What is the treatment for an ACL injury?

Do R.I.C.E. therapy immediately after the injury:

  • R: Rest.
  • I: Ice.
  • C: Compression.
  • E: Elevation.

The type of treatment you receive is up to you. Many people with ACL tears decide to have surgery so that they can return to the activities they did before the injury. If your activity level isn’t as high, you might choose to not have surgery. But, keep in mind that your torn ACL won’t heal on its own.

What are the surgical treatments? How is the surgery done?

Surgery to reconstruct a torn ACL is done with a graft of a tendon (tendons connect muscles to bones) from your body, such as a hamstring (from the back of the thigh), or the kneecap/patellar tendon (from the front of the knee). Occasionally, a cadaver tendon (a tendon from someone who died and donated his/her body to science) can be used in older individuals who are still very active. Cadaver tendons are typically not used in young athletes because of the higher rates of re-tear.

The surgery is minimally invasive, which means that instead of making a large incision with a scalpel, the surgeon uses an arthroscope, a thin wand-like instrument. The surgeon inserts the arthroscope and the working instruments through small incisions in your knee.

What happens after ACL surgery?

After surgery you’ll need to keep your wound clean and dry. You’ll use ice to reduce swelling and pain. You may use a brace and crutches.

You’ll have physical therapy to strengthen your knee and the muscles around it. The first few days following surgery, you’ll perform gentle range-of-motion and simple strengthening exercises, and some weight-bearing exercises. Physical therapy will start within the first week, including advanced strengthening and balance activities.

After about 12 to 16 weeks, if you’re not an athlete, sport-specific activities are added to the rehabilitation program, such as hopping, jumping and agility drills. An athlete should be able to return to normal activity about six to nine months after the ACL surgery.

How soon after treatment will I feel better? What’s the recovery time?

Six to nine months is typically how long it takes to recover from ACL surgery.

What are the nonsurgical treatments?

Nonsurgical treatments include bracing and physical therapy:

  • Bracing: Putting a brace around your knee will keep it stable. You’ll have to use crutches so that you don’t put weight on that leg.
  • Physical therapy: Exercises will help your knee function and strengthen the leg muscles around it, supporting it.

Keep in mind that if you choose not to have surgery, you’re at a higher risk of re-injuring your knee.

What are the complications of surgery?

  • Infection. Infection is rare, but still a risk with any type of surgery.
  • Stiffness. Stiffness in the knee is common post-surgery, but physical therapy can help it. This can be avoided by performing rehabilitation to regain all of your motion before surgery.
  • Viral transmission. Receiving a graft from a cadaver always comes with a risk of contracting diseases like HIV and Hepatitis C. There is less than a one in a million chance that you’ll get an HIV-infected graft.
  • Blood clot. A blood clot can be life-threatening, but it’s rare. The clot can break off in the bloodstream and cause a pulmonary embolism in the lungs or a stroke in the brain.
  • Kneecap pain. This complication is common when using patellar tendon grafts.
  • Growth plate injury. Early ACL reconstruction in a child or adolescent risks this. If possible, the surgeon will delay the procedure until the skeleton is fully grown or utilize special techniques to avoid injuring the growth plate.

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