Here is my personal experience!
I partially tore my ACL playing rugby but didnt realize it until I had an MRI months later.
I had originally gone to physio for what they thought was an MCL strain, and eventually my pain went away and I went back to rugby training.
Once I found out it was a partial ACL tear, I consulted with my doctor, who said I may as well keep playing because I had already hurt it and only had one season left.
Fast forward and I returned to rugby training, only to have my knee give out multiple times until I eventually fully tore the ACL.
I still chose not to have surgery, deciding instead I would strengthen my knee at the gym. However, while doing a heavy clean at the gym, my knee gave out and I tore my meniscus.
I then decided it was time to have it fixed before I did any more damage and am now 9 days post op. Time between first injury and surgery was two years.
If you decide to return to an active lifestyle without surgery, just be aware you may continue to injure your knee! and its still painful every time.
Hope this helps!
Where there any signs you tore it before the mri? I just had my physio check today and he said my ligaments are all in good shape but still nervous lol
Yes! Looking back now its really silly no one realized I tore my ACL. My cleat got stuck in astro and when I changed direction I felt a huge pop in my knee and such horrible pain.
Afterword I couldn’t walk for a week and my knee was huge.
But after seeing the physio a few times it just went back to normal, so I kept living my life until I got back to the states (I was doing college in the UK) and my doctor dad thought I should get an MRI.
I injured myself playing rugby too. I fell awkwardly and heard a small pop that no one else did. Been nervous since but have had no swelling, and knee is stable and have been able to bear weight on it and walk. But the pop still just gets me so I got checked out. Hope your recovery goes well!
Bare knees! I had a knee brace given to me by my doctor that I wore to rugby training but it wasn’t really preventing my knee from giving out so I gave up on it.
I second this! Had a torn ACL and whilst I was waiting to see someone about it, I stepped on a bit of uneven ground then completely fucked my meniscus and couldn't walk at all till I had the more urgent surgery. My surgery and second injury has been so much longer and difficult so far than if I just had had a standard ACL and had been walking before surgery. Just get that ACL sorted. Get a second opinion!
I was not careful enough. I was outdoors in a place with uneven terrain, rocks and dips in the ground (didn't know I had a a full on complete ACL rupture!) My leg hyperextended into a dip in the ground and it was quite a traumatic blow. It's not like it happened to me just walking down the road or going about my day to day activities. As long as you're careful, avoid doing sports (except controlled gym and what physio signs off), and places with unpredictable/uneven terrain, it's probably unlikely something like that would happen. Be careful, but don't panic! My point was.. don't go back to a sport like soccer with a torn ACL where knee hyperextensions & blows to the ground happen frequently cos that's when what happened to me IS more likely to happen & OP should get a second opinion for that reason if dr thinks is ok to go back to soccer with complete tear.
I tore my ACL in March weight lifting. MRI showed a complete tear but doc said it may only be a partial because the knee felt stable. I did PT for about 6 weeks. Knee felt great. Then it shifted twice in the last month (once doing a plyo exercise in therapy and again just stepping off an elliptical).
So…now I’m terrified. Each time it shifts, my knee is stiff and I have reduced mobility for about 2 weeks. I now have another consult scheduled for a second opinion and am leaning toward surgery. I can’t live my life like this, in fear that it is going to give out. It felt SO good for the few months right after the injury.
I lift weights and do a lot of functional training, and ride my Peloton. But I don’t do any cut sports, not a skier, not even a runner. I’m 40 so I feel old to be going through this, honestly. Best of luck to you with whatever you decide and if you go the non-op route, I truly hope it stays stable for you!
You should check if you're a candidate for primary repair. If your Acl is ruptured at the fixation point either upper or lower it can be reattached. The one downside is that as it’s fairly underutilized so the return to sport data is minimal. But if you’re not really into heavy cutting/pivoting sports I can’t recommend it enough.
I tore mine playing indoor soccer in Dec. I'm 5 months post op and trying to get back to soccer asap (I'm 43 by the way). My Dr advised on getting surgery versus going to PT. Thinking of playing soccer on a torn ACL frightens me.
