Torn ACL may not always mean surgery
July 22nd, 2010
03:53 PM ET

Torn ACL may not always mean surgery

Tearing an ACL doesn't always mean a trip to the operating room, especially if you're young and active, researchers  report in the New England Journal of Medicine.

The knee's ACL, or anterior cruciate ligament, acts like a rubber band that connects your thigh bone to your leg bone. It provides stability to the knee especially when playing sports such as soccer, basketball or tennis that call for stopping, planting and pivoting. When it pops or tears it requires a trip to your doctor.

Researchers at Lund University in Lund, Sweden wanted to find out whether recovery and use of the knee were more successful depending on when or whether you had surgery.

The experts asked 120 young, active adults who had torn an ACL to undergo one of two different treatments. The first group had surgery shortly after the injury while the other patients received rehabilitation with the option of later ACL surgery if needed. Physical therapists supervised rehabilitation sessions for the second group and often advised patients to use a knee brace when playing sports.

At the end of two years less than half those in the rehab group had opted for ACL knee surgery. And when patients were asked about how satisfied they were with their knee – measured by function, pain levels, and the ability to return to pre-injury activities – the answers were about the same between patients who had gotten surgery shortly after injury and those who had not.

But delaying surgery is not without risks. Elite athletes who plan to continue playing sports requiring quick changes in direction and lots of twisting need a healthy ACL and are usually advised to undergo surgery soon after their injury. Also, the likelihood of developing arthritis increases if an unstable knee gives way leading to a fall. A torn ACL may mean more wear and tear on other knee structures which may mean a trip to your surgeon for a different type of knee operation.

Orthopedic Surgeon Bruce Levy with the Mayo Clinic in Rochester, Minnesota, says no one treatment strategy is right for all patients.

"It's important that every patient discuss the pros and cons of surgical management and non surgical management with their doctor and that a treatment strategy be individually tailored to the specific knee injury and the specific knee of the patient," says Levy.

soundoff (71 Responses)
  1. Kaushal Mashru

    I Tore my ACLbefore 3 Months falling from bike. My MRI Reports says following Things:

    * High grade ACL Injury,
    * Depreesed Fracture of postero-medial tibial corner with contusion of posterior tibial condyles.
    * Grade II Sprain of MCL
    * Mild Joint Effusion.

    I Consulted with two doctors, one doc advised surgery, while other suggested me physical therepy.

    Please suggest what should i Do.


    September 26, 2014 at 10:32 | Report abuse | Reply
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  4. Sale

    It is amazing how some people have no idea what they are talking about. Someone sugests get ACL repaired right away because posibility of arthritis later in life. Absolutely wrong. Whether you have your ACL repaired or not you are at the same risk of developing arthritis. The ACL reconstruction brings back stability to your knee but it does not improve your chances of avoiding arthritis that is why most of the people with repaired ACL end up with arthritis 7-8 years after the surgery. On the other hand if you choose not to have surgery you stll might be OK. The most important thing to remember is the level of instability in your knee. If you don't have an ACL but your knee is stable than there is small chance you will injure other parts of your knee. Heck you can have your reconstruction surgery and still unstable knee and you are at higher risk of further injury than someone who did not have surgery but has stable knee. I injured bot of my ACL, first time I had surgery, second time I did not. My knee without ACL feels better than the other one. For those who had surgery 1-2 years ago and feel great wait until you get to 7-8 years from your surgery and then tell us how you feel.

    March 26, 2015 at 20:58 | Report abuse | Reply
    • Cbear

      Great response, I had the same ACL events occur and chose surgery on my left knee. On my right knee my ACL was completely torn off and I chose to not have the surgery.. My ACL outcome has the been the same as yours.

      September 1, 2015 at 16:47 | Report abuse |
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  6. kaleem md

    No, Tear of ACL, whether it's partial or complete, it can never heal on its own, neither any medication or exercise can help in healing.It has got only one treatment and that is Surgery.It's ACL reconstruction either by the Open method or by Arthroscopic method followed by knee physiotherapy.

    August 15, 2017 at 02:31 | Report abuse | Reply
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    No, Tear of ACL, whether it's partial or complete, it can never heal on its own, neither any medication or exercise can help in healing.It has got only one treatment and that is Surgery.It's ACL reconstruction either by the Open method or by Arthroscopic method followed by knee physiotherapy.

    August 15, 2017 at 02:31 | Report abuse | Reply
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