The anterior cruciate ligament (ACL) is the main ligament that stabilises the knee during twisting/pivoting activities. It is commonly injured whilst playing sport, such as football or netball, and skiing in the winter months.

My philosophy around an ACL injury is that surgery is not always indicated, but a stable knee that you can trust is essential.

Physiotherapy exercises can help improve muscle control and stability, but in active patients wishing to get back to sports surgical reconstruction is often required to enable a stable knee.

I need to perform an accurate assessment of your knee in a timely fashion to ensure that there are no other associated injuries (meniscal tears or cartilage damage) that have occurred at the time of ACL injury.

If surgery is indicated I aim to provide a personalised ACL reconstruction for you, to maximise your chances of a successful outcome. I have experience using multiple different grafts, either hamstrings, patella tendon, or quadriceps tendon, to ensure the surgery is optimised for your individual circumstances. The operation is generally performed as a daycase procedure under general anaesthetic, with a nerve block to help with pain.

Sometimes at the time of surgery there is damage to the meniscus cartilage, and I will try and repair this if at all possible. If you have a meniscal repair you will be in a brace post-operatively. I may also do additional procedures, such as a lateral extra-articular tenodesis (LET), if you are at a higher risk of re-rupture, with the aim of giving you the most stable knee possible. These procedures will slow down your recovery and rehabilitation post-operatively.

Physiotherapy is vitally important, in both the pre and post-operative period. The importance of forming a good relationship with your physiotherapist is paramount to achieving a successful outcome following surgery.

Physiotherapy is important for a number of reasons to:

• Ensure your muscle strength is good before surgery

• Ensure you get your range of movement back following the injury/surgery

• Ensure your muscle strength and knee co-ordination returns after surgery

• Ensure you are ready to get back to sporting activities

• Ensure your risk of re-injury is as low as possible

It is likely that you will be on crutches for 4-6 weeks after surgery, and you will not be able to drive for a similar length of time.

ACL Reconstruction