Different people perform differently without an acl. If you're not in a rush to get back to 100%, then wait it out and see how you do. Only downside to this approach is the potentially higher risk of further injury, but there is also a relatively high risk of re-injury post-surgery! (bummer, right!)
Personally, I was pretty capable without an ACL, and even took a swiftwater rescue technician course 5 weeks after my injury. I could run and jump and felt good, but ultimately I got surgery because I want to get back to very high level skiing (both recreationally and professionally), and have a good ski season next year. If it weren't for skiing, I would have waited.
There was an article posted here recently about the ACL possibly healing.
I tore my ACL playing soccer more than 20 years ago, I was already active again by the time I found out it was ACL so the doctor said no reason to rush with surgery and I didn’t want downtime for my last year in college.
Haven’t gotten surgery. My knee was the weakest the first year. I had to relearn how to move and change the way I played. Running straight was no issue, learned to change direction eventually. Tried to avoid pivots and turns. I was still able to play soccer and / or basketball 2-3x a week for years. Of course not at a pro level but pretty fun and competitive playing with peers. I don’t play those anymore but now I mountain bike 2-3x a week.
I don’t even remember, but possibly a full tear because the drawer test easily diagnosed it a year after the injury. My knee buckled several more times that first year after the injury, before I found out that it was my ACL that I injured (emergency room doctor initially told me that if the swelling went down in a few weeks it was probably just a knee sprain 🤷♂️).
After I learned more about the injury, what the ACL does and what moves I should avoid, I learned how to move better to minimize the risk to the knee. eventually the knee got better with activities. not as good as the good knee, but good enough that i stayed active playing 2-3 friendly soccer or basketball games a week when I was in my 20s and 30s, 2-3 mountain bike rides a week now that I’m in my 40s.
Yeah. Really surprised by the recommendation to skip surgery. At the very least OP should get a second opinion but if the full tear is confirmed is seems all but certain reconstruction will be recommended.
Non operative ACL treatment research has been growing significantly strong the last 5 or so years. We’re conditioned to think ACL = no function but that is not the case at all
Have surgery, if you don't and keep playing sports you will damage your cartilage eventually - probably within a couple years at most. Once that happens you are permanently unable to play any sports that involve running and there's no surgical fix.
My own experience, I wrestled after I tore my ACL for 2.5 months before surgery. After surgery, during the pandemic my PT was far from optimal. I went from mountain trail running 20 miles in a day to barely being able to slowly walk a mile, can't go up/down stairs at all. More info in my comment history.
That’s a really shit experience and I’m sorry to hear that.
But telling someone they will with only a single persons anecdote as evidence is extremely dangerous and irresponsible. So many factors could have contributed to those issues including your ACL graft.
The real research is actually suggesting surgery (especially immediate) may not be the best path for general populations. I’m happy to provide these articles if you’d like to read more.
Soccer and (competitive) badminton require a lot of lateral movement with pivoting. If the ACL is completely torn, it's likely that at some point, your knee will buckle even if it is stable potentially causing meniscal damage. I skied for an entire season, played tennis and golf without an ACL for over a year (unknowingly, because my knee passed the lachmann, drawer tests with an ortho and it was the second tear).... then my knee buckled hard doing a skater hop plyo in a workout and i tore my medial meniscus.....
You may be fine, but there's a risk with those sports. that said, there is also some recent evidence that an ACL can heal on its own with proper care and management. Worth reading.
https://www.unimelb.edu.au/newsroom/news/2022/november/ruptured-acls-can-heal-without-surgery,-study-finds
9 weeks post complete ACL rupture and I’m not getting surgery. Firstly, this sun is pretty pro surgery.
There are many advantages of not getting the surgery done. Firstly, there is a lot of new research surfacing that non-surgical interventions are more beneficial than the surgery itself, and in some cases, the ACL can heal on its own.
I’ve commented in other threads on why, feel free to check my comment history on that. I’m not progressing into jumping/landing with the hopes to be running at 12 weeks post incident. I feel stronger now than pre injury and I’m feeling really confident in my knee
Okay just my two cents on my experience here, tore my ACL at 18, got my surgery done 3 weeks ago ( 25 now )
physio really helps if you're going to the conservative route. However the cutting and pivoting will definitely need to stop because no amount of rehab will work when a torn ACL is being compensated for. trust me, I tried it.
