Anterior Cruciate Ligament (ACL) Repair
Doctors at the OHSU Sports Medicine Clinic offer a full range of treatments for injuries of the knee, including ACL tears.
The best treatment for you depends on several factors including how recently your injury occurred, what concurrent injury you may have sustained and what your goal are for post treatment function. Our goals are to treat your pain, improve your function, reduce your newly acquired risk of degenerative joint disease and prevent additional future injuries.
The knee is a complex joint made up of principally three bones which are stabilized with several ligaments that interact to hold these bones in close proximity and dissipate stress. These ligaments work to allow you to turn, pivot and jump while protecting your cartilage (meniscus and hyaline). In concert these structures protect us from gravity. Four ligaments act to stabilize the knee joint while performing both simple tasks like walking down stairs and complex tasks like gliding over moguls while skiing. One of these ligaments, the ACL, is particularly vulnerable to injury while landing from jumps, twisting or hyper extending your knee.
Injury of the ACL is often associated with immediate pain, swelling and instability, but not in all cases. After a week or so of recovery and proper rehabilitation, some people may not notice many symptoms. However, untreated or improperly rehabilitated ACL injuries can become associated with chronic joint instability and an increased likelihood of further injury, particularly damage to cartilage and meniscus. This can occur even in the absence of symptoms.
At your first appointment, your doctor will have reviewed your history, including any past and current injuries, obtain images and review your personal expectations. Your answers give the doctor detailed information about your goals and the potential to return to full function, as well as the risk of further injury. This helps determine how urgent and what types of treatments will be most likely to get you back to a pre-injury level.
Conservative (Non-Surgical) Treatment
Treatment of a torn or injured ACL depends on your degree of injury, symptoms and activity level. Non-surgical treatment for an ACL injury includes rehabilitation exercises and education to reduce swelling and restore motion. This often includes a program of physical therapy and instruction on how to strengthen the area and your core muscles to reduce the risk of future knee instability.
Surgery for ACL injuries involves replacing the torn ACL, as this ligament will not heal on its own even if the ends are sewn together. Minimally invasive techniques for ACL reconstruction can include replacing the ligament with a tissue graft. Several graft options are available and recommendations on graft types are based on a variety of factors such as your age, activity level, goals and health history. OHSU provides all graft options available and our surgeons have extensive experience with ACL injuries and the appropriate treatment required. We specialize in repairing ACL injury in patients with repeat injury, sometimes called “revision” ACL surgery.
After surgery and rehabilitation, your risk of re-rupturing a reconstructed ACL should be equal to injuring a normal ACL. Exercises to reduce the risk of ACL injury to either knee will be part of your post-surgery rehabilitation recommendations and physical therapy prescription.