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ACL Ligament - Injuries, Causes and Symptoms

What is the ACL Ligament in the Knee?

The ACL Ligament, or the Anterior Cruciate Ligament, crosses in front of your knee in the middle, and together with the Posterior Cruciate Ligament or PCL, keeps your knee in place as it moves back and forth. The ACL in particular, maintains the stability of your knee while it rotates as it keeps your shinbone from sliding up and out in front of your thighbone.

A/Professor Andrew Dutton Acl Ligament Illustration

Unfortunately, damage to the ACL is quite common among knee injuries, and when the ACL is damaged, a Meniscus Tear or Cartilage Injury might be sustained, as well. This is because the knee is an entire system in itself where ligaments, tendons, cartilage and bones interact, making it crucial to get a proper diagnosis and the corresponding treatment.


Single Tunnel Double Bundle Intrafix ACL Reconstruction is an advanced surgical technique designed to repair and restore the anterior cruciate ligament (ACL) in the knee. This method focuses on mimicking the knee’s natural anatomy by reconstructing both the anteromedial and posterolateral bundles of the ACL within a single tunnel.

The Intrafix system is employed to secure the graft reliably in place, enhancing the stability and biomechanical properties of the knee joint. This technique offers improved rotational stability compared to traditional single-bundle ACL reconstruction, potentially leading to better functional outcomes and a lower risk of re-injury. By more accurately replicating the ACL’s natural complexity, the Single Tunnel Double Bundle approach aims to allow patients to return to their pre-injury levels of activity with confidence.

Dr. Andrew Quoc Dutton successfully performed the first Single Tunnel Double Bundle Intrafix ACL reconstruction in Singapore.

double bundle acl mayo foundation


For any injuries to the ACL ligament, A/Professor Andrew Quoc Dutton provides minimally invasive and customised therapeutic interventions. Book your consultation today with our Harvard fellowship-trained orthopaedic surgeon practising at Mount Elizabeth Hospital, Singapore. He also holds subspecialty interests in arthroscopic/keyhole surgeries, sports injuries, knee and hip replacements, and cartilage regeneration.

Frequently Asked Questions on ACL Ligament

Athletes who play football, basketball, soccer and similar sports are more prone to ACL injuries because these sports involve quick changes in speed or direction, jumps, sudden stops and forceful contact. Those who do gymnastics or downhill skiing, or play tennis, volleyball or hockey are also likely to injure the ACL.

Female athletes are also more likely to suffer ACL injuries than males because of the structure of their legs and the way they jump and land.

Singapore Knee

The kind of treatment the surgeon will recommend for an ACL injury will depend on the person’s age and activity level. If a person is older and is not so active, nonsurgical treatments might be preferred, as compared to how surgery might be preferable for a younger person involved in sports, and who would like to start playing again.

But as long as the knee is still stable overall, nonsurgical treatments might be an effective option. These treatments include wearing a knee brace to help protect the knee, and using crutches to avoid putting weight on it. Once the swelling starts to subside, physical therapy exercises may also be done to help get the knee moving again and strengthening the muscles around it.

If surgery was not used to treat an injured ACL, there is the risk that the person’s leg will remain somewhat unstable until such time when surgery will be considered. A study showed that people who went through rehabilitation for ACL injuries chose to have surgery later on for their unstable knees.

There is also the possibility that a graft may not be successful, rejected by the patient’s immune system, or a disease carrier if a cadaver’s tissue was used. The knee might also be injured again, its range of motion might still be limited, and may continue to be painful, stiff or weak even after the procedure. Other surgical risks include infection, blood clots and bleeding.

Before the ACL is treated, the surgeon will examine your knee and ask you about your symptoms as well as your medical history. Though damaged ligaments can already be diagnosed during this examination, the surgeon may ask for an MRI and an X-ray, using the latter to make sure there aren’t any broken bones.

If the knee is swollen because of accumulated blood, the surgeon might drain the knee using a needle. If surgery is going to be done, you may have to wait for three or four weeks before the procedure to wait for the swelling and bleeding to stop. You may want to ask or discuss with your surgeon where a tissue transplant will come from.

Make sure you follow the pre-surgery instructions which may include a 12-hour fast and avoiding aspirin and other blood-thinning medications.

To facilitate the recovery of your ACL, placing ice on your knee for 20 to 30 minutes every three or four hours may help reduce swelling and pain. You can also wear a knee brace or an elastic knee bandage or sleeve, and keep your leg elevated on a pillow while you’re resting.

You can also take anti-inflammatory pain medications such as naproxen, aspirin or ibuprofen, but make sure you follow the surgeon’s instructions and don’t take them for a longer period than you have to. If you’re not sure about the dosage, ask the surgeon.

Since it will take some time for a surgically replaced ligament to grow, it could take up to six months or longer for an athlete to be able to play sports again after the procedure. Be sure to follow through with the physical therapy programme that will be given you to help regain your knee movement sooner, and to protect the replaced ACL.

Eventually, the ACL will be able to handle increasing pressure, and the programme exercises may be focused on getting an athlete back in the game. Make sure that your knee isn’t swollen anymore and doesn’t hurt when you walk, run or jump. However, you might have recourse to other activities that will be gentler on your knees such as swimming instead of running.

Be sure you have the approval of your surgeon before you resume your usual level of activity; otherwise, you could make your injury worse or permanently damage your knee.

Pain is your body’s way of telling you that something is not right. Don’t just brush it off and risk the chance of compromising your movement and interupting your daily activities. Get it checked today for the right intervention the soonest possible time. Book your appointment with Dr. Dutton, here.

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