ACL Injury

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. There are approximately 200,000 cases of ACL injuries with nearly 100,000 ACL reconstructions each year. People who participate in high-risk sports such as football, basketball, skiing, and soccer are generally at a higher risk for ACL injuries.Nonsurgical Treatment

In nonsurgical treatment, physical therapy and other rehabilitative exercises are used to restore the knee to a condition close to its pre-injury state. This treatment may be facilitated with the use of a hinged knee brace. However, many people who chose a non-surgical method of treatment experience secondary type injuries due to repetitive instability. Nonsurgical treatments are likely to be most successful for patients with the following:

  • With partial tears and no instability symptoms
  • With complete tears and no knee instability symptoms during low-demand sports who are willing to give up high-demand sports
  • Who do light manual work
  • Whose growth plates are still open (children)
  • Surgical Treatment

In a surgical method of treatment for an ACL tear, the torn ACL is generally replaced by a substitute graft made of tendon. The grafts commonly used to replace the ACL are:

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

Patients treated with surgical treatment usually have a long-term success rate of 82 percent to 95 percent. Recurrent instability and graft failure are seen in approximately 8 percent of patients.
Rehabilitation

Physical therapy is a crucial part of successful ACL surgery. Exercises typically begin immediately after surgery. Much of the surgery's success highly depends on the patient's commitment to rigorous physical therapy.
The goals of rehabilitation for ACL reconstruction include reducing knee swelling, maintaining mobility of the knee cap, and regaining full range of motion of the knee. Strengthening the quadriceps and hamstring muscles are also important parts of ACL rehabilitation.

Patients may return to sports when there is no longer any swelling, when full knee range of motion is achieved, and when muscle strength, endurance, and functional use of the leg has been restored.