The Anterior Cruciate Ligament (ACL) is one of the key ligaments that help stabilize the knee movements.

ACL injuries are most common in athletes and can range from mild sprains to complete tears.

Can an ACL be cured without surgery? It depends on various factors including the severity of injury, the patient’s activity level, medical history and their goals for recovery.

Before understanding whether we can opt conservative treatments for ACL injury, we need to know what ACL is, its functions and treatments options are.

In this blog we are discussing if ACL can be cured without surgery.

What is ACL?

The Anterior Cruciate Ligament (ACL) is one of the two cruciate ligaments that stabilizes the knee joint from the sliding up of their tibia bone to the thigh bones (femur).

It also plays a small resisting internal rotation and prevents any excessive movements.

ACL Injury & Their Classifications

ACL tear is usually associated with a sudden directional or speed change while the foot remains firmly planted, rapid deceleration, jumping etc… It can be classified into direct contact, indirect contact and non contact injuries.

ACL injury is mostly associated with sports injuries.

Symptoms

• A sensation of painful ‘pop’ during impact
• Immediate swelling of knee, often due to hemarthrosis ( bleeding into the knee joint)
• Painful and restricted knee movement
• Instability symptoms

ACL Injuries are further classified into grade I, II and III sprains.

Grade I ACL Injury

• The ligament fibers are stretched
• Tear less than one-third of the ligament
• Symptom:- mild tenderness and swelling
• The knee feels stable

Grade II ACL Injury

• Partial tear
• Tear between one- third and two-third of the ligament
• Symptom:- mild tenderness and swelling, some loss of function, painful
• The joints feel unstable

Grade III ACL Injury

• The fibers have completely torn
• Symptom:- tenderness, limited pain
• The knee feels unstable with rotation instability.
• Hemarthrosis ( bleeding into knee joints) within 1 or 2 hours

Non Surgical Treatment Options

Surgical and Nonsurgical treatments option differ in

• Whether the patient undergo ACL reconstruction and,
• Future participation in sports and other activities.

For individuals, non athletes and those with lower activity levels can consider the conservative treatment options.

These include BOX

1. Physical therapy

They help in strengthening the muscles around the knee (quadriceps femoris and hamstring muscles).

Strict rehabilitation and follow ups should be maintained during the recovery period.

Physical therapy includes

• Rest
• Anti inflammatory measures (medications or ice packs)

2.Wearing knee braces

Braces help stabilize and inhibit excessive knee movements. They act as supplementary safeguards.

3.Modification in activities

Activities should be adjusted to avoid actions that may cause excessive stress on the knee.

Limitations:

Conservative treatment can be beneficial for people depending on their lifestyle and activities levels.

In cases of isolated and grade I tears with no other ligamentous or cartilage injuries the associated pain and dysfunction can be treated with physical therapy.

However in absence of surgical treatment, the knee remains unstable and remains vulnerable to future injuries.

For athletes and people with high activity levels, conservative treatments alone may not be sufficient, and surgical intervention may be necessary for optimal recovery.

In case of inefficiency of conservative treatment non surgical interventions are necessary. It depends on the patient's medical history, severity of condition and patient's goal on recovery.

Surgical Treatment; ACL Reconstruction

If there are recurrences or if the physician finds it necessary, ACL reconstruction surgery is performed.

ACL reconstruction surgery is one of the most common procedures in sports medicine. It is considered a ‘gold strategy’ for young adults who wish to return to their pre- injury activities.

The procedure involves replacing torn ligaments with tissue graft taken from one's own body.

ACL surgery is scheduled at 3 to 6 weeks after the swelling subsides. Surgery planning is important for proper and complete healing. Early or late surgery can lead to severe complications.

Conservative Treatment vs. Surgical Treatment

Making Right Choices

In many cases, patients opt for surgical methods due to knee instability/giving away and due to the high activity demands.

For grade I and grade II tears the body can heal the injury overtime. But for complete tears surgical intervention is recommended.

Irrespective of the treatments the results achieved can be near normal knee functions with functional limitations.

Deciding between conservative and surgical treatments should be in consultation with an orthopedic surgeon. The decision should get along with the severity, goals and lifestyle of the patient.

Each case is unique. So there is no clear distinction between what is right and what is wrong.

The question here will be which one is more right, or which one is right for me.

An ACL injury can be healed without surgery. If it is a partial tear or a dysfunction the body can heal and repair the ACL. But whether the body can regain its stability depends on other factors too.

So it is important to consult a healthcare professional to get a personalized opinion on which treatment plan is most suitable for you — conservative treatment or surgical treatment.

Always keep in mind, there is no absolute risk-free treatment. There will always be limits and limitations.

Give your body enough time to heal. Listen to your doctor’s advice and be prompt with follow up treatments to fasten your recovery process.