Who Should Get an ACL Reconstruction Surgery?

Key Takeaways:

• People who are active, or whose knee gives out on them as they perform regular activities like walking should consider an ACL reconstruction surgery.
• People who are not active and don’t experience any knee symptoms or people with advanced knee arthritis do not need to get an ACL reconstruction surgery.
• If your knee regularly gives out, there is a higher risk of injury to the meniscus and the knee cartilage.

If you have been diagnosed with a torn ACL, you might be wondering: what’s next? Both conservative treatments and surgical reconstruction are available for most who tear their ACL. But, there are factors that might affect which recovery path you take.

What is the ACL?

The ACL, or anterior collateral ligament, is a ligament in the middle of the knee. Most ACL injuries result from twisting, sudden stops or changes in direction, jumping, and landing. The symptoms of a torn ACL are:

• A popping sound when the injury occurs
• Knee pain, specifically on the outside of the knee
• Knee swelling
• Knee instability

ACL tears often limit the range of back-and-forth motion of the knee. Fully straightening the knee is particularly painful. These tears can be a grade 1, 2, or 3, depending on how severe the tear is.

Grade 1 is a mild sprain. Grade 2 is a partial tear. Grade 3 is a complete tear.

Who Should Get an ACL Reconstruction Surgery?

When surgically treating a torn ACL, it must be a reconstruction surgery, not a repair. Reconstruction surgery entails “making” a new ACL from a graft of replacement tissue. This tissue usually comes from a portion of the patient’s own iliotibial band, hamstring, quadriceps or patellar tendon (Hospital of Special Surgery). Recovery can take up to a year or more.

Surgery is only recommended if:

• The patient is young.
• The patient experience lasting pain and instability in their knee.
• The patient finds their knee giving out during normal activities like walking, which threatens the other ligaments in the knee.
• The patient is very active, or regularly participates in twisting motions, jumping, or changing directions.
• It is a grade 3 tear.

Who Should NOT Get an ACL Reconstruction Surgery?

ACL reconstruction surgery is not for everyone. Surgery presents risks like infection, anesthetic complications, worsened joint stiffness, nerve damage, or ongoing pain. For these reasons, some people might decide themselves that they do not want surgery. Surgery is NOT recommended for:

• Patients with advanced or early-onset arthritis in their knee, which contraindicates ACL reconstruction surgery.
• Patients that are not particularly active and do not experience pain or instability.
• Patients with a Grade 1 sprain.

Frequently Asked Questions About ACL Reconstruction Surgery

1. How long does the surgery take?
   1. This surgery usually lasts 60–90 minutes, depending on complexity and whether other repairs like meniscus surgery are performed at the same time.
2. Is ACL reconstruction painful?
   1. During the surgery, you will be placed under general anesthesia. Post-operative discomfort is common but manageable with pain medication, ice therapy, elevation, and early controlled movement. Pain typically improves within the first 1–2 weeks.
3. Will I regain full strength in my knee after an ACL reconstruction surgery?
   1. While there is a chance that the reconstruction will fail, most patients regain near-normal strength and function with proper rehabilitation. However, returning to competitive sports too early greatly increases the risk of re-injury. Don’t be hasty!

If you or someone you love has suffered an ACL injury in the Louisville, Kentucky-area, board certified sports medicine physician Dr. Stacie Grossfeld at Orthopaedic Specialists PLLC can help. Orthopaedic Specialists PLLC is accepting new patients, and same day appointments are available. For additional information or to schedule an appointment, please contact Orthopaedic Specialists PLLC today at 502-212-2663.