft to the thigh bone and shin bone, small holes are drilled into the bones.
    • The graft is then threaded through the bone tunnels and fixed to the bones through screws and other fixation devices to hold the graft in place.
    • Finally, the incisions are closed through sutures and the knee is bandaged.

    ACL reconstruction surgery through arthroscopy is a minimally invasive procedure that results in lesser post-surgery pain and enables the patient to recover much faster as compared to an open knee surgery.

    Revision ACL Surgery

    When an initial ACL reconstruction fails or if the ACL is re-injured, it will call for a revision surgery.

    • A revision ACL surgery is much more complex as compared to a first-time reconstruction surgery.
    • There could be scar tissue in the knee area from the previous surgery, the bone structure might have changed, and the previous graft would need to be removed before replacing it with a new one.
    • Such a revision surgery may need to be carried out as an open knee procedure instead of arthroscopy.
    • The kind of graft the surgeon chooses for the revision surgery may differ from the previous graft choice.

    Graft Sources For ACL Surgery

    The graft that the surgeon chooses for an ACL reconstruction or revision surgery can be obtained from different sources discussed below:

    Patellar Tendon Autograft

    A patellar tendon autograft is a graft taken from the same patient’s patellar tendon, which connects the kneecap to the shin bone.

    Hamstring Tendon Autograft

    Hamstring tendon autograft is obtained from the semitendinosus hamstring tendon on the posterior and medial length of the thigh and inner side of the knee.

    Quadriceps Tendon Autograft

    Quadriceps tendon autograft is usually used for ACL reconstruction in patients who are taller and heavier. The graft is obtained from the middle-third part of the patient’s quadriceps tendon and a bone plug from the top of the kneecap.

    Allografts

    The grafts that are taken from other human donors instead of from the patient himself are called allografts. Allografts are mostly used for patients who have had a failed ACL reconstruction or who require repair and reconstruction in more than one knee ligament.

    Do I need Surgery For My ACL Tear?

    ACL surgery may be required in case you have a severe ACL tear and if you want to return to sports. However, if you're having a minor ACL tear, recovery can be done through rehabilitation.

    4 Non-Surgical ACL Treatment Options

    Physiotherapy

    Physiotherapy can help strengthen the muscles around the knee, improve range of motion and improve overall knee stability. This is suitable for mild to moderate ACL injuries.

    Bracing

    Wearing a knee brace can provide support and stability to the knee joint.

    Activity Modifications

    Avoid high-impact or high-risk activities that can strain the knee. 

    Pain Management

    Over-the-counter drugs, ice therapy and other pain management techniques can reduce discomfort.

    Exercises to Relieve ACL Tear Pain

    Play Video

    ACL Tear Treatment With Dr James Tan

    Dr James Tan, our knee pain specialist at Ray of Health, Singapore deals with various orthopaedic conditions of the body. Dr Tan offers comprehensive ACL tear treatment, having experience in treating professional athletes and sportsmen from Singapore National teams.

    At the first appointment, Dr James Tan will carry out a thorough physical exam for your ACL tear pain, evaluate your medical history, and order any additional diagnostic tests if required. He will then create a personalised treatment plan based on your specific condition and needs, and recommend the necessary treatment options to you. Contact him today for more information about ACL tear treatment or any other orthopaedic condition.

    Frequently-Asked Questions About ACL Tear Treatment

    The most common cause of an ACL tear is when the ACL is torn during sports activities such as basketball, football, and rugby. You may also tear your ACL if you are old and your ligaments and tendons have started degeneration.

    Disclaimer

    The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice or treatment. Always consult your healthcare provider or specialist doctor regarding any medical condition that you might be facing and act on the doctor’s recommendations.

    References:

    1. Jennifer Evans; Ahmed Mabrouk; Jeffery l. Nielson, "Anterior Cruciate Ligament Knee Injury", National Library of Medicine, National Center for Biotechnology Information, 2023, https://www.ncbi.nlm.nih.gov/books/NBK499848/
    2. C. Benjamin Ma, MD, David C. Dugdale, MD,  A.D.A.M. Editorial team, "Anterior cruciate ligament (ACL) injury", 2022, https://medlineplus.gov/ency/article/001074.htm
    3. Benjamin Todd Raines, Emily Naclerio, and Seth L Sherman, "Management of Anterior Cruciate Ligament Injury: What's In and What's Out?", 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609378/

    About The Author

    dr james tan

    Dr James Tan Chung Hui

    Dr James Tan is a skilled orthopaedic surgeon at Quantum Orthopaedics located at Camden Medical and Mount Alvernia Hospital, known for providing specialised medical services. Dr Tan has more than 10 years of experience in sports surgery and exercise medicine in Singapore. Apart from partnering with the industry to introduce various treatment techniques, Dr Tan has treated athletes from the Singapore National Teams and professional footballers from the Singapore Premier League and the Young Lions.

    Dr Tan specialises in treating sports injuries of the knee, shoulder and elbow joints, as well as cartilage and meniscus surgery. He is a member of the elite Asian Shoulder and Elbow Group and a founding member of the Singapore Shoulder and Elbow Surgery Society.

    Medical Education and Affiliations
    MBBS - National University of Singapore (NUS), Faculty of Medicine
    Member of the Royal College of Surgeons of Edinburgh (MRCS)
    MMed - Master of Medicine in Orthopaedic Surgery (NUS)
    Fellow of Royal College of Surgeons (Edinburgh)
    Adjunct Assistant Professor | NUS, LKC
    Senior Consultant Orthopaedic Surgery, Sports and Exercise Medicine
    Head of Department | Orthopaedic Surgery and Sports Medicine Centre
    Awards
    Principal Investigator of Tissue Engineering
    National Medical Research Council grants
    Collaboration with Scientists at NTU, TUM, A*Star, Osteopore & Trendlines Medical Singapore

    Follow us on social media!

    Accreditations

    1. Mount Elizabeth Orchard
    2. Mount Elizabeth Novena
    3. Farrer Park Hospital
    4. Mount Alvernia Hospital
    5. Aptus Surgery Centre
    6. Novaptus Surgery Centre

    Insurances

    1. Great Eastern
    2. Prudential
    3. HSBC Life

    Corporate

    1. MHC
    2. Fullerton
    3. Adept
    4. Alliance