Anterior Cruciate Ligament

What Is Anterior Cruiciate Ligament

The ACL is a broad ligament joining the anterior tibial plateau to the posterior femoral intercondylar notch.The tibial attachment is to a facet, in front of, and lateral to the anterior tibial spine.The femoral attachment is high on the posterior aspect of th e lateral wall of the intercondylar notch.

Common causes of ACL Injury

The most common cause of ACL rupture isACL Tear

  • A traumatic force to the knee in a twisting moment.
  • A direct or an indirect force.
  • Sudden un prepared side-stepping, pivoting
  • Landing from a jump.
  • Contact sports Injury such as football field, on the snow fields
  • A motor vehicle accident


Symptoms of an ACL injury can include:

  • Feeling a "pop" inside your knee when the ACL tears
  • Significant knee swelling and deformity within a few hours after injury
  • Severe knee pain that prevents you from continuing to participate in your sport (most common in partial tears of the ACL)
  • No knee pain, especially if the ACL has been completely torn and there is no tension across the injured ligament
  • A black and blue discoloration around the knee, due to bleeding from inside the knee joint
  • A feeling that your injured knee will buckle, "give out" or "give way" if you try to stand

How do we Diagnose ACL Injury

The diagnosis of ACL tear can be confirmed by three tests:

  • Lachman test,
  • Dynamic extension test, and the
  • Pivot Jerk test.

Apart from above clinical test Dr. Ashwani may advice an plan radiograph or MRI to
evaluate the extent of injury.

Treatment Options

Management can depends on Extent of damage (Grade of Tear)

  • Grade I — A mild injury that causes only micro-scopic tears in the ACL. Although these tiny
    tears may stretch the ligament out of shape, they
    do not affect the overall ability of the knee joint
    to support your weight.
  • Grade II — A moderate injury in which the ACL ispartially torn. The knee can be somewhat unsta-ble and can "give way" periodically when you
    stand or walk.
  • Grade III — A severe injury in which the ACL iscompletely torn through and the knee feels very

Conservative Option


Nonsurgical Treatment

Immediately after an ACL injury, the so-called R.I.C.E. treatment is recommended.



Progressive physiotherapy and rehabilitation

Use Assistive and support Devices


Surgical Option

Since the ACL does not heal, the ligament needs to be replaced (reconstructed).


The ACL is reconstructed using arthroscopic techniques. The arthroscope is a fiber optic instrument ACL Tear treatmentwhich is placed into the knee joint through a small incision. A camera is used and the image is viewed on a TV monitor to look and take pictures. The arthroscope allows evaluation of the entire knee joint, including the knee cap (patella), the cartilage surfaces, the meniscus, the ligaments (ACL & PCL), and the joint lining. Small instruments ranging from 3-5 millimeters in size are inserted through addi-tional incisions so that the joint structures can be evaluated for any damage, any injury can be diagnosed, and damaged tissue can be repaired, reconstructed, or removed.

The word arthroscopy comes from two Greek words,

“arthro” (joint) and “skopein” (to look).

ACL Reconstruction is a Good option for symptomatic Grade II and Grade III injury:

The goal of the anterior cruciate ligament reconstruction (ACLR) surgery is to restore
stability and function to the knee to allow return to your previous level ofactivity. Surgery for the ACL uses an arthroscopically assisted technique that has proven
to be very effective.

What various grafts available ACL Tear Grafts

  • Patellar Tendon Grafts
  • Hamstring Grafts
  • Allograft



Most patients have their arthroscopic surgery performed as outpatients and are home
several hours after the surgery.

For many people, shoulder arthroscopy provides an alternative to open shoulder surgery.

In comparison to open shoulder surgery, shoulder arthroscopy provides:

  • Better cosmetic
  • Shorter recovery time
  • Less pain
  • Less need for pain medication after surgery
  • Less damage to soft tissues at the incision site
  • Fewer complications
  • Greater improvement in strength and range of motion
  • Minimal scars.
  • Minimal hospital stay.
  • Decreased pain and swelling.
  • Improved motion. 


Upcoming Events
  • Coming up with a mega campaign "Lets Fight Arthritis" on the occasion of World Arthritis Day, at A4 Block, Gauri Shankar Mandir, Paschim Vihar, New Delhi. The campaign will be on 9th October 2016(Sunday). 

  • Health Awareness Campaign on 28th August at Gurudwara Singh Sabha E Block Karampura, Delhi.

  • Coming up with a mega campaign on Spine & Back Pain on 5th June 2016 at Gurudwara New Ranjeet Nagar (near Satyam Ciema), Patel nagar, Delhi in association with Sukhmani Charitable Trust, Delhi.

  • Coming up with an awareness campaign on Arthritis Management & Control on 22nd May 2016 at Guru Ram Dass Charitable Medical Centre - Gurudwara Sri Guru Singh Sabha, Moti Nagar, Delhi.  

  • Mega campaign on Arthritis Management on "Mother's Day" 8th May 2016 at West Patel Nagar, Delhi - 110008

  • Mega campaign on Arthritis Management in association with "Varishth Nagrik Kesari Club" - Punjab Kesari Delhi on 6th April 2016 (Wednesday)

  • Dr. Ashwani Maichand Participated in Shoulder Conclave 2016 at JWT Marriott, Pune

  • Dr. Ashwani Maichand was the Table instructor for young doctors at Cadaver Joint Replacement Training on 21st February 2016 at All India Institute of Medical Sciences (AIIMS)

  • Arthritis Awareness campaign on 28th february 2016 from 10 am to 1 pm at Minomax Knee & Shoulder Clinics (8/29, West Patel nagar, Delhi, India)

  • Participating as a speaker on "Dificult cases of Hip & Knee Replacement" in 2nd Masters Course in Arthroplasty at Meril Academy, VAPI, Gujarat from 4th to 6th February 2016






Click here for our Events List



Contact Us
Dr Ashwani Maichand
M.S., M.Ch. (Ortho)
Fellowship Joint Replacement
Specialist : Knee & Shoulder
Dr. Rahul Kakran
M.s., M.Ch (Ortho)
Specialist : Minimal Invasive Spine Surgery (MISS)
Dr. Rajni Koundal
Consultant Physiotherapy
For Appointment : 9999074745
( Mr. Sunny ) 
For Upcoming Events : 9999071715
( Mr. Sarabjeet Singh)
Address : 
MinOmaX Knee & Shoulder Clinics
8/29, West Patel Nagar,opp. D.A.V. Sr. Secondary School (near Metro Pillar no. 198, Delhi-110008)
Timings : Daily 5:00 PM to 7:00 PM  ( Except Sunday).
Please Take Prior Appointment to avoid inconvinience.