ACL Injuries

Frequently asked Questions

If I have torn my ACL, am I guaranteed to get arthritis in that knee?

Absolutely not! While an ACL injury does increase the risk of developing osteoarthritis (OA), it’s far from a certainty. Think of it as a yellow flag, not a red one. The goal isn’t just to fix the ACL but also to address contributing factors. Through proactive management, including restoring stability, optimising mechanics, and promoting cartilage health, we can significantly reduce your chances of developing OA. You have the opportunity to be an active participant in preserving your long-term knee health. We may use specific injections as part of our surgical procedure, and we will also perform post-operative injections to address inflammation.

How does ACL reconstruction affect my long-term risk of developing arthritis? Does surgery eliminate the risk?

ACL reconstruction aims to restore stability and normal knee mechanics, which can help reduce the abnormal stresses that contribute to OA. Reconstruction does not eliminate the risk completely. Even with successful surgery, the initial injury and any associated cartilage damage can still increase your susceptibility. That’s why a comprehensive approach, including rehab, lifestyle modifications, and ongoing monitoring, is crucial. By optimising joint health and function, we strive to minimise your long-term risk. We also take intra-operative and post-operative steps to minimise pain and inflammation.

What are some of the latest research findings on the link between ACL injuries and arthritis, and how might these influence my treatment decisions?

Research continues to improve our understanding of the ACL-OA connection. Studies are investigating the role of early cartilage damage, inflammation, and genetics in OA development. There’s growing interest in regenerative medicine approaches, such as stem cell therapies and growth factor injections, to promote cartilage healing and prevent OA progression. By staying informed about the latest advances and discussing these with your healthcare team, you can make well-informed decisions about your treatment and long-term care. Again, small steps can make big differences. We strive to keep up to date and perform innovative strategies to maximise outcomes.

If I choose non-surgical treatment for my ACL tear, what does a typical day look like during the initial recovery phase?

Initially, expect to focus on the RICE protocol: Rest, Ice, Compression, and Elevation. This helps manage pain and swelling. You might use crutches to keep weight off your knee and a brace for support. Physical therapy will begin soon, focusing on gentle range-of-motion exercises and muscle activation. As you progress, you’ll gradually increase weight-bearing and begin strengthening exercises. The goal is to regain knee function, reduce instability, and prepare for a return to modified activities. Remember, consistency and adherence to your rehabilitation program are key. As a team, we will focus on your success and return.

I’m considering non-surgical treatment because I’m worried about the risks of surgery. Are there any risks associated with not having surgery?

It is wise to consider and evaluate the advantages and disadvantages! While non-surgical treatment avoids surgical risks, there are potential downsides. You might experience persistent knee instability, making it difficult to participate in certain activities. There’s also a risk of further damaging the knee with each episode of giving way and an elevated risk of early osteoarthritis if the knee is unstable. If non-operative treatment fails and the knee is unstable, future tears of the knee and cartilage may develop. We will continually assess you and can proceed with surgery if needed.

What is “functional testing,” and why is it so important before returning to sports?

Functional testing goes beyond simple strength measurements. We assess your ability to perform sport-specific movements like hopping, jumping, cutting, and pivoting. These tests reveal how well your knee functions under dynamic load and whether you’ve regained the necessary coordination and control to handle the demands of your sport. Passing functional tests demonstrates that you’re not just strong, but also able to apply that strength in a safe and controlled manner. This step is essential for minimising your risk of re-injury.

What does the ACL recovery timeline look like for kids, and how can we keep them motivated during rehab?

Recovery can take 6-9 months or more for athletes to return to sports after surgery. It’s important to have realistic expectations about recovery. A structured rehabilitation program is essential to facilitate healing, regain strength, and improve knee function. Celebrate small victories, involve them in setting goals, and connect them with other young athletes who have successfully recovered from ACL injuries. Keep your eye on the long-term goal of getting better and doing the things they love again.

I’m worried about surgery affecting my child’s growth. What precautions are taken?

That’s a valid concern! If your child is within a year or two of skeletal maturity, most physicians feel the risks are small, and a standard ACL reconstruction is usually performed. However, in younger patients, we use specialised surgical techniques to minimise any risk to the growth plates. These techniques aim to reconstruct the ACL while carefully avoiding the growth centres in the knee. We always prioritise your child’s long-term growth and development.

The rehab timeline says 6-9 months, but I feel great! Can I return to sports sooner?

While some athletes feel ready sooner, research shows that returning before nine months significantly increases the risk of re-injury. The healing process and neuromuscular adaptation take time, regardless of how strong you feel. We prioritise long-term joint health over a rushed return. If you are a young athlete, you should wait at least nine months. We use a holistic approach, not just a timeline, and will guide you with the utmost care.

What are some of the less obvious signs that I might not be quite ready to return to sport, even if I feel strong?

It’s great to feel strong after ACL rehab! However, be aware of subtle signs like persistent swelling after activity, achiness that lingers into the next day, or feeling “guarded” or hesitant during certain movements. These can indicate underlying inflammation or incomplete neuromuscular control, suggesting your knee isn’t quite ready for full sports participation. We also use psychological testing to evaluate for potential kinesiophobia (fear of movement). Listen to your body and be honest with your rehab team. Pushing through these subtle signs can increase your risk of re-injury. We want you to return with confidence.

Why Is the ACL Important for Everyday Movements?

The ACL is essential for everyday movements because it stabilizes the knee during walking, climbing stairs, or standing up from a seated position. It inhibits excessive anterior translation of the tibia and aids in regulating knee rotation. This stability allows smooth, coordinated motion, reducing strain on other ligaments and muscles. Without a healthy ACL, even simple movements can feel unstable or uncomfortable, making routine tasks challenging. Injuries to the ACL can lead to weakness, decreased mobility, and a higher risk of further joint damage. Proper rehabilitation and strengthening activities are essential for recovering function and avoiding long-term consequences.