Reviewed by Shirdi Sai Hospital Team
An ACL tear can cause knee instability, pain, buckling, and difficulty walking confidently. In some patients, the injury may begin after a twisting movement and continue for months if the ligament does not heal properly or if another knee structure, such as the meniscus, is also injured. When knee buckling increases and daily movement becomes difficult, orthopedic evaluation becomes important.
This case study explains how an adult patient with a right knee ACL tear and medial meniscus tear was evaluated and treated at Shirdi Sai Hospital, New BEL Road. The patient underwent arthroscopic ACL reconstruction with partial medial meniscectomy and was discharged in stable condition with physiotherapy and follow-up advice. The case is shared for awareness only, with patient identity fully removed.
Case Summary
An adult male patient came to Shirdi Sai Hospital with a history of twisting injury to the right knee several months earlier. The patient had already taken treatment, but symptoms did not settle completely. Over time, pain increased and the right knee started buckling while walking.
The patient was evaluated by the Orthopedics team and admitted for further management. Based on clinical findings and diagnosis, the patient was treated for:
- right knee ACL tear
- medial meniscus tear
The surgical procedure included:
- arthroscopic right ACL reconstruction
- partial meniscectomy of the medial meniscus
After surgery, the patient was monitored in the hospital. The post-operative course was stable. Pain gradually reduced, oral intake was tolerated, and the patient was able to ambulate with support. The patient was discharged in a hemodynamically stable condition with medicines, brace support, physiotherapy advice, and follow-up instructions.
What Was the Patient’s Main Problem?
The main concern was right knee pain with buckling while walking. Knee buckling means the knee suddenly feels unstable, gives way, or feels unable to support body weight properly during movement.
In this case, the problem began after a twisting injury. This type of injury can damage knee ligaments, meniscus, or other supporting structures. When the ACL is torn, the knee may lose stability, especially during walking, turning, climbing stairs, or sudden direction changes.
The patient’s symptoms included:
- previous twisting injury to the right knee
- persistent pain despite earlier treatment
- increased pain over recent weeks
- buckling of the right knee while walking
- difficulty trusting the knee during movement
These symptoms suggested that the knee instability needed orthopedic evaluation and treatment planning.
Final Diagnosis
The final diagnosis was:
Right ACL Tear with Medial Meniscus Tear
The ACL, or anterior cruciate ligament, is one of the main stabilizing ligaments of the knee. It helps control forward movement and rotation of the shin bone in relation to the thigh bone.
The medial meniscus is a C-shaped cartilage cushion on the inner side of the knee. It helps absorb shock, distribute load, and support smooth knee movement.
When both the ACL and medial meniscus are injured, patients may experience pain, instability, swelling, catching, locking, or buckling depending on the tear pattern and severity.
What Is an ACL Tear?
An ACL tear is an injury to the anterior cruciate ligament inside the knee. It commonly occurs due to twisting, sudden stopping, pivoting, sports injury, fall, or accident.
Common symptoms of an ACL tear may include:
- knee pain after injury
- swelling
- instability
- buckling or giving way
- difficulty walking confidently
- difficulty turning or changing direction
- reduced confidence in the knee
- pain during activity
Some ACL injuries improve with rehabilitation in selected patients. However, when instability continues, when the knee buckles during daily activity, or when associated meniscus injury is present, surgical treatment may be considered after orthopedic evaluation.
What Is a Medial Meniscus Tear?
A medial meniscus tear affects the cartilage cushion on the inner side of the knee. It can occur along with ligament injuries, especially after twisting movements.
Symptoms may include:
- pain on the inner side of the knee
- swelling
- catching sensation
- locking sensation
- pain while bending the knee
- discomfort while walking or squatting
- instability when combined with ligament injury
Treatment depends on the type, location, and severity of the tear. Some tears may be managed with physiotherapy and medicines. Some tears may require arthroscopic treatment, especially if they are causing mechanical symptoms or are associated with other knee injuries.
Why Was Surgery Considered in This Case?
Surgery was considered because the patient had a diagnosed ACL tear with medial meniscus tear and ongoing knee buckling while walking. The symptoms had continued despite earlier treatment and were affecting knee stability.
The decision for surgery was based on:
- history of twisting knee injury
- persistent pain
- increased buckling of the right knee
- confirmed ACL tear
- associated medial meniscus tear
- orthopedic evaluation
- need to improve knee stability and function
The goal was not only pain relief. The main goal was to restore knee stability, treat the meniscus injury appropriately, and support safer movement with rehabilitation.
Patients with similar symptoms can consult the Orthopedics department at Shirdi Sai Hospital for evaluation of knee pain, ACL injury, meniscus tear, sports injury, fracture care, arthroscopy, and rehabilitation guidance.
What Is Arthroscopic ACL Reconstruction?
Arthroscopic ACL reconstruction is a minimally invasive knee surgery performed using a small camera called an arthroscope and specialized instruments. The damaged ACL is reconstructed using a graft to help restore knee stability.
Arthroscopy allows the surgeon to view the inside of the knee joint through small incisions. This approach is commonly used for ligament reconstruction and meniscus-related procedures when surgery is required.
In this case, arthroscopic right ACL reconstruction was performed as part of the treatment plan.
What Is Partial Medial Meniscectomy?
Partial medial meniscectomy means removing only the damaged portion of the medial meniscus while preserving as much healthy meniscus tissue as possible.
This may be done when the torn part of the meniscus is not suitable for repair or is causing symptoms. The decision depends on tear type, location, tissue quality, stability, and surgeon assessment.
In this case, partial meniscectomy of the medial meniscus was performed along with ACL reconstruction.
Treatment Approach at Shirdi Sai Hospital
The patient was admitted under orthopedic care and evaluated before surgery. The treatment pathway included:
- orthopedic evaluation
- pre-operative assessment
- physician fitness before surgery
- surgical planning
- arthroscopic ACL reconstruction
- partial medial meniscectomy
- post-operative monitoring
- antibiotics and supportive medicines as required
- pain control
- gradual diet restart
- mobilization support
- discharge advice
- physiotherapy guidance
- OPD follow-up recommendation
The post-operative course was documented as uneventful. Pain gradually reduced, and the patient tolerated oral soft diet. The patient was able to ambulate and was discharged in stable condition.
Recovery Plan After ACL Reconstruction and Meniscus Surgery
Recovery after ACL reconstruction and meniscus surgery depends on the injury, procedure, patient condition, physiotherapy compliance, muscle strength, and follow-up care.
In this case, discharge advice included:
- mobilization with support
- long knee brace
- continued physiotherapy
- straight leg raise exercises
- isometric quadriceps exercises
- follow-up review in OPD
Physiotherapy is a key part of recovery because surgery alone does not restore full strength, balance, and confidence. The knee needs structured rehabilitation to regain movement, muscle control, and stability.
Why Physiotherapy Matters After ACL Surgery
After ACL reconstruction, the thigh muscles, especially the quadriceps, can become weak. Swelling, pain, reduced movement, and fear of using the knee can slow recovery.
Physiotherapy helps with:
- reducing stiffness
- restoring knee movement
- improving quadriceps strength
- improving walking pattern
- reducing swelling
- improving balance
- supporting gradual return to activity
- protecting the reconstructed ligament during healing
Exercises such as straight leg raises and isometric quadriceps exercises are commonly used in early rehabilitation when advised by the treating team.
Patients should not restart sports, running, heavy lifting, squatting, or twisting activities without orthopedic and physiotherapy clearance.
ACL Tear with Meniscus Tear: Why Early Evaluation Matters
An ACL tear with meniscus injury can affect knee function more than an isolated minor knee sprain. If instability continues, the knee may buckle repeatedly, which can increase the risk of further injury.
Patients should not ignore:
- knee buckling while walking
- repeated giving way sensation
- swelling after activity
- pain after twisting injury
- knee locking or catching
- difficulty climbing stairs
- difficulty turning quickly
- inability to trust the knee
- pain that continues for weeks after injury
Early diagnosis helps decide whether physiotherapy, bracing, activity modification, arthroscopy, ACL reconstruction, meniscus repair, partial meniscectomy, or another treatment option is suitable.
Warning Signs After Knee Surgery
Patients should follow discharge instructions and return for review if warning signs appear.
Important warning signs include:
- fever
- severe pain
- pus discharge from wound
- increasing swelling
- redness around wound
- wound soakage
- calf pain or swelling
- breathing difficulty
- sudden worsening of knee pain
- inability to move the limb as advised
- fall or fresh injury after surgery
The discharge instructions in this case specifically advised review if fever, severe pain, or wound discharge occurred.
What This Case Teaches Patients
This case highlights a common problem: knee ligament injuries are often underestimated when pain temporarily improves. A patient may continue walking after injury, but instability may become clear later as buckling, giving way, or reduced confidence in the knee.
Key lessons:
- Twisting knee injuries should not be ignored if pain persists.
- Knee buckling is an important instability symptom.
- ACL tears may need surgery when instability affects daily activity.
- Meniscus tears can occur along with ACL injury.
- Arthroscopy can be used to treat selected ACL and meniscus injuries.
- Physiotherapy is essential after surgery.
- Follow-up care is important for safe recovery.
Shirdi Sai Hospital and Sathya Sai Hospital Are Different
Some patients searching online may confuse Shirdi Sai Hospital with Sathya Sai Hospital because the names sound similar. They are not the same hospital.
This case study refers to Shirdi Sai Hospital Pvt. Ltd., located at No. 519, 2nd Main, Nethravathi Street, Devasandra, New BEL Road, Bangalore – 560054.
Before visiting, patients should confirm the hospital name, location, phone number, and official website. For this case study and related orthopedic care, the correct hospital is Shirdi Sai Hospital on New BEL Road.
You can visit the official Shirdi Sai Hospital website for hospital information and appointments.
Why Patients Choose Shirdi Sai Hospital for ACL and Meniscus Injury Care
At Shirdi Sai Hospital, New BEL Road, knee injuries are evaluated through the Orthopedics department with attention to symptoms, injury history, instability, pain pattern, imaging, and functional difficulty. The hospital’s Orthopedics services include care for ACL tears, meniscus tears, sports injuries, arthroscopy, fracture care, rehabilitation support, and musculoskeletal conditions.
Patients may choose Shirdi Sai Hospital because:
- orthopedic care is available on New BEL Road
- ACL and meniscus injuries are evaluated clinically
- arthroscopy is available for selected joint problems
- surgical and non-surgical options are considered based on the case
- rehabilitation guidance supports recovery after surgery
- emergency and multispeciality support are available when needed
- the hospital is accessible for patients from Devasandra, Mathikere, RMV 2nd Stage, Sanjaynagar, Hebbal, and nearby areas
For patients with knee buckling, ligament injury, meniscus tear symptoms, or sports-related knee pain, orthopedic consultation at Shirdi Sai Hospital can help identify the next step.
Patient Privacy Note
This case study has been written with patient identity removed. Personal identifiers such as name, registration number, address, exact admission date, discharge date, and identifying personal details have not been included.
The purpose of this case study is patient education and awareness. Treatment decisions vary from patient to patient. A similar diagnosis does not mean every patient will need the same surgery, medicines, hospital stay, brace, or rehabilitation plan.
Frequently Asked Questions
What is an ACL tear?
An ACL tear is an injury to the anterior cruciate ligament, one of the main stabilizing ligaments inside the knee. It can cause pain, swelling, instability, and knee buckling.
What are the symptoms of ACL tear?
Common symptoms include knee pain, swelling, instability, buckling, difficulty walking, and loss of confidence while turning, climbing stairs, or changing direction.
When does an ACL tear need surgery?
ACL surgery may be considered when the knee remains unstable, buckles during daily activity, or when there is an associated injury such as a meniscus tear. The decision depends on orthopedic evaluation.
What is arthroscopic ACL reconstruction?
Arthroscopic ACL reconstruction is a minimally invasive procedure where the damaged ACL is reconstructed using a graft through small incisions and camera-guided instruments.
What is partial meniscectomy?
Partial meniscectomy means removing only the damaged portion of the meniscus while preserving as much healthy tissue as possible. It may be done when the torn part is not suitable for repair.
Is physiotherapy needed after ACL surgery?
Yes. Physiotherapy is essential after ACL surgery to regain knee movement, muscle strength, balance, walking confidence, and safe return to daily activities.
When should I consult a doctor after a twisting knee injury?
Consult an orthopedic doctor if pain persists, swelling appears, the knee buckles, walking becomes difficult, or there is locking, catching, or repeated giving way sensation.
Conclusion
This case shows how a twisting knee injury with persistent pain and buckling was diagnosed as a right ACL tear with medial meniscus tear and treated with arthroscopic ACL reconstruction and partial medial meniscectomy at Shirdi Sai Hospital, New BEL Road. The patient recovered in stable condition after surgery and was advised brace support, physiotherapy, medicines, and follow-up care.
Knee buckling after injury should not be ignored. It may indicate ligament instability or meniscus involvement. Early orthopedic evaluation helps patients understand whether rest, physiotherapy, bracing, arthroscopy, ligament reconstruction, or another treatment pathway is suitable.
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