An ACL injury usually announces itself. A twisting or landing incident, often with a pop, the knee giving way, and swelling within an hour. If that describes what happened to you, it needs assessing properly rather than waiting to see.
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Do you need surgery
Not automatically, and this surprises people. Some people manage very well without a reconstruction, particularly if they are not returning to sports that involve cutting, pivoting and landing. Others need the ligament reconstructed to have a stable knee for the activities they want. That decision depends on your knee, your sport and your age, and it is made in conjunction with a surgeon and your physiotherapist.
What is clear either way is that rehabilitation determines the outcome more than the surgical technique does.
Prehabilitation matters
If you are having a reconstruction, the state of the knee going into the operation affects how it comes out. Regaining full movement and quadriceps strength before surgery is associated with better outcomes afterwards, so the weeks before the operation are working time rather than waiting time.
Getting back to sport
This is where ACL rehabilitation is most often let down. Returning on a timescale rather than on measured criteria is associated with higher re-rupture rates, and a knee at nine months that has not regained quadriceps strength is not a knee that is ready however good it feels. We measure strength side to side, hop and jump tests, and control when you land and turn, and those results set the pace.
We will tell you honestly where you are against those markers, including when it is not what you want to hear.
Frequently Asked Questions
Do all ACL injuries need surgery?
Is physiotherapy worth doing before ACL surgery?
When can I play sport again after an ACL reconstruction?
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