It feels like we all know someone who “tore their ACL.” And that feeling is right on point: Over 200,000 people per year sustain an injury to their anterior cruciate ligament (ACL). These frequently occur during sports participation and often are noncontact injuries. 

So, what exactly is the ACL? In short, it’s a primary stabilizer of the knee joint. Think of it as a strong rope connecting your thigh bone and shin bone together, helping to keep your knee in place.  The ACL plays such an important role in the daily function of your knee, and injuries to the ACL are not only a problem for sports.  Luckily, there are various treatment options if you find yourself with an ACL injury. 

Determining Treatment

The optimal treatment for a patient with an ACL injury is determined by various factors: the extent of injury, the patient's current and expected activity level, different anatomic factors, as well as the presence of other damage such as meniscus tears. 

While conservative treatment consisting of physical therapy and functional bracing can be successful, many people will continue to have feelings of instability of their knee and functional issues preventing them from participating in activities.  Even in patients who tolerate an injured ACL well, knees that have an ACL injury are at significant risk of developing additional cartilage and meniscus injuries as soon as 3 months after the original injury. For these reasons, surgery is often recommended soon after ACL injury, especially in younger more active patients.  For older patients who are not engaged in competitive sports, the long-term health of their knee is often improved with early surgical treatment after ACL injury.

When surgery is indicated, the ACL can be repaired or reconstructed. If ACL repair is not possible, reconstruction of the ACL is performed, which is re-creation of the ligament using other tissue, usually from the same knee.  Advances in our understanding of the biological processes involved in ligament reconstruction, along with improvements in surgical techniques and implants, have led to better postoperative outcomes.

Phases of Recovery

Rehabilitation and recovery after surgery goes through different phases and typically lasts anywhere from 6 to 12 months. The rehabilitation plan may be adjusted depending on individual patient factors and injury variables:

Phase 1: Address pain and swelling

In phase one, there is a primary goal of restoring mobility to the knee joint.  Physical therapy is an important part of this phase as well as each subsequent phase of recovery.  

Phase 2: Restore everyday functions

After 1 to 2 months, once range of motion has been restored, physical therapy is centered on activities of daily living and gradual strengthening of the knee.  This is key as ligament reconstruction is still healing so it can remodel like a normal ligament.  

Phase 3: Progressive increase in strength and agility

At approximately 5 to 6 months after surgery, rehabilitation shifts focus to more challenging and sport-specific exercises including plyometrics and neuromuscular training. 

Phase 4: Get back in the game

Successful return to sport and unlimited activities while limiting the chance of recurrent injury requires the restoration of good mechanics, strength and agility.  Success rates in returning to the same level of activity after ACL reconstruction are excellent. 

At Montefiore Einstein Orthopedic Surgery, our fellowship-trained Sports Medicine surgeons are equipped with the latest technology, knowledge and experience to treat ACL injuries for all patients and formulate individualized treatment plans based on many different factors for every patient. For more information visit: montefiorenyack.org/services/orthopedic-spine or call 845-358-1000.