Australia has one of the highest rates of ACL rupture and ACL reconstruction surgery worldwide, largely due to high participation in pivoting and contact sports.

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An ACL rupture is a traumatic knee injury involving a tear of the anterior cruciate ligament at the centre of the knee. It most commonly occurs during twisting or pivoting movements and is often associated with meniscal or multi ligament injuries. ACL injuries affect both recreational and elite athletes.

In the acute phase, the knee typically becomes swollen and painful due to bleeding within the joint. Early management focuses on ice, compression, and swelling control, allowing pain to settle. Maintaining early knee movement is essential, as stiffness can delay recovery and impact future surgical outcomes. This early phase of rehabilitation, known as prehabilitation, plays a key role in treatment.

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After the initial pain settles, ACL rupture is characterised by knee instability, particularly during pivoting or change of direction activities. Due to its poor blood supply, the ACL has limited capacity to heal back to its original functional anatomy.

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Not all ACL ruptures require surgery. Many patients with isolated ACL injuries can manage well with structured physiotherapy, focusing on strengthening the muscles that stabilise the knee. However, for patients with ongoing instability, associated injuries, or those aiming to return to pivoting sports, ACL reconstruction surgery remains the most reliable treatment option.