| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg, drkevinkoo@bjc.sg |
| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg, drkevinkoo@bjc.sg |
| Monday to Friday | : 8:30am to 5:30pm |
| Saturday & Sunday | : Closed |
| Public Holiday | : Closed |
Anterior Cruciate Ligament (ACL) Tear & Injury in Singapore
Knee injuries are common, particularly among athletes and the knee is one of the most frequently affected joints. Among these injuries, an anterior cruciate ligament (ACL) tear is both common and significant. While it is often associated with high-impact sports, an ACL tear can also affect non-athletes and may make everyday activities painful and difficult.
What Is an ACL Tear?
The anterior cruciate ligament (ACL) is a key stabilising ligament in the knee, connecting the thigh bone to the shin bone. It helps control forward movement and rotation of the knee. An ACL tear occurs when the ligament is overstretched or ruptured, causing knee instability. This can lead to the knee giving way during activity and may affect movement, strength and daily function.
What Are the Common Causes of ACL Tears?
Most ACL tears occur when the ligament is stretched beyond its normal limits, often during sudden or awkward movements. These injuries commonly happen during sports or physical activity. Typical causes include:
- Sudden deceleration combined with a change in direction.
- Pivoting while the foot remains firmly planted.
- Awkward landings after a jump.
- Abrupt stops while running.
- Direct impact or blows to the knee.
What Are the Symptoms of ACL Tears?
An ACL tear often presents with sudden and noticeable symptoms. Common signs include:
- A loud pop or a popping sensation in the knee at the time of injury
- Immediate pain and difficulty continuing an activity
- Rapid swelling of the knee
- A feeling of instability or the knee giving way
- Reduced range of motion
- Difficulty bearing weight on the affected leg
How Are ACL Tears Diagnosed?
An ACL tear is diagnosed using a combination of medical history, physical examination and imaging studies.
Medical History: The doctor will ask how the injury occurred, review your symptoms and note any previous knee problems.
Physical Examination: Special tests are performed to assess knee stability, including:
- Lachman test, where the thigh is stabilised and the shinbone is gently pulled forward to assess abnormal movement
- Pivot shift test, where controlled rotation and bending of the knee may reveal a shifting sensation if the ACL is torn
Imaging Studies: MRI scans are commonly used to confirm an ACL tear and identify associated injuries. X-rays or ultrasound may also be used to assess bone involvement or soft tissue changes.
What Are the Different Grades of ACL Tears?
ACL injuries are classified into three grades based on the extent of ligament damage. Each grade reflects the level of knee stability and functional impact.
Grade 1
This is the mildest form of ACL injury. The ligament is overstretched but not torn, and it continues to provide stability to the knee.
Grade 2
This grade involves a partial tear of the ACL. The ligament becomes looser, which may result in noticeable knee instability during movement.
Grade 3
This is the most severe type of ACL tear. The ligament is completely torn or detached from the bone, leading to significant instability and loss of knee support.
What Are the Risk Factors of ACL Tears?
Several factors can increase the likelihood of an ACL injury. These include:
- Sports Participation: High-intensity and pivot-heavy sports such as football, basketball, gymnastics, skiing and soccer place greater stress on the knee.
- Gender: Women have a higher risk of ACL tears due to anatomical, hormonal and neuromuscular differences.
- Poor Conditioning: Weak core, hip or leg muscles can reduce knee control and increase strain on the ligament.
- Previous Knee Injury: A prior ACL tear raises the risk of injury to the same knee or the opposite knee.
- Improper Footwear: Poorly fitting or unsuitable footwear can increase the risk of slipping or twisting movements.
What Are the ACL Treatment Options?
Treatment for an ACL tear depends on several factors, including the severity of the injury, activity level, age and overall knee stability. Management generally falls into two main approaches.
