At Lidder Orthopaedics, we specialise in the diagnosis and treatment of ACL injuries and complex knee sports trauma, including ligament injuries, meniscal tears, and tendon ruptures. Treatment is tailored to restore stability, performance, and long-term knee health.
Common ACL and Knee Sports Injuries
Overview:
The anterior cruciate ligament (ACL) stabilises the knee during pivoting and cutting movements. ACL rupture is a common sports injury requiring specialist assessment.
Symptoms:
Sudden “pop” at injury
Rapid swelling within hours
Knee instability or “giving way”
Difficulty returning to sport
Causes:
Non-contact pivoting injury
Landing from a jump
Sudden change in direction
Contact sports trauma
Diagnosis:
Clinical examination (Lachman, pivot shift tests)
MRI scan to confirm ACL rupture and associated injuries
Non-Surgical Treatment:
Physiotherapy-based rehabilitation (“copers”)
Strength and neuromuscular training
Activity modification
Bracing in selected cases
Surgical Treatment:
ACL reconstruction using graft (hamstring, patella tendon, or quadriceps tendon)
Combined meniscal or cartilage procedures if required
When Surgery is Considered:
Persistent instability
Desire to return to pivoting sports
Associated meniscal or cartilage injury
Failure of structured rehabilitation
Overview:
Meniscal tears commonly occur concurrently with ACL injuries due to twisting forces on the knee.
Symptoms:
Joint line pain
Swelling
Locking or catching
Pain with twisting movements
Causes:
ACL injury mechanism
Twisting or pivoting trauma
Secondary degenerative changes
Diagnosis:
MRI scan
Clinical examination
Non-Surgical Treatment:
Physiotherapy
Activity modification
Pain management
Surgical Treatment:
Arthroscopic partial meniscectomy
Meniscal repair (preferred when possible)
When Surgery is Considered:
Mechanical locking
Unstable or displaced tear
Combined ACL reconstruction cases
Overview:
Meniscal repair restores and preserves the meniscus, improving long-term knee joint health.
Symptoms:
Pain and swelling
Mechanical symptoms (catching or locking)
Causes:
Traumatic ACL-related tears
Peripheral vascular zone tears (repairable region)
Diagnosis:
MRI
Intra-operative assessment
Non-Surgical Treatment:
Selected stable tears may be observed
Physiotherapy
Surgical Treatment:
Arthroscopic meniscal suturing techniques
Often combined with ACL reconstruction
When Surgery is Considered:
Repairable tear pattern
Young or active patients
Combined ACL injury
Important Note:
Preserving the meniscus significantly reduces long-term arthritis risk.
Overview:
Osteochondral injuries involve damage to the cartilage surface and underlying bone, often occurring with ACL injuries.
Symptoms:
Deep knee pain
Swelling
Catching or locking
Pain with weight-bearing
Causes:
High-impact sports injury
ACL rupture mechanism
Shearing forces within the knee
Diagnosis:
MRI scan
CT scan for lesion characterisation
Non-Surgical Treatment:
Rest and offloading
Physiotherapy
Activity modification
Surgical Treatment:
Microfracture
Cartilage repair or grafting (OATS, MACI in select cases)
Combined ACL reconstruction if required
When Surgery is Considered:
Large or unstable lesions
Persistent symptoms
Associated ligament instability
Overview:
The MCL provides stability on the inner side of the knee and is commonly injured in contact sports.
Symptoms:
Inner knee pain
Swelling
Instability with valgus stress
Tenderness along medial knee
Causes:
Direct blow to outer knee
Twisting injury
Often occurs with ACL injury (“unhappy triad”)
Diagnosis:
Clinical examination
MRI scan
Non-Surgical Treatment:
Bracing
Physiotherapy
Activity modification
Gradual return to sport
Surgical Treatment:
Rarely required
Repair or reconstruction in severe combined injuries
When Surgery is Considered:
High-grade tears with instability
Combined ACL and multi-ligament injuries
Overview:
The LCL stabilises the outer knee and is less commonly injured but often associated with complex trauma.
Symptoms:
Outer knee pain
Instability
Difficulty with lateral movement
Causes:
Varus force injury
High-energy trauma
Multi-ligament knee injury
Diagnosis:
Clinical examination
MRI scan
Non-Surgical Treatment:
Bracing
Physiotherapy (low-grade injuries)
Surgical Treatment:
Reconstruction or repair in high-grade injuries
When Surgery is Considered:
Complete rupture
Multi-ligament knee injury
Persistent instability
Overview:
The patella tendon connects the kneecap to the tibia and is essential for knee extension.
Symptoms:
Sudden pain below kneecap
Inability to straighten knee
Swelling and bruising
Functional weakness
Causes:
Sudden contraction (jumping, landing)
Sports injury
Chronic tendinopathy weakening tendon
Diagnosis:
Clinical examination
Ultrasound or MRI
X-ray may show a change in patella position
Non-Surgical Treatment:
Rare for complete rupture
Bracing for partial tears
Physiotherapy for tendinopathy
Surgical Treatment:
Surgical repair of tendon rupture
Reinforcement techniques if required
When Surgery is Considered:
Complete rupture (urgent repair required)
Significant functional deficit
Overview:
The quadriceps tendon connects the thigh muscles to the patella and is critical for knee extension.
Symptoms:
Sudden pain above the kneecap
Inability to straighten the knee
Swelling and bruising
Weakness
Causes:
Sudden eccentric load
Falls or sports injury
Degenerative tendon changes
Diagnosis:
Clinical examination
MRI or ultrasound
Non-Surgical Treatment:
Partial tears: bracing and physiotherapy
Activity modification
Surgical Treatment:
Surgical repair for complete rupture
Reinforcement or augmentation in complex cases
When Surgery is Considered:
Complete rupture
Loss of active knee extension
High functional demand patients
Dr Surjit Lidder provides specialist care for ACL reconstruction and complex knee sports injuries, offering both non-operative rehabilitation and advanced arthroscopic and reconstructive surgery.
You should seek specialist assessment if you experience:
Knee instability after injury
Rapid swelling after trauma
Suspected ACL rupture
Locking or catching symptoms
Difficulty returning to sport
Failure of physiotherapy
For a second opinion and peace of mind.