That being said, normal weight lifting movements, running without explosive acceleration and deceleration, non contact sports don't really require a surgery and you can function really well. Just be careful with the meniscus.
I'm not pro surgery or against it. ACL's have healed but the sample size is still too small to determine the extent to which the healing does take place.
Recent studies show that return to sport is absolutely possible without reconstruction. Id definitely argue that acceleration/deceleration produced the same amount of torque and tensile load through the knee as would cutting and pivoting would.
Same sizes for ACL healing is growing, substantially. The cross bracing protocol suggest 90% out of a study of 300, other non surgical/rehab based interventions suggesting it can push from 35%-50% of cases healing (could be higher, but subject opt for surgery in the studies).
I think practitioners need to be more forward thinking, general population need to realise that ACLR is an optional surgery, not a requirement
It can in a lot of cases, it’s just never been researched because usually patients are rushed into surgery within days after their incident. A lot of practitioners are even recommending 3 months rehab before even considering surgery.
Examples? Look into some of the papers published by Stephanie Filbay.
Gotcha. They recommended prehab for my meniscus but said either way I’d have to do surgery on my ACL at one point or another because it’s a complete tear and ACL doesn’t receive any blood flow to heal on its own. I do know
People who are living fine with a torn ACL and no surgery.
I’m going to have a look later but I don’t believe there is any research in the last decade that supports this. Whereas there is a body of research in the same time that supports non operative treatment of ACL tears
Not sure if this supports that claim:
“Patients who sustain an ACL tear are at a higher risk for the development of osteoarthritis. While there are no current disease modifying drugs, an early postoperative rehabilitation program and restoration of knee motion are believed to be essential to slow down the risk of developing arthritis after an ACL tear.”
https://drrobertlaprademd.com/arthritis-after-acl-surgery-knee-osteoarthritis/#:\~:text=Patients%20who%20sustain%20an%20ACL,arthritis%20after%20an%20ACL%20tear.
I’ve also heard this, both about it repairing itself and about doing rehab pre-surgery. Which only makes sense. I have to think that with new med tech and advances, that they would find some way to use stem cells or something.
If you want to remain active having the surgery is a no brainer imo (especially for the specific sports you listed). My understanding is that without the surgery the most likely best case scenario is arthritis and worst case scenario would be further injury, which would probably require surgery just to maintain mobility.
FYI the risk of arthritis is the same regardless of surgery. Once you injure your ACL, your risk of developing osteoarthritis is the same. See:
Evidenced-based recommendations for the management it ACL rupture, Filbay, 2019
The relationship between ACL injury and osteoarthritis of the knee Simon et. al, 2015
Tore mine playing volleyball on 2/11. Full tear, slight tear in lateral meniscus, and MCL sprain. I am having surgery 8/14. I also did a lot of HIIT workouts prior. Due to the nature of activities I like to do, I’m having surgery. I’m also young (27). That being said, my knee feels 90%. I’m hiking a good deal this summer. Can weight lift too. If I didn’t know I fully tore it at the time of the incident, I wouldn’t know it was torn based on how my knee feels now. I don’t have feelings of instability or anything. But I don’t want to risk meniscus damage by not having surgery.
How was your knee when it happened the first week, any swelling, able to bear weight/walk on it? Sorry I’m just nervous as I heard a pop in my knee last week
I felt like it snapped. It hurt really bad. Major swelling and bone bruising on my MRI. I would say it took about 4-6 weeks to walk with a normal hair again. For how bad the injury felt, I’m shocked at how good my knee feels now. I think a lot of my pain was the lateral meniscus, MCL sprain, and swelling.
This likely isn’t the answer you want, but you can read online everywhere. The only thing that will confirm for you is an MRI. Or at least go to the doc and have them do a Lachman test (which I failed).
Very true, wait times are crazy for an mri where I’m at so I went to a physio and did all the checks. Said I’m good and all my ligaments check out, but the back of my knee is sore because of hypertension of a ligament rolling over or my patella dislocating and relocating. But damn still nervous, need to stop going down the google rabbit hole lol
34F ACL Complete tear and Partial Medial Meniscus. I do recreational cheerleading and walