The anterior cruciate ligament (ACL) is a ligament in the knee joint that acts like a rope that holds bones together. ACL injuries are common and can occur during non-contact accidents, or as the result of a direct impact with another object or player in sports. The injury can consist of a strain of the ligament, a partial tear, or a complete rupture. Sometimes, another knee ligament will be involved, and in many cases, the meniscus will also be injured.

ACL knee injuries may cause pain in and around the knee joint, as well as bruising, swelling, and varying levels of stiffness or immobility. Not all ACL knee injuries will require surgery. Surgery is indicated if knee instability or knee buckling exists, or even if a sensation of buckling (i.e. a trick knee), or a knee that “feels like it wants to go out”. Surgery is almost always recommended for patients age 40 or younger, and for patients greater than 40 years of age who wish to return to a high activity level, such as participation in cutting or pivoting sports, walking on uneven surfaces, or working in an outdoor environment. Surgery is also recommended in active patients with associated knee meniscus tears, where the torn ligament and torn meniscus are treated during the same surgery.

A thorough physical examination and imaging scans will confirm the precise knee injury, and will allow your physician the opportunity to offer a treatment recommendation.

For some patients who are less active or do not have buckling; non-surgical treatment of rehabilitation, and wearing a brace, are different options, especially if patients are willing to give up physically demanding activities. In young children, where open bone growth plates are still developing, surgical treatment is performed using highly specialized, growth plate sparing techniques.

Non-surgical treatment for ACL injuries will include the following: