Cruciate ligament tears: what you need to know
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Medically reviewed by
Prof. Matthieu Ollivier
Updated on
August 6, 2026
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Submit your file in just a few minutes and get an expert opinion in under 7 days.
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What is a medical second opinion?
Following a diagnosis or a proposed treatment plan, a medical specialist can analyze your file and provide an additional perspective.
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Your health insurance may cover your second opinion.
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Are you looking for a second opinion for a loved one?
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How does a second opinion work on Diagdoor?
How does a second opinion work on Diagdoor?
Upload your medical documents online; our team will review your file within 48 hours, and an expert will provide their opinion in less than 7 days. Simple, secure, 100% online.
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Not sure if your case is eligible?
Our medical team can guide you before you submit your request. Describe your situation, and we will help you determine if Diagdoor can be of assistance.
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A knee injury during physical activity, a distinct popping sound, and a knee that swells in the hours that follow: an anterior cruciate ligament (ACL) tear is one of the most common ligament injuries. What sets it apart from other knee injuries is that the ACL cannot heal on its own. The decision on how to treat it, whether surgically or otherwise, depends on each patient's profile.
Key points
- The ACL does not heal on its own: unlike other ligament structures, an anterior cruciate ligament tear will not recover without intervention. A treatment plan is necessary.
- There are two main options: ligament reconstruction (surgical replacement of the ligament with a tendon graft) and conservative treatment through physical therapy alone.
- The decision depends on the individual patient: age, level of athletic activity, knee instability, and the condition of associated structures (meniscus, cartilage) guide the choice.
- No absolute surgical emergency: in the vast majority of cases, the time taken before making a decision allows for gathering information and considering all options.
The ACL: a key ligament that cannot repair itself
The anterior cruciate ligament is one of the four main ligaments of the knee. Located in the center of the joint, it connects the femur (thigh bone) to the tibia and ensures knee stability during changes of direction, jumps, and rotations. Unlike other ligament structures, the ACL is unable to regenerate spontaneously after a tear: a treatment plan is necessary.
The tear most often occurs during a pivoting motion or upon landing from a jump, in team sports or skiing, usually without direct contact. It can be complete (both bundles severed) or partial (only one bundle affected). Associated meniscus or cartilage injuries are common and play an important role in treatment planning.
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~50,000
ACL reconstructions performed each year in France
2 to 3 times
higher risk of ACL tear for women than for men
Signs of an ACL tear: from popping to instability
Three signs often appear simultaneously during an ACL tear: a distinct popping sound at the time of injury, rapid swelling of the knee (hemarthrosis) in the hours that follow, and a feeling of instability or the knee giving way. These symptoms may subside in the following days, even though the injury remains just as severe. Persistent instability, even without intense pain, warrants a specialist consultation.
How to confirm the diagnosis: clinical examination and imaging
The diagnosis is primarily based on a clinical examination performed by an orthopedic surgeon, notably the Lachman test (evaluating the mobility of the tibia in relation to the femur). MRI (magnetic resonance imaging) is the gold standard: it confirms the tear and checks for associated injuries, primarily to the meniscus and cartilage. An accurate diagnosis, incorporating all existing injuries, directly determines the choice of treatment.
Surgery or physical therapy: options for an ACL tear
ACL reconstruction, which involves replacing the ACL with a tendon graft, is the gold standard for active patients experiencing significant instability. For other profiles, conservative treatment through physical therapy alone is a valid option. The choice between these two paths depends on several patient-specific factors and should be evaluated with a specialist.
Why consider a second opinion before ACL surgery
An ACL tear is one of the orthopedic injuries where practices vary most among surgeons: graft technique, timing of the operation, and associated meniscus procedures. A second opinion from a surgeon specializing in knee surgery allows for a full review of your case, an evaluation of the available options, and a clearer path forward. This process complements your existing care plan rather than contradicting it.
Frequently Asked Questions
Is an ACL tear serious?
An ACL tear is a serious injury that requires specialized care, but in most cases, it is not a surgical emergency. Without proper treatment, chronic instability can lead to secondary damage to the meniscus and cartilage.
How do I know if I have torn my ACL?
Indicative signs include a popping sound at the time of injury, rapid knee swelling, and a feeling of instability. Only a clinical examination by an orthopedic surgeon, supplemented by an MRI, can confirm the diagnosis.
Is surgery mandatory for an ACL tear?
No: treatment depends on the patient's profile, activity level, and the functional instability of the knee. For some, conservative treatment through physical therapy alone is a valid option.
Can you walk with a torn cruciate ligament?
Yes, walking is possible in most cases, even in the acute phase. This does not mean the injury is minor: persistent instability should be evaluated by a specialist.
How long does it take to recover from an ACL tear?
Recovery time depends on the chosen treatment and the patient's profile. After ligament reconstruction, the pace of rehabilitation and the goals for returning to activity are defined by the medical team based on each patient's situation.
Need the opinion of a
orthopedic surgeon
Upload your file to Diagdoor. A
orthopedic surgeon
specialist
of an ACL tear
analyzes it and provides a reasoned opinion in less than 7 days.
Sources
- French National Authority for Health (HAS), Meniscal and anterior cruciate ligament injuries, Recommendations
- French National Authority for Health (HAS), Therapeutic management of meniscal lesions and isolated ACL lesions of the knee in adults
- French National Authority for Health (HAS), Follow-up and referral criteria for physical therapy after anterior cruciate ligament reconstruction
- French National Authority for Health (HAS), LARS evaluation report, epidemiological data, 2012
- Ameli.fr, Knee sprain: returning to your activities
- Journal of Sports Traumatology, 2009
Further Reading
Why get a second opinion?
Understand the situations in which a second opinion can help you confirm a diagnosis or guide your treatment plan.
How does it work?
Understand the situations in which a second opinion can help you confirm a diagnosis or guide your treatment plan.
Did you know?
The ACL is located inside the knee joint, in an environment that does not allow for spontaneous healing. This anatomical feature explains why a tear does not heal on its own and requires appropriate management.
Have you been offered surgery?
Have you been offered surgery?
Surgery is never trivial. A medical specialist will analyze your file to confirm the recommendation or explore other therapeutic options.
Is there an alternative to surgery?
Is there an alternative to surgery?
A surgeon specializing in your condition will re-evaluate your file to confirm if surgery is necessary or to identify less invasive solutions.
Have you been presented with several treatment options?
Have you been presented with several treatment options?
Have you been presented with several treatment options?
An expert physician will analyze your medical records and history to help you choose the most appropriate strategy for your situation, whether it be medical treatment, surgery, or monitoring.
Torn between two treatments?
Torn between two treatments?
A specialist will explain exactly what each option entails, including effectiveness, side effects, and daily impact, so you can make your decision with confidence.
Still unsure about your diagnosis?
Still unsure about your diagnosis?
Still unsure about your diagnosis?
A specialist doctor will analyze your complete file (tests, imaging, medical history) to provide you with a reasoned diagnosis and guide your care.
Have you just received a diagnosis?
Have you just received a diagnosis?
Have you just received a diagnosis?
Have your medical file reviewed by a specialist in your condition. You will receive an additional opinion in less than 7 days, helping you move forward with clarity.
Is your condition rare or complex?
Is your condition rare or complex?
Diagdoor gives you access to a doctor who specializes in your condition to confirm your treatment plan, no matter where you live.
When facing cancer or a serious illness, every decision counts.
When facing cancer or a serious illness, every decision counts.
A doctor at an expert center will review your file to confirm your care plan, clarify the available options, and help you make decisions with confidence.
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
Have you received a diagnosis or been offered a treatment plan?
Submit your file in just a few minutes and get an expert opinion in under 7 days.
What is a medical second opinion?
What is a medical second opinion?
Following a diagnosis or a proposed treatment plan, a medical specialist can analyze your file and provide an additional perspective.
Your health insurance may cover your second opinion.
Your health insurance may cover your second opinion.
Many partner health insurance providers cover the Diagdoor service with no upfront costs. Check your eligibility as soon as you create your account.
Are you looking for a second opinion for a loved one?
Are you looking for a second opinion for a loved one?
The process is entirely online. Upload your available medical documents, and our team will take care of the rest.
How does a second opinion work on Diagdoor?
How does a second opinion work on Diagdoor?
Upload your medical documents online; our team will review your file within 48 hours, and an expert will provide their opinion in less than 7 days. Simple, secure, 100% online.
Not sure if your case is eligible?
Not sure if your case is eligible?
Our medical team can guide you before you submit your request. Describe your situation, and we will help you determine if Diagdoor can be of assistance.
Need the opinion of a
orthopedic surgeon
Need the opinion of a
orthopedic surgeon
Upload your file to Diagdoor. A
orthopedic surgeon
specialist
of an ACL tear
analyzes it and provides a reasoned opinion in less than 7 days.
