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A sprain or tear to the anterior cruciate ligament is one of the most common types of knee injury. Athletes who compete in demanding sports, such as basketball, rugby or football, are often most at risk of damaging these ligaments. Depending on the severity of the damage, ACL injuries may require surgery.

The anatomy of the knee consists of three bones – the femur (thighbone), tibia (shinbone) and patella (kneecap) – which meet to form the knee joint. The bones are connected by ligaments, predominantly by the four primary ones in the knee which act like strong ropes to keep the bones together and maintain knee stability.

The cruciate ligaments are located inside the knee and form an ‘x’ shape to control the back and forth movement in the knee. The anterior cruciate ligament runs at the front of this ‘x’, with the posterior ligament at the back. Considered ‘sprains’, injured ligaments are graded on a scale according to the severity of the injury.

The first sign of an ACL injury is often a popping sensation in the knee. Patients are likely to experience severe pain and be unable to continue their activity. There may be sudden swelling and loss of range of motion as well as instability when weight bearing.

Grade 1 sprains refer to mild damage to the ligament where it has been slightly stretched but still helps to stabilise the knee joint. Grade 2 sprains stretch the ligament to the point it becomes loose. This type of sprain is quite rare and is often classed as a partial tear to the ligament. Grade 3 sprains refer to a complete tear to the ligament where it has split into two pieces, making the knee unstable.

Leading orthopaedic surgeon Professor Ali Ghoz offers a range of surgery options to ACL patients. A recent successful operation was carried out on 24-year-old physicist Josh Gibson. As a student at Durham University, he sustained damage to his anterior cruciate ligament while playing rugby. Despite physiotherapy, the injury continued to disrupt Josh’s life.

The operation carried out by Professor Ghoz has enabled Josh to resume many of his sporting activities. As a testament to the successful ACL surgery, Josh recently skydived after a hike into the Grand Canyon. Modern, minimally invasive surgery and a good rehabilitation programme offer ACL patients the chance to return to daily activities.