Anterior cruciate ligament rupture is a common soft tissue knee injury, often affecting young athletic individuals keen to return to pre-injury levels of function. Increasing sporting activity is reflected by an increasing incidence of anterior cruciate ligament rupture. Although treatment has advanced considerably over the years, there are still a number of contentious issues that are considered in this review. The anterior cruciate ligament is a dense band of connective tissue, comprising an anteromedial and posterolateral bundle based on tibial insertion sites. It is important to appreciate the position and orientation of these bundles at the time of reconstructive surgery. The bundles, with their load sharing behaviour through knee flexion, affect antero-posterior and rotational stability of the knee. In the first part of this review, we consider the clinical presentation of anterior cruciate ligament injury and relevant anatomy, knee kinematics, mechanism of injury and incidence of anterior cruciate ligament ruptures.

Soft-tissue ankle injuries are extremely common and frequently present in the emergency department or to the general practitioner. The lateral ligament complex is most commonly affected, usually following an injury with the ankle in an inverted, plantar-flexed position. The diagnosis is usually clinical, and delayed examination and reassessment 3—5 days after injury is recommended as pain and swelling hinder accurate assessment immediately following injury. Applying the Ottawa ankle rules can reduce the number of unnecessary radiographs. Treatment is usually non-operative with the focus on controlling ankle swelling and pain, and early restoration of ankle movements. Surgical repair of ligaments may be indicated in certain cases, though the role of surgery in the acute setting remains unclear. In the present review, we discuss the anatomy, mechanism of injury, risk factors, clinical presentation, diagnosis, treatment and outcome of soft-tissue ankle injuries as well as consider how such injuries may be prevented.