Is Surgery the Only Answer to an ACL Injury?

When faced with an anterior cruciate ligament (ACL) injury, the prospect of surgery can be daunting. However, the good news is that surgery is not always the only solution. ACL injuries can be managed non-surgically, and various factors influence the decision between surgical and non-surgical treatment. 

In this article, we explore therapies for ACL injuries in Singapore, explore non-surgical treatment options, and discuss when surgical intervention may be necessary.

Understanding ACL injuries

ACL is one of the major ligaments in the knee, playing a crucial role in stabilising the joint. Injuries to the ACL are common and can result from various activities, including sports, falls, and sudden twisting motions.

ACL injuries are categorised into different grades based on severity, ranging from a mild sprain to a complete tear. In many cases, the decision between surgical and non-surgical treatment hinges on the degree of the injury, the individual’s activity level, and overall health.

Non-surgical treatment

Who is it for?

Non-surgical treatment for ACL injuries is a viable option for individuals with partial ACL tears or those who have a lower activity level. It is also often recommended for older patients who may not need a fully functional ACL for their daily activities. 

Rest and activity modification

Rest and activity modification are essential components of non-surgical ACL injury treatment. These involve reducing weight-bearing activities and avoiding movements that stress the injured knee. 

Physical activities should be adjusted to accommodate the healing process, and a gradual return to normal activities is recommended once the knee is stable and strong.

Physical therapy

Physical therapy is the foundation of non-surgical ACL injury treatment. A trained physical therapist can develop a customised rehabilitation program to strengthen the muscles surrounding the knee joint and improve stability. 

Physical therapy may involve exercises to increase the range of motion, build strength, and enhance proprioception (awareness of the joint’s position). Physical therapy can be highly effective in restoring functionality and reducing pain.

Bracing

Bracing is another non-surgical option for ACL injuries. A knee brace can help to support and stabilise an injured knee, lowering the risk of further damage. 

Braces are beneficial during physical activities and sports, providing a sense of security to the individual. However, individuals with highly active lifestyles may need more support than bracing provides.

Anti-inflammatory medication

Anti-inflammatory therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can alleviate pain and inflammation caused by ACL injuries. 

These drugs can be beneficial in the short term, particularly in the early stages of non-surgical treatment. They are, however, only temporary solutions and should only be used under the supervision of a healthcare practitioner.

Surgical treatment

Who is it for?

Surgery is recommended for individuals with complete ACL tears, high activity levels, and those involved in sports or activities that require a fully functional ACL. Surgical treatment may also be considered for those with unstable knees, persistent pain, or individuals who wish to return to high-impact sports.

ACL Reconstruction surgery

ACL reconstruction surgery involves replacing the torn ACL with a graft, typically taken from the patient’s tissue (autograft) or a donor (allograft). This surgical procedure aims to restore the stability and function of the knee joint. 

Recovery and rehabilitation following ACL reconstruction are essential, and they often include physical therapy to regain strength and mobility.

Total knee replacement

In some cases, especially for older individuals with degenerative knee conditions and a history of ACL injury, total knee replacement may be recommended. 

This procedure involves replacing the entire knee joint with an artificial implant. While it is not a direct treatment for ACL injuries, it can be a viable option for those with extensive knee damage.

Rehabilitation

Whether a patient undergoes ACL reconstruction or another surgical intervention, rehabilitation is a critical phase of the recovery process. Physical therapy is essential to regain knee strength and function. Rehabilitation duration and exercise intensity may vary based on the surgery and the individual’s health.

Consult Spire Orthopaedic

While surgery is a common approach for ACL injuries, it is not the only answer. Non-surgical methods can be highly effective, particularly for individuals with partial tears or lower activity levels. Operation and non-surgical treatment should be decided with a medical practitioner, considering the individual’s specific circumstances and goals. 

Spire Orthopaedic specialises in orthopaedic care in Singapore and has a team of experts experienced in both surgical and non-surgical treatment options for ACL injuries. We can guide you to the most suitable approach based on your needs and goals.

Book an appointment today.

References
https://orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/
https://www.hss.edu/condition-list_acl-surgery.asp
https://my.clevelandclinic.org/health/diseases/16576-acl-tear