How do you and your doctor decide if you need surgery?

This is a very complicated question and generally can only be answered by discussion with your orthopedic surgeon. There are a few guidelines, however. Typically, the decision to reconstruct the ACL is based on the following:

  1. Patient's age and activity level.
  2. Associated injuries, such as a meniscal tear, medial collateral ligament injury, or significant cartilage injury.
  3. Response to rehabilitation.
  4. Amount of instability and magnitude of the patient's symptoms.

Generally speaking, a young high school football player who injures his ACL and wants to continue to compete at the same level or higher (e.g., college play) will require a reconstruction. Another player may decide that he doesn't want to play football ever again and is happy surfing the internet and swimming; this person may not require an ACL reconstruction. A 32-year-old skiier who has injured her ACL and medial meniscus, and wants to continue to ski recreationally, should probably have her ligament reconstructed. As you can see, the permutations are endless; the decision needs to be made on a patient-by-patient basis with a surgeon who knows you and your lifestyle demands. Most sports medicine orthopedic surgeons do not place an "upper age limit" on whether to reconstruct the ACL.

If you and your doctor have decided on surgery to reconstruct the ACL, then you will want to learn more about ACL reconstruction surgery.

If surgery is not necessary, then strengthening excercises, particularly of the hamstrings are prescribed. Non-operative exercise therapy for ACL tears includes:

  • Maintaining range of motion.
  • Regaining stability by improving your muscle strength. By strengthening the muscles you can compensate for the absence of the ligament. 
  • Knee bracing to help you regain stability of your knee, especially for sports. For significantly unstable knees; or for return to competitive sports where you can't afford to be slowed down, no brace can surpass the DonJoy eXtreme Knee Brace in stability and comfort. Ossur/Innovation Sports also offers the Ossur CTi OTS Pro Sport Knee Brace, which allows you to obtain the technologies found in the CTi custom knee brace at a fraction of the cost. The DonJoy Legend Knee Brace is the former top-of-the-line brace that also provides excellent stability and light weight, at a lower cost. We also offer the DonJoy Playmaker Knee Brace as a solution for moderate instability, even for those people who want to return to contact sports. Our Drytex Hinged Knee Brace is great for people with mild instability who want some extra support, particularly in side-to-side motions.

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