By: Nicole Skipper, ATC
For most athletes, one of the injuries they fear sustaining is a tear of the anterior cruciate ligament (ACL). Their season is likely over, and they worry their career could be too. With a rehabilitation process of 6 months to a year, athletes must decide quickly how they want recover. Listed below are options available to discuss with your physician for surgical and nonsurgical ACL tear repair.
You do not have to have surgery. Athletes and non-athletes can live an active lifestyle with a torn ACL. The deciding factors to determine if it’s safe or to not fix the tear include the amount of instability and surrounding tissue damage. Partial ACL tears, physical activity with low demand for cutting and twisting, low instability, and no tears or fractures of structures in the knee joint may be reasons to not have surgery. You will still go through physical therapy with a goal of obtaining pre-injury strength and function.
Surgery is a common treatment for ACL tears. “Active patients involved in sports or jobs that require pivoting, turning or hard-cutting as well as heavy manual work are encouraged to consider surgical treatment.” Lifestyle and activities of daily living are important deciding factors to determine if you should have surgical intervention, not your age.
Once you have decided to have surgery, you need to discuss the best type of repair for your injury, lifestyle, and body. The first decision is allograft verse autograft repair. Allograft repair means tissue from another source, such as a cadaver. ACL grafts from cadaver patellar, hamstring, and achilles tendons can be used in surgery in the same ways as autograft tissues. Autograft repair means using tissues from your own body to replace the torn ACL. The four most common autograft tissues are the quadriceps, hamstring, patellar tendon, and combination of semitendinosous and gracilis tendons – a technique known as double bundle.
Athletes need to discuss the pros and cons to their surgical or nonsurgical repair of their torn ACL. They should be prepared to ask questions and understand what their decision means for their recovery process. An ACL tear isn’t the end of the world, just another challenge to overcome.