When is Knee Surgery for an ACL Tear the Best Option?

Tearing an ACL — which stands for anterior cruciate ligament — is a common injury. Trips and falls, auto accidents, improper lifting techniques, and even playing with your kids or dogs can rip your ACL, which is one of the stabilizing ligaments in your knee.

We see a lot of ACL tears here at the practice of Neil Ghodadra, MD, with locations in Los Angeles and Thousand Oaks, California. Our patients range from young children just learning their sport, to serious adult athletes, to elderly folks who are less stable on their feet. 

If you’ve torn your ACL, you may wonder if surgery is your best option. It may be, but it’s typically not the first choice. Here are the various treatments Dr. Ghodadra recommends for torn ACLs.

What is the ACL?

Your ACL, as mentioned earlier, stands for anterior cruciate ligament. It’s one of four main ligaments that holds your knee joint together. It runs diagonally through the middle of your knee joint and blocks your shin bone from sliding forward too far and jutting out in front of your thigh bone.

How did I tear my ACL?

Some athletes have a high risk for tearing their ACL because of the demands they put on their knees. Although direct contact is occasionally the cause, the majority of ACL tears occur when a player pivots, cuts, or side steps, planting the foot and then changing directions suddenly. 

Studies show that at the high school level, soccer, football, basketball, and baseball have the highest rates of ACL injuries. However, nonathletes can be susceptible, too. 

Do I need surgery?

Immediately after an ACL injury, there’s usually considerable pain, and swelling usually follows soon after. That’s why the first course of treatment recommended is always the RICE method, which stands for rest, ice, compression, and elevation. This can help reduce the inflammation and pain, so we can evaluate your knee and determine the extent of the damage.

When you see Dr. Ghodadra, he’ll examine your knee, talk to you about your accident, and assess your symptoms. He may also order an X-ray or an MRI to get a better look at the inner workings of your injured knee. 

The best treatment will depend on several variables, including the severity of your injury, your age, weight, and activity level, your level of instability, and your activity goals post-recovery. Here are some possible treatments:

Anti-inflammatory medications

Along with the RICE method, you may need to take some nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or acetaminophen to keep the swelling down and ease discomfort.

Bracing

If you’re in good overall health, you can expect a partially torn ACL to heal on its own in about three months. However, until it does, your knee will be slightly unstable and need some help staying in alignment. A brace can support the healing process, and it may even be necessary to wear for a while when you return to your sport. 

Physical therapy

Your ACL injury will affect your flexibility and range of motion, so it will be important to work with our physical therapist to restore function, strength, and mobility to your healing knee.

Platelet-rich plasma therapy

Because anterior cruciate ligaments are notorious for healing slowly, Dr. Ghodadra can speed up the process with a platelet-rich plasma (PRP) injection. In this treatment, he takes a small sample of blood from your arm. He then spins the blood at high speed to separate the plasma — which contains growth factors that can help spur healing — from the other components in your blood.

He then injects the plasma serum into your injury. The growth factors then get right to work, helping to renew cells and regenerate tissue.

Surgery

Although surgery is always a last resort, it’s sometimes the best option, especially if you’ve torn your ACL completely. Dr. Ghodadra uses arthroscopic surgical techniques, which are minimally invasive, to repair torn ACLs. 

Although he may opt to suture it, that’s not always the best option for athletes, as it may not hold up under rigorous sports conditions. Instead, he may use a grafted section of ligament from somewhere else in your body to completely replace the damaged ACL.

In many cases, the ACL isn’t the only tissue that’s damaged. If you have torn cartilage as well, Dr. Ghodadra may need to perform cartilage restoration. There is no blood supply to cartilage, so it won’t heal on its own. Dr. Ghodadra, a global leader in this field, uses advanced techniques to create blood flow and stimulate the generation of new cartilage. 

If you’ve torn your ACL, Dr. Ghodadra can help. To get a thorough evaluation and discuss your treatment options, book an appointment online or over the phone with the practice of Neil Ghodadra, MD, today.

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