The anterior cruciate ligament is a relatively large ligament, which sits in the middle of the knee joint between the femur or thighbone and the tibia or shinbone.

This ligament is important in controlling rotation between the two bones of the knee joint.

The ligament is often injured as a result of sporting activities and these can range from skiing and football to netball and martial arts. At the time of the injury the patient may hear a “pop”. The knee may be painful and swell quickly.

The knee symptoms may then settle down resulting in recurrent feelings of giving way, insecurity or buckling of the knee, particularly when changing direction, twisting, pivoting or sidestepping.

As a result of the accident there is also loss of the nerve fibres within the knee ligament and these provide a sense of where the joint is in space. This is called proprioception.

On returning to sports, particularly those which involve pivoting or twisting, the knee may give way again, potentially sustaining an injury to other structures within the knee.

Treatment of this injury involves confirming the diagnosis and establishing whether there are any associated injuries within the knee. A careful examination of the knee is required followed by an MRI scan. Often a reconstruction of the torn ligament is required. Adrian has a specialist interest in ligament reconstruction been involved in over 2000 anterior cruciate ligament reconstructions.