Snap! You felt a pop, your knee give out, and a bolt of pain. A trip to the doctor’s office and some medical imaging confirms your fears…you have an ACL tear. So now what? Surgery and a long (9+ month) rehab process? Surprisingly, many people will make a full and complete ACL recovery without surgery!
Are you a candidate to avoid ACL reconstruction surgery and the long, difficult rehab that comes with it? Let’s discuss…
Will My Knee Be Messed Up If I Don’t Have ACL Surgery?
First, we have to discuss the success of ACL reconstruction surgeries. Having the surgery and rehab itself does NOT guarantee that long term the replaced ligament will remain intact. In fact, an alarming body of research has come forward showing increasing rates of revision surgeries (having to get the surgery done again after a second ACL tear) and large numbers of people tearing their opposite ACL!
It may surprise you that there is research showing that at 5 years after injury we didn’t see significantly different outcomes in people that had surgery versus those that completed a structured rehab program. Even more surprising to many in the medical field is the research looking at joint arthritis in those that do vs. do not undergo surgical reconstruction. For example, a twenty year study found no difference in arthritis between those getting surgery and those doing conservative care.
What about sports? To elaborate, you’ll also be surprised by the number of incredibly high level athletes compete with ACL deficient knees.
Should Everyone Do ACL Recovery Without Surgery?
NO! But many people undergoing this surgery and incredibly long rehab process don’t really need to. Instead they can skip the surgery and work with a knowledgeable sports physical therapist and get back to the activities they love quicker. There are a few indicators that someone may do well with conservative management of their ACL tear.
- One or less episodes of the knee giving out since the original injury
- A timed hop score of ≥ 80% of the other side
- A Knee Outcome Survey-Activity of Daily Living Scale (KOS-ADLS) score of ≥ 80%
- A global rating score (GRS) of ≥ 60%
Every individual is different. Many individuals really need the surgery but many who have torn their ACL unnecessarily have this surgery. At Onward Physical Therapy we would love the opportunity to discuss helping you return to the activities you love. Please schedule an appointment with our sports physical therapy team or a free phone call to discuss your options.