Sports knee injuries may cause pain with instability but there is no reason to hang up your boots for good, explains consultant orthopaedic surgeon, Mr Adrian Harvey

According to Liverpool football legend Graeme Souness, it’s the number one injury that the players fear. ACL - anterior cruciate ligament – injuries are hard to prevent and frequently occur in both contact and non-contact sports including netball, football and skiing.

The ACL is an important ligament within the knee as it is one of the main rotational stabilisers. The joint can be injured in a number of ways, which importantly do not have to include contact but can involve a simple twisting, pivoting or jumping and landing. For example, a netball player may sustain an ACL rupture due to an incorrect landing. These injuries can be more common in female athletes due to biomechanical, anatomical and hormonal factors.

A number of knee injuries including ACL, meniscal and cartilage injuries occur in sports like rugby and football where there is player contact and resultant force on the knee. Cyclists and runners are less at risk, due to the nature of their exercise.

Symptoms fall into two broad groups. The first are patients who present with an acute injury which is often fairly evident and memorable. Sometimes the patient may hear a ‘pop’ or ‘snap’, followed by swelling of the knee. These twisting injuries occur in skiing where a binding does not release and in football where a foot is fixed on the pitch and the player has pivoted their body weight on it. In many cases, players are stretchered off the pitch.

Alternatively a patient may present with a knee that is insecure or unstable and gives way. When questioned, patients can recall a memorable injury but the swelling has gone down and the knee is not necessarily painful but gives way when practising sports which involve directional change or twisting.

It is very important that a correct diagnosis is made. The patient should see a specialist to undertake investigations, as many knee injuries do not occur in isolation and can be associated with a meniscal (cartilage) tear or concurrent injury to another knee ligament.

Although we can treat some injuries non-operatively, this decision should be made on an individual patient basis, taking into account a number of factors, including sporting aspirations and the potential instability of the knee.

Once the cruciate ligament is ruptured, the body cannot heal it and we cannot repair it. Instead, we reconstruct the ligament using key-hole surgery which usually takes about an hour.

After a period of post-operative rehabilitation, patients will be on crutches but weight bearing for about three weeks before starting physiotherapy. In general, patients will be back jogging and running in three to four months, pivoting at six months and hoping to get back to contact sports from nine months onwards.

Top tips for healthy knees

• Top tips Both exercise in moderation and a healthy diet are essential, weight is a key risk factor in developing conditions such as osteoarthritis of the knee

• Wearing appropriate footwear, especially for surfaces like Astroturf, could reduce the incidences of these types of injuries

• Consider non-impact exercise such as cycling which is beneficial for the knee

Meet the surgeon

Adrian Harvey has been a consultant orthopaedic surgeon and knee specialist at Nuffield Health Bournemouth Hospital for 14 years. Adrian has performed more than 2,000 ACL reconstructions and treated many elite sportsmen and women, including AFC Bournemouth football players. Those interested in booking a private consultation are invited to call customer services on 01202 375032.

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