An ACL tear can be a debilitating injury with potentially life-long consequences, if not treated properly and quickly. Many people are afraid that they will have to undergo surgery to correct the problem, but in certain cases, non-surgical treatments may be an option.
Unfortunately, there is no way to gauge the severity of an ACL tear without professional imaging and evaluation. At Dayton Orthopedic Surgery & Sports Medicine, our doctors provide comprehensive diagnostic services and treatment for ACL tears, so you can get back to your life faster.
What is an ACL?
The ACL (anterior cruciate ligament) is a ligament located in the knee that connects the thigh bone (femur) to the shin bone (tibia). It is one of the four main ligaments that stabilize the knee joint and helps prevent the tibia from sliding out in front of the femur. An ACL tear is a common knee injury, typically caused by sudden changes in direction or stops.
It is the most common knee injury in athletes of all ages.
Diagnosing an ACL Tear
ACL injuries are often but not always characterized by a popping sound or sensation at the time of injury. Immediately afterward, you may start to notice pain, swelling, joint instability, and restricted mobility in your knee.
ACL tears are categorized by severity:
Grade 1 injuries are mild sprains without any tearing.
Grade 2 injuries are more severe sprains that represent a partial tear.
Grade 3 injuries are the most severe and involve a complete tear of the ligament.
Once we reach a diagnosis, we develop a customized treatment plan to help your ACL heal as quickly as possible.
Treatment Options for a Grade 1 or 2 ACL Tear
A Grade 1 or Grade 2 ACL tear can usually heal with conservative, non-surgical treatment. That said, they will not ‘heal on their own’. Less severe tears still require careful treatment in order to return to full function. Your treatment team may suggest:
Rest
It is essential to fully rest your injured leg. As your ACL is so integral to every function of the knee (turning, twisting, bending, bearing weight), it will be impossible to heal an ACL tear while trying to use your leg normally. The injured leg must be isolated and straightened, with weight kept off it, as much as possible.
Ice
We may give you instructions to ice your knee for 20 minutes at a time, several times a day. Applying ice to a torn ACL can help reduce swelling and inflammation in the affected joint. The cold temperature constricts blood vessels, which slows the flow of blood and reduces the amount of inflammation-causing chemicals that enter the area. This can also help to numb the area and reduce pain.
It’s important to note that ice should not be applied directly to the skin, but rather through a towel or cloth. It’s also important to limit icing to 20 minutes at a time and avoid icing if you have poor circulation.
Knee Bracing and/or compression
A brace can help a torn ACL in a few ways:
- Stability: A brace can provide additional support to the knee joint, helping to stabilize it and prevent further injury.
- Pain relief: The brace can help to take pressure off of the ACL, which can reduce pain and discomfort.
- Protection: Bracing can also help to protect the knee from further injury during the healing process, allowing the ACL to heal properly.
- Rehabilitation: Some of the braces can be adjusted to different levels of support, which can be used to progress the knee through the stages of rehabilitation.
It’s important to note that a brace is not a substitute for surgery, but it can be used as a temporary measure to provide support and protection to the knee while waiting for surgery or during the rehabilitation process. A physiotherapist should be consulted to determine which type of brace would be best for your individual condition.
Physical Therapy
As you begin to heal, we may prescribe physical therapy and rehabilitation exercises to build strength in your knee. Physical therapy can help a person with a torn ACL by reducing pain and inflammation, restoring range of motion, and strengthening the muscles around the knee.
A physical therapist will develop an individualized treatment plan that may include exercises to improve flexibility, muscle strength and endurance, and balance. The therapist will also demonstrate how to use crutches or other assistive devices and may use manual therapy techniques to help reduce pain and improve joint mobility. The ultimate goal of physical therapy is to help regain full function of the knee and get back to normal activities.
Treatment Options for a Grade 3 ACL Tear
Our team may recommend surgery if you have a Grade 3 ACL tear, you’re an athlete, or you have an ACL injury in combination with other knee injuries, such as a meniscus tear.
The main surgical options for a grade 3 ACL tear include:
- ACL Reconstruction: This is the most common surgical option for a grade 3 ACL tear. The torn ligament is removed and replaced with a new ligament, often taken from a tendon in the patient’s own body (such as the patellar tendon or hamstring tendon) or from a donor.
- Allograft Reconstruction: In this procedure, the torn ligament is removed and replaced with a ligament from a cadaver.
- Remodelling: This procedure is less common and involves repairing the torn ACL without replacing it. The surgeon will try to repair the ligament as much as possible and then use other techniques such as bone marrow stimulation to encourage healing.
- Hybrid surgery: This involves combining two or more of the above surgical options.
In the vast majority of cases, we use minimally-invasive arthroscopic surgical treatment. To learn more about arthroscopic surgery, read our article on arthroscopy.
So, Can an ACL Tear Heal on its Own?
The short answer is, no. Doing nothing to help your injury will likely set you up for a lifetime of complications, including arthritis and excess wear-and-tear on your other joints and ligaments. At the very least, you should be seen and assessed by a medical professional to ascertain the extent of your injuries, and to obtain a treatment plan.
Don’t let your ACL injury keep you on the sidelines. Book an appointment at Dayton Orthopedic Surgery for personalized care that gets you back to your life faster.