It’s true—not everyone who tears their ACL needs surgery, but some do. So how do you know which category you fall into?
In this post, we’ll take a look at a few commonly asked questions when it comes to ACL tears, some non-surgical treatment options, and what to expect if you decide to opt for surgery.
Let’s get started!
Is there an alternative to ACL surgery?
This depends on how badly the ACL is torn. There are three grades of tears: Mild (Grade 1), moderate (Grade 2), and severe (Grade 3). Whereas a Grade 1 tear is when the ligament is stretched but not completely torn, a Grade 2 tear involves a partial tear of the ligament, and a Grade 3 tear is when the ligament is completely ruptured. Whereas Grade 1 and 2 tears usually don’t require surgery, surgery is more common for Grade 3 tears.
Alternatives to ACL surgery can include physical therapy, using a brace, platelet-rich plasma (PRP) therapy, and stem cell therapy.
Can an ACL repair itself without surgery?
No. Ligaments can’t repair themselves on their own. Therefore, if you have a full—or Grade 3—ACL tear, it can’t be repaired without surgery.
What happens if you tear your ACL and don’t have surgery?
This will also depend on the severity of the tear. If you have a Grade 3 tear, you may experience weakness, buckling, pain, and or giving out of the knee during day-to-day activities if you don’t opt for surgery. Additionally, without surgical intervention, you put yourself at a higher risk of developing osteoarthritis in the affected knee over time. This is due to the increased instability and abnormal movement patterns, which can accelerate the wear and tear on the joint.
Can you walk with a torn ACL without surgery?
This, too, depends on how severe the tear is and whether there are additional injuries, such as a concomitant meniscus tear. With Grade 1 and Grade 2 tears, walking may be possible and not very difficult after the inflammation goes down. However, with Grade 3 tears or if there is an accompanying meniscus injury, you may experience significant pain, instability, and limited movement. These factors can make walking challenging and may require the use of braces or other support to maintain mobility.
Can walking on a torn ACL make it worse?
Walking with a Grade 3 tear may increase the risk of further injury to the knee, such as additional ligament damage or cartilage tears. This risk is particularly high if you have a concomitant meniscus tear, as the instability caused by the torn ACL can exacerbate the meniscus injury and lead to more severe damage over time.
What can I expect if I opt for ACL surgery?
If you decide ACL surgery is right for you, here’s what you can expect:
Pre-Surgery
Before surgery, you’ll have consultations with your orthopedic surgeon who will evaluate the extent of your injury through physical exams and imaging tests like an MRI. Physical therapy might be recommended to strengthen the muscles around the knee before surgery.
The Day of Surgery
The day of surgery, you’ll check into the hospital or surgical center, change into a hospital gown, be given an IV, and meet the anesthesiologist, who will give you general anesthesia. During the procedure, your orthopedic surgeon will arthroscopically reconstruct the torn ACL, typically using a graft from your patellar tendon, hamstring tendon, or a donor, depending on what you choose. The procedure usually lasts between one and two hours.
Post-Surgery
You’ll spend some time in a recovery room under observation as the anesthesia wears off, and pain management will be initiated; this often involves medications and an ice machine for the knee. Since most ACL surgeries are outpatient, you’ll likely go home the same day.
Rehabilitation and Recovery
During the first few weeks, you’ll need crutches and a knee brace to stabilize the knee. Pain and swelling are common, which is why ice and elevation are recommended. Physical therapy will start almost immediately to maintain your range of motion and prevent stiffness, and will last several months, focusing on gradually restoring strength, flexibility, and function. Exercises will progress from gentle movements to more intense strength training and functional drills. During this time, you’ll have regular follow-up visits with your surgeon to monitor your healing and progress.
Full recovery and a return to sports or intense physical activities usually takes six to 12 months, depending on your progress and adherence to the rehabilitation program.
How long is too long to wait for ACL surgery?
While there is no strict deadline for ACL surgery, many doctors recommend not delaying surgery beyond three months, as it may increase the risk of developing additional ligament damage, cartilage damage, or meniscus injuries due to knee instability. Other factors to consider will be how functional the knee currently is, as well as prehabilitation and rehabilitation timelines.
If you’d like to better understand your ACL tear, your treatment options, and get advice from an ACL specialist, please contact us to book an appointment with Dr. Woodson, our ACL reconstruction specialist, today.