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| 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 |
Treatment for ACL Tear & Injury in Singapore
An anterior cruciate ligament (ACL) tear is one of the most common knee injuries and a frequent cause of knee instability. While it often occurs during sports that involve pivoting, jumping or sudden changes in direction, ACL injuries can also affect non-athletes. Without appropriate treatment, an ACL tear may lead to ongoing instability, reduced function and difficulty returning to everyday activities.
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.
- Twisting movement during sports or exercise
What Are the Symptoms of ACL Tears?
Symptoms can vary depending on the severity of the injury, but many people notice a sudden change in knee function at the time of injury. While some individuals are still able to walk, the knee may feel unstable or unreliable during movement.
Common symptoms may include:
- A popping sound or sensation at the time of injury
- Sudden knee pain following a twisting or pivoting movement
- Rapid swelling that develops within the first few hours
- A feeling of instability or the knee giving way
- Reduced range of motion
- Difficulty bearing weight on the affected leg
- Loss of confidence when turning, pivoting or changing direction
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 I (Mild Sprain)
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 II (Moderate Tear)
This grade involves a partial tear of the ACL. The ligament becomes looser, which may result in noticeable knee instability during movement.
Grade III (Complete Rupture)
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.
Can ACL Tears Occur with Meniscus or Cartilage Injuries?
Yes. ACL tears frequently occur alongside other knee injuries, particularly damage to the meniscus or articular cartilage. In fact, studies suggest that approximately 50% to 60% of individuals who sustain an ACL tear also experience a meniscus tear during the same injury event. The twisting or pivoting forces that damage the ACL can also place significant stress on the cushioning structures within the knee.
Cartilage injuries may also occur at the time of ACL trauma, particularly when the joint surfaces collide during the injury.
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 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.
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.
When is ACL Surgery Considered?
ACL reconstruction surgery may be considered when a complete ACL tear results in persistent instability or when patients wish to return to activities that involve cutting, pivoting, jumping or rapid changes in direction.
Surgery is commonly recommended for active individuals, athletes or those whose work places significant demands on the knee. The decision depends on factors such as activity level, associated injuries, knee stability and personal goals.
What to Expect Before, During and After ACL Reconstruction Surgery
ACL reconstruction is typically performed using minimally invasive arthroscopic techniques to restore stability to the knee. The procedure is usually carried out as a day surgery or may require an overnight stay, depending on the individual case.
Before the Surgery:
Your surgeon will assess the injury through a physical examination and imaging studies such as X-rays or MRI scans. You may also be advised to undergo physiotherapy before surgery and will receive instructions regarding fasting and medications.During the Surgery:
The procedure is performed under general anaesthesia. Through small keyhole incisions, the torn ACL is replaced with a tendon graft, which is secured within the knee to restore stability.After the Surgery:
Following surgery, you will be monitored in the recovery area before being discharged home or the next day. A knee brace, pain management measures and crutches may be required during the early stages of recovery. Physiotherapy typically begins soon after surgery to help restore movement, strength and knee function.
What Are the Types of Grafts Used in ACL Reconstruction?
ACL reconstruction involves replacing the torn ligament with a graft that acts as a scaffold for new ligament tissue to develop.
Autograft:
An autograft uses tissue taken from the patient's own body, commonly from the hamstring tendon, patellar tendon or quadriceps tendon. This is the most frequently used graft option.Allograft:
An allograft uses donor tissue obtained from a tissue bank. It may be considered in selected cases depending on the patient's needs and treatment goals.
Recovery After ACL Tear Treatment or ACL Surgery in Singapore
Recovery timelines vary depending on the severity of the injury and whether surgery is required.
Typical recovery milestones may include:
- Early rehabilitation focused on reducing swelling and restoring knee movement
- Progressive strengthening exercises to improve muscle control and stability
- Balance and neuromuscular training to support safe movement patterns
- Gradual return to low-impact activities under professional guidance
- Sports-specific rehabilitation for individuals returning to athletic activities
Recovery following ACL reconstruction often takes between six and nine months, although return to competitive sports may take longer depending on the individual's progress.
Can ACL Tears Be Prevented?
Although ACL tears cannot always be prevented, especially during high-risk sporting activities, certain measures may help reduce the risk of injury.
- 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.
Frequently Asked Questions (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.
Can a torn ACL heal without surgery?
A complete ACL tear generally does not heal on its own because of the ligament's limited healing capacity. Some partial tears may be managed with physiotherapy and bracing, depending on the degree of instability and the individual's activity level.
How much does ACL surgery cost in Singapore?
The cost of ACL surgery in Singapore depends on factors such as the hospital type, ward class and eligibility for government subsidies. The total cost typically includes the surgeon's fees, anaesthesia, hospital charges and implants. A personalised cost estimate can be provided following consultation and assessment.
Will my knee be as strong as it was before my ACL reconstruction?
Many patients regain excellent strength and function following ACL reconstruction and rehabilitation. However, recovery outcomes vary, and achieving the best possible result often depends on commitment to physiotherapy and rehabilitation.
Meet Our Specialist in ACL Injuries
Dr Kevin Koo Oon Thien
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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| 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 |