Do ACL Tears Always Require Surgery?

Whether you’re an athlete, a weekend warrior, or you lead a more sedentary lifestyle, knee injuries are never great news for anyone. Yet these joints are among the most commonly injured thanks to how hard they work.

ACL (anterior cruciate ligament) tears account for about half of all knee injuries. Each year in the United States, doctors perform about 400,000 ACL reconstruction surgeries.

At New Braunfels Orthopaedic Surgery & Sports Medicine, our team of highly qualified orthopedic surgeons certainly performs our fair share of ACL surgeries, helping athletes and nonathletes alike to regain full use of their knees. If you’re dealing with an ACL tear and you want to know whether surgery is in your future, the short answer is: Maybe.

For the longer answer, read on.

A brief background on ACL tears

Your ACL is one of four ligaments in your knee, and these connective tissues, which attach bone to bone, keep your knee stable.

Your ACL and its counterpart, the PCL (posterior cruciate ligament), criss-cross your knee and control the back-and-forth movement in the joint. Your ACL travels diagonally across the middle part of your knee, and this tissue prevents your shinbone from sliding forward and also provides rotational stability in this major joint.

With an ACL tear, there are different degrees of ligament damage, which we break out into three categories:

• Grade 1 — the ligament is stretched
• Grade 2 — the ligament is loose, and there’s a partial tear
• Grade 3 — there’s a full tear in the ligament or it separates from the bone completely

Unfortunately, partial tears of the ACL are rare. Most tears are full, or Grade 3, tears.

When ACL surgery makes sense

As noted, most ACL tears are full or near-full tears. Making matters even worse, about half of ACL injuries also include damage in the meniscus or damage to the articular cartilage inside the joint.

While the severity and degree of the damage to your knee is certainly a hurdle, the even bigger one is that your ACL doesn’t have the resources to repair itself. If you’re dealing with a full tear in your ACL, it won’t knit back together or reattach itself to the bone without outside help.

Through ACL reconstruction surgery, we use tendon tissue from another part of your body, or donor tissue, to reconstruct your ACL and re-establish stability in your knee. Simply stitching your existing ACL back together has proven not to be a viable solution; reconstruction delivers much better results.

After your surgery, there’s a period of rehabilitation. Once you’re finished with rehab, you should be able to move around on your knee as you did before.

Conversely, if you don’t want to opt for ACL surgery, that’s certainly possible, but you should expect ongoing instability in your knee when this connective tissue isn’t working. If you aren’t active, this route can work. If you enjoy an active lifestyle, however, surgery is generally the better option.

For a better idea about which ACL tear approach would work best for your lifestyle and goals, please call our office in New Braunfels, Texas, at 830-341-1386 or use our online form to request an appointment today.