Is Surgery Needed for my ACL Injury?

Is Surgery Needed for my ACL Injury?


Article by Zoe Russell

Is Surgery Needed For My ACL Injury?

The Anterior Cruciate Ligament (ACL) plays a pivotal role in stabilising the knee. Together with your muscles, other ligaments, and receptors in the joint capsule and surrounding tissues, it maintains knee stability.

An ACL injury often appears as a devastating setback, and decisions on treatment are frequently made shortly after the injury, often leaning towards surgical reconstruction.

Did you know there are three treatment options for ACL injuries?

  1. Early Surgical Reconstruction: Swift surgical intervention.
  2. Delayed Surgical Reconstruction after 3 Months of Rehabilitation: A surgical approach following a period of rehabilitation.
  3. Non-Surgical Management: A non-invasive approach.

Current evidence indicates that delaying the decision on surgical intervention until three months of rehabilitation can lead to better long-term outcomes, particularly for recreationally active individuals (Grindem et al., 2014). This differs from elite athletes, who often opt for early surgery.

The choice of treatment varies among different populations based on individual characteristics and available evidence (Ardern et al., 2014). Everyone with an ACL injury should undergo structured rehabilitation, including testing.

So, how do you determine the best course of action?

Several individual factors come into play, including:

  • Age
  • Activity Level

Research suggests that if you wish to remain recreationally active, surgical reconstruction may not be necessary (Frobell et al., 2010; Frobell et al., 2013). On the other hand, there’s no current research supporting a non-surgical approach for elite athletes (Frobell et al., 2013; Grindem et al., 2014).

For those aiming to return to high-impact sports that involve cutting or rapid directional changes (Level I Sports), surgical repair may be the preferred choice. However, it’s advisable to complete pre-surgical rehabilitation before making a decision.

Looking ahead, it’s crucial to consider your future goals. Understanding where you are now and where you want to be is essential.

Knee stability is another factor. Some individuals can dynamically stabilize their knee using their muscles, even without a functional ACL. This can be assessed through prehabilitation programs and ongoing testing.

Concomitant injuries, such as those to the menisci or articular cartilage, may also impact your treatment choice and its timing.

Past medical history plays a role too.

Who Helps Your Decision?

The decision-making process should involve you, your physiotherapist, and your orthopaedic specialist (Ardern et al., 2014). It’s essential to outline all available options, discuss them thoroughly, and develop a comprehensive rehabilitation and recovery plan. Comprehensive outcome testing is recommended, covering physical, psychological, and quality of life measures.

Research in this field is continually evolving, so it’s crucial to consult with a physiotherapist who stays up-to-date with the latest findings.

At PhysioWorks, we offer personalised prehabilitation and rehabilitation programs tailored to your sport and injury. Throughout the program, we conduct tests to monitor your progress and communicate directly with your treating specialist as needed.

If you require a prompt diagnosis and rehabilitation plan, remember that PhysioWorks provides same-day appointments for your convenience.

More information: Common Knee Injuries


ACL Diagnosis

ACL Treatment Options

Related Knee Injuries

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