Non-Surgical Treatment
Non-surgical care is often recommended for partial tears, such as Grade 1 and some Grade 2 injuries, or for individuals with lower physical demands. This approach focuses on restoring knee function and may include:
- Rest, ice, compression and elevation (RICE) to manage pain and swelling.
- Structured physiotherapy to improve strength, balance and joint control.
- Knee bracing to provide additional support during movement.
Surgical Treatment
Surgical treatment, most commonly ACL reconstruction, is typically recommended for complete (Grade 3) tears. It is often considered for active individuals or those who wish to return to sports or physically demanding work. Surgery is followed by a structured rehabilitation program to restore strength, stability and knee function over time.
What Are Potential Complications of Untreated ACL Tears?
An untreated ACL tear can lead to ongoing knee problems that extend beyond the initial injury. Over time, instability in the knee may place added stress on surrounding structures, increasing the risk of further damage. Possible complications include:
- Persistent knee pain, swelling and a feeling of instability.
- Injury to other structures, such as the meniscus or cartilage.
- Progressive muscle weakness due to reduced activity and altered movement patterns.
- Limited range of motion and reduced joint control.
- Difficulty returning to sports, exercise or physically demanding work.
Addressing an ACL tear early helps reduce the risk of these long-term issues. Without appropriate treatment, what begins as a single ligament injury can gradually lead to chronic knee dysfunction and lasting mobility limitations.
Can ACL Tears Be Prevented?
While ACL tears cannot be completely prevented, especially in sports that involve cutting or pivoting, certain strategies can help reduce the risk. Prevention focuses on improving strength, control and movement patterns. Helpful measures include:
- Using proper technique during sports and exercise.
- Allowing adequate rest and recovery after intense activity.
- Warming up and stretching before physical activity.
- Practising safe landing, jumping and turning movements.
- Wearing appropriate footwear that offers good support and traction.
FAQs About ACL Tears
Is ACL injury more common in young people?
ACL tears are more common in adolescents and young adults who participate in high-intensity sports. However, they can occur at any age, particularly during activities involving sudden changes in direction or impact.
Can an ACL tear heal on its own?
A complete ACL tear does not heal on its own. Some partial tears may improve with rest, physiotherapy and bracing but full knee stability is often not restored without surgery.
Can I walk if my ACL is torn?
Many people are able to walk with a torn ACL, especially on flat surfaces. However, the knee may feel unstable and there is a risk of further injury without proper support or treatment.
Are there long-term effects after an ACL injury?
Even with treatment, some individuals may have a higher risk of developing knee osteoarthritis later in life. Proper rehabilitation, muscle strengthening and joint protection strategies can help minimise long-term complications.
How long does recovery from an ACL tear take?
Recovery time varies based on injury severity and treatment. Non-surgical rehabilitation may take about 3 to 6 months. Surgical recovery usually takes 6 to 9 months and can extend to a year or longer for a full return to high-level activity.
Is physiotherapy necessary if I feel better after the injury?
Yes. Even if pain and swelling improve, physiotherapy is important to restore strength, balance and neuromuscular control. Skipping rehabilitation may increase the risk of re-injury or ongoing instability.
Our ACL Specialist in Singapore
FRCSEd (Orth), FAMS
Dr Kevin Koo is an orthopaedic surgeon with more than two decades of clinical practice in managing knee conditions, including ACL injuries. Over the years, he has treated a wide range of patients with varying activity levels and clinical needs. His practice covers both minimally invasive techniques and complex knee reconstructions, allowing treatment plans to be tailored to each patient’s condition and recovery goals.
| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg , drkevinkoo@bjc.sg |
| Mon - FriMonday to Friday | :8:30am to 5:30pm |
| Sat, Sun and PHSaturday, Sunday & PH | :Closed |
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get in touch as soon as possible.
| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg , drkevinkoo@bjc.sg |
| Mon - FriMonday to Friday | :8:30am to 5:30pm |
| Sat, Sun and PHSaturday, Sunday & PH | :Closed |