What are the treatment options for an ACL tear?
I was informed that I suffered an ACL tear while skiing. Do I need to undergo surgery to repair it? My friend mentioned that he didn’t have surgery.
Thank you for your question – another really good one on this forum.
Dr Alan has given you an excellent summary of the treatment option and I would only add that what you plan to do really impacts on your treatment decision.
If you are keen to return to a twisting/turning sport, then an ACL repair should be considered. But if running and cycling are your main areas of interest, then it is not desperately necessary and seeing a physiotherapist to build up muscle after the injury might be the way forward. Indeed, I have had a number of patients who decided against surgery as they did not feel it was necessary, and they continue to be physically active and sporty to this day.
Great question and again shows how important individualisation of medical care is rather than following general rules!
The anterior cruciate ligament (ACL) provides stability to prevent the shin bone (tibia) sliding forwards and rotating in relation to the thigh bone (femur).
Patients with a complete ACL tear may find that they are unable to play sports where they need to turn, sidestep or pivot rapidly e.g. soccer, basketball, because their knee keeps ‘giving way’.
Everyone reacts differently to an ACL injury, and your friend may not have had exactly the same injury, activity level and symptoms that you have.
When I meet a patient with a suspected ACL tear I assess them as an individual to determine what effect the injury is having on their lives.
ACL reconstruction may improve the quality of their life and allow them the/ opportunity of returning to sports, but there is a lengthy rehabilitation period of up to a year.
If you are young, your knee is unstable and preventing you from playing the sport(s) you love, then you might benefit from an ACL reconstruction. There is also some evidence that having an ACL reconstruction can reduce (but not completely eliminate) the risk of developing osteoarthritis in later life.
Here are some useful resources for those with an ACL injury: