How To Know When an ACL Injury Requires Surgery

ACL tears are a common knee injury, especially among athletes. Tears to the knee’s anterior cruciate ligament (ACL) can vary significantly in severity. Some tears can be treated without surgery, but other times surgery is unavoidable. The severity of the tear as well as some lifestyle and risk factors are taken into account when choosing a course of treatment.  

Understanding ACL Tears

The ACL is one of four ligaments in the knee which contribute to its movement and stability. ACL tears most commonly occur after sudden twisting or trauma to the knee. Athletes whose sport require frequent turns, stops, or contact may tear their ACL. For example, football players, ballet dancers, and soccer players are prone to this injury. It may also occur after an accident or even after a simple action such as bending down to pick something up.

ACL tears vary in severity as follows:

• Grade I – The ligament is stretched and stressed but not torn. Mild to moderate pain may occur, but the issue is not severe.
• Grade II – The ligament tears but is still intact. Pain, instability, and trouble moving the knee may all occur.
• Grade III – The ligament is completely torn and severed into two pieces. Grade III tears are severe and usually cause dramatic, immediate symptoms.

When Surgery is Considered

In many cases, surgery is the best option for restoring functionality to the knee and relieving symptoms. Untreated ACL tears can lead to more severe problems, such as osteoarthritis and hip issues. However, no surgery is without risks and downsides, so the benefits must be weighed against the risks.

Severe, Grade III tears often require ACL reconstruction, while Grade I tears are unlikely to require reconstruction. For moderate tears, the decision is based on issues such as:

• How the patient has responded to non-surgical treatments
• Where the tear is and how likely it is to respond to non-surgical treatments
• How active the individual is and whether they require full use of the knee (for example, athletes are much more likely to require surgical treatment than less active individuals)
• How old the patient is, since age affects whether full use of the knee is required and how the patient will respond to surgery
• Whether there are any other risk factors, such as preexisting diseases that would make surgery a more risky prospect  

ACL reconstruction is usually performed using minimally invasive, arthroscopic surgery. This allows the doctor to operate on the knee without opening up the knee and making large incisions.

Only a physician can determine whether surgical ACL reconstruction is the right choice in any individual case. Dr. Howard Marans would be happy to meet with you about treatment for your ACL tear. To schedule a consultation today, please click below and enter your information or call OC Orthopedic at (714) 979-8981.