I’ve injured my ACL! Now what?
The “dreaded” ACL injury can range between a significant inconvenience for most to career ending for others. This ligament injury often receives negative media coverage and sporting commentators or coaches often talk about the significant repercussions of the surgery and the 9-12 months of rehabilitation that is to follow. But does it really have to be this way? Are there other options to this type of knee injury and is surgery the only way forward in making a full recovery.
Well thankfully the answer is no. There is a growing body of evidence indicating that non-surgical approaches for ACL injuries can be just as effective in recovering and returning to sport as surgical. With one benefit often being the faster return to activity time frames of 3-6 months.
Now, it is important to clarify first up that there is a category of patients who require surgery and who do benefit more in the long-term from going under the knife, rather than going down the non-surgical route. Those with more complicated injuries involving additional structures of the knee or those knees presenting with significant instability would benefit more from this surgical approach.
However, in patients with otherwise healthy and functionally stable knees, the conservative approach with a period of early onset rehabilitation has been shown to have just as successful an outcome as ACL reconstruction surgery, with some cases experiencing even poorer outcomes in the event of early surgery. It is important to remember that the ACL does have the capacity to heal, and researchers are currently looking into what methods could promote optimal healing. Also, there is no evidence that indicates increased arthritic changes of the injured knee in the long-term for those that take a non-surgical path compared to surgical.
Unfortunately, there is no golden ticket to effort free and guaranteed return to sport after an ACL rupture. Both surgical and non-surgical options have their pros and cons and it is important that each ACL injury be addressed at a specific and individual level. It is important in this regard that if you suffer an ACL injury, you spend time collaborating with your physiotherapist and other health care professionals to discuss the best option for your circumstance. Contrary to current popular thinking it could well be that it does not involve surgery.
By Leroy Dekker
Physiotherapist
