Anterior cruciate ligament (ACL) rupture

Patient will report a significant injury e.g. during sport. Usually involving non-contact running associated with rapid acceleration/deceleration and change of direction with noncontact valgus load at or near full knee extension. However can result from landing incorrectly from jump or after direct contact or collision.

• Mechanism of injury - see above
• Effusion present
• Able to play on if during sport.

• Effusion
• Quads atrophy
• Positive Lachmans.

• X-ray to rule out bony injury.
• MRI to confirm diagnosis.

Fracture, meniscal injury, medial ligament tear.

• If suspect torn ACL then refer to Orthopaedic.
• If ACL rupture is confirmed on MRI the decision to reconstruct the ACL is dependent on continued instability following extensive rehabilitation.
• Threshold to initiate a referral: X-ray/MRI findings.