Does an ACL Tear Always Require Surgery?

If you’re suffering from the pain and lack of mobility a torn anterior cruciate ligament (ACL) brings, you’re not alone. Every year, about 250,000 Americans tear this fibrous body of tissue, which serves to connect your femur to the lower leg bone at your knee.   

While ACL injuries often happen when you twist, turn, or stop suddenly, they can also occur after a collision or as the result of hyperextension of your knee. But no matter how it happened, an ACL tear can keep out of the game for months. 

At Victory Sports Medicine & Orthopedics in Skaneateles, Syracuse, and Auburn, New York, board-certified orthopedic surgeon Marc Pietropaoli, MD, and our team have the skill and experience needed to accurately diagnose ACL tears and other injuries that may mimic the symptoms of ACL injuries, ensuring you get the best treatment possible.  

Many of our patients with ACL tears and injuries worry that surgical repair is their only option, but the truth is that there are several treatment options available. Here’s a closer look at ACL tears and if surgery is required for this type of injury. 

Understanding the ACL

The knee is a complex joint where your lower leg bones and thigh bone, or femur, come together at the kneecap. Tough, fibrous ligaments called the collateral and cruciate ligaments, work to hold the bones together and help you move fluidly. 

The cruciate ligaments include both your anterior cruciate ligament and posterior cruciate ligament. These ligaments cross, forming an X shape, to help stabilize your knee joint and allow you to move in multiple directions.  

What causes ACL injuries?

Most ACL injuries occur during activities that don’t involve contact with other people. Instead, sports or activities that involve a sudden change in motion, like basketball or downhill skiing, are the most common cause of ACL injuries, including: 

ACL injuries don’t always mean an ACL tear, but all ACL injuries can lead to instability in your knee joint and may cause trouble with mobility. 

How to spot an ACL tear

The most obvious sign of a torn ACL is a popping sound or sensation at the time of injury. This is typically accompanied by pain and an inability to bear weight on the injured leg. Other symptoms you might experience with a torn ACL include:

Because the knee is a complex joint, other injuries in the area may cause the same or similar symptoms. It’s important to visit an expert, like the team at Victory Sports Medicine & Orthopedics, to ensure you receive the right diagnosis.

Surgery vs. other torn ACL treatments

Before recommending any treatment option, it’s important to have an accurate diagnosis of your condition. Dr. Pietropaoli reviews your symptoms, medical history, and conducts a physical exam to look for signs of an ACL tear. He may also order imagining studies, like an MRI or X-ray, to confirm the diagnosis. 

Whether your torn ACL requires surgery depends on the severity of your injury and the level of instability of your knee. Dr. Pietropaoli also takes into account your activity level and other factors, such as your ability to bear weight, before making any treatment recommendations. 

When surgery is required

If Dr. Pietropaoli determines your ACL is completely torn, surgical intervention is required to ensure your ligament heals properly and fully. Patients with an active lifestyle or poor knee stability may also require surgery for torn ACLs. 

At Victory Sports Medicine & Orthopedics, Dr. Pietropaoli performs ACL reconstruction using a bone-patellar tendon-bone graft, typically from the tissues around your kneecap. Other cases may call for the use of different graft and allograft sources, including:

Dr. Pietropaoli places the graft materials and reconstructs the damaged ACL using specialized surgical implants to hold the graft in place. As you heal, the graft strengthens and adds additional stability to your knee.

There are rare instances when Dr. Pietropaoli will recommend an ACL repair.  He uses the latest ACL repair techniques, such as with an Internal Brace, in the patients he deems amenable for an ACL repair.  ACL repair can often can lead to a quicker recovery than a full blown ACL reconstruction.

When nonsurgical treatments may be considered

Patients with decent knee stability, older patients, and patients who don’t lead very active lifestyles may be candidates for nonsurgical treatment modalities. These conservative treatments may include:

Dr. Pietropaoli may also recommend combining one or more of these nonsurgical treatments with ACL reconstruction to speed healing and improve your outcome.   

If you’re struggling with a torn ACL, don’t wait to contact the experts at the Victory Sports Medicine & Orthopedics office nearest you. You can request an appointment online or schedule a consultation by calling our friendly staff at 315-303-8352. 

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