ACL Reconstruction Surgery

We’ve talked a lot about anterior cruciate ligament (ACL) injuries, because they account for around 40 per cent of all knee injuries. Which means they are one of the most frequent problems seen by orthopaedic surgeons like Mr Punwar.

ACL injuries are particularly prevalent amongst athletes – particularly in sports like basketball and football, where pivoting occurs a lot. But anything that involves a sudden stop or change in direction can cause an ACL tear.

How do you know if your knee injury is a torn ACL?

Here are five major signals that your injury is a torn ACL:

A popping sound

This is probably the biggest giveaway of an ACL tear. At the time that the injury occurs, if you hear a popping sound coming from the affected knee, it is likely to be ligament damage.


The most common sign of an ACL tear is pain in the affected knee. Patients often report that the pain is immediate and worsens when they try to stand up. Athletes are unable to return to play. Of course, pain alone is not necessarily indicative of a specific injury. Most injuries will cause a certain level of pain – but in combination with the popping sound and other symptoms listed here it could suggest a torn ACL.


Whilst with some injuries swelling occurs slowly in the hours after the event. With an ACL tear the swelling tends to be immediate and obvious. This is because the ACL has a good blood supply which is disrupted when the ligament tears.

Instability/difficulty walking

Many patients with ACL tears report that they are unable to stand or put weight on the affected knee after the injury. Some say that when they try to stand, the knee buckles or gives way beneath them. It would therefore be very difficult for people with this injury to walk unaided. Other parts of the knee, such as the shock absorbers, are often damaged at the same time as the ACL. This can lead to locking and clicking.

Is it possible to have a partially torn ACL?

It is not only possible, but in fact very common to have a partial tear. Research has shown that between 10 and 27 percent of ACL injuries are partial tears. ACL tears are graded into three categories:

  • Grade 1 is the mildest category, where the patient is usually still able to walk and has some knee stability. The ligament has been stretched, but not fully torn
  • Grade 2 tears are where the ligament has been further stretched and is partially but not completely torn
  • A complete tear is Grade 3

What should I do if I think I have an ACL tear?

Following immediate treatment in an emergency department, if you think your knee injury might be an ACL tear, the best thing is to have it assessed by a specialist. Patients are usually given crutches, painkillers and have an X-ray in the emergency department but it can be difficult to make a definitive diagnosis at that time.

Orthopaedic surgeon Mr Shah Punwar is highly experienced in knee injuries and will perform a thorough examination as well as organising an urgent MRI scan where necessary. The road to recovery can be quite long after an ACL injury. Mr Punwar offers both careful surgical reconstruction and a personalised rehabilitation plan to get you back to sport as soon as possible.

If you have concerns about your knee injury, and would like to book a consultation with Mr Punwar at either of his practice locations, please call his LIPS practice team on 0208 194 8541.

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