What is the ACL?
The anterior cruciate ligament (commonly called the ACL) is one of four main ligaments in the knee and essentially serves as the main stabilizer for the knee. It provides stability in the knee through protection of anterior translation (forward sliding movement of the knee) as well as rotational control. This allows individuals the ability to perform cutting and pivoting activities (suddenly changing direction when running and walking). Without an ACL, these activities would not be possible as the knee would continue to give way.
How Does the ACL Tear?
Most ACL tears occur in athletes although they can occur in anyone sustaining a fall or twisting injury with regular activity. The typical mechanism of an ACL injury is a non-contact injury when an athlete is cutting (running and suddenly changing direction) or turning. Oftentimes, seemingly minimal trauma can cause a tear. Other situations occur with a contact injury in sports or a fall. Symptoms of an ACL tear include the feeling or hearing the sound of a “pop” in the knee, pain, and swelling in the knee in the first several hours after the injury.
Does Everyone Need Surgery After ACL Tears?
ACL tears are not always treated surgically. In sedentary individuals or those who want to pursue only straight line or low-impact activities, ACL tears can be treated with rehabilitation alone. However, for anyone who wants to get back to sports and activities that require cutting and pivoting movements, the ACL injury needs to be addressed with either an ACL repair or an ACL reconstruction. Typically, in all young, healthy individuals, surgery is recommended to provide a healthy, stable knee for the rest of the patient’s life.
How are ACL Tears Treated?
The ACL does not have the capacity to heal on its own, except in rare cases of a partial tear. Therefore, for any athlete, whether that is the “weekend warrior” or a professional, surgery is required.
There are two main categories for surgical repair of ACL tears:
The type of surgery recommended at MedStar Georgetown depends on the individual patient. Different patients fall into different categories of surgery based on their age, anatomy, sports activities, and features of their ACL tear found in MRIs (magnetic resonance imaging). A one-size-fits-all approach is not taken or recommended as some treatment methods are better for some types of ACL injuries versus others. Our surgeons customize the approach to the patient.
What is the Recovery Time After an ACL Tear?
Full recovery after an ACL tear takes anywhere from 4-9 months depending on the patient and the technique used. However, the patient typically remains very functional throughout the recovery period.
Physical therapy will begin around 5 days after either the reconstruction or repair procedure to begin working on range of motion and strengthening the ligament and surrounding muscles and tendons. At MedStar Georgetown, we allow the patient to progress to bearing full weight on the knee, as tolerated, immediately. This is more convenient for patients than mandatory crutches and allows patients a quick, functional return to regular activities of daily living.
Patients can begin activity on a bike immediately with progression to an elliptical machine around 6-8 weeks and running around 3 months. Full return to sports activities generally occurs between 6-9 months following the injury.