Do ACL Injuries Require Surgery?

10/05/2021

Do ACL Injuries Require Surgery?

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. In common, the ACL injury is more prevalent in people who engage in high-risk sports, such as soccer, skiing, etc.

Almost half of the ACL sprains occur in combination with injury to the articular cartilage, meniscus or other ligaments. Additionally, patients may have injuries to the bone beneath the cartilage surface. These may be observed on a magnetic resonance imaging (MRI) scan and may indicate injury to the overlying articular cartilage.

Cause Of ACL Injuries

It is estimated that the majority of ACL injuries occur through non-contact mechanisms, while a smaller per cent result from direct contact with another player or object.

The mechanism of damage is often linked with deceleration combined with pivoting, cutting or sidestepping manoeuvres, clumsy landings or "out of control" play.

Nonsurgical Treatments For ACL Injuries

In the non-surgical procedure, progressive physical treatment and recovery can recover the knee to a state close to its pre-injury time and instruct the victim on how to prevent instability. This may be supplemented with the use of a hinged joint brace. However, many people who prefer not to have surgery may experience secondary injury to the knee due to repetitive instability episodes.

When Surgery Is Required?

Surgical treatment is usually recommended in dealing with ACL ruptures in combination with other injuries in the knee. However, choosing against surgery is reasonable for select cases.

Surgical Treatment

ACL damages are not commonly repaired by stitching them back together because reconstructed ACLs have usually been exposed to fail over time. Therefore, the torn ACL is normally substituted by a graft made of a tendon.

  • Patellar tendon autograft
  • Hamstring tendon autograft
  • Quadriceps tendon autograft
  • Allograft

Patient Considerations

Active adult sufferers associated with sports or occupations that need swivelling, turning or hard-cutting, as well as complex manual work, are urged to consider a surgical procedure. This involves older victims who have earlier been excluded from consideration for ACL surgery.

In kids or adolescents with ACL ruptures, early ACL repair creates a potential risk of growth plate injury, leading to bone growth difficulties. The doctor can delay ACL operation until the child is closer to skeletal maturity or the surgeon may revise the ACL surgery method to decrease the risk of growth plate injury.

A person with a ripped ACL and notable instability is at a high risk of incurring another knee injury and should therefore consider ACL rehabilitation.

Surgical Procedure

Before any surgical procedure, the patient is normally sent to physical therapy. Patients who have a hard, swollen knee lacking full range of movement at the time of ACL operation may have notable problems retrieving motion after surgery. It normally takes three or more weeks from the time of injury to achieve full range of motion. It is also suggested that some ligament injuries be braced and permitted to heal before ACL surgery.

Surgical Complications

  • Infection
  • Viral transmission
  • Bleeding, numbness
  • Blood clot
  • Instability
  • Stiffness
  • Extensor mechanism failure
  • Growth plate injury
  • Kneecap pain

It is ideal to take into serious consideration your doctor’s advice if you’re suffering from an ACL injury as they will be the best judge for your condition and take the best decision for your speedy recovery.

Dr V V Satyanarayana E
Consultant Orthopaedic Surgeon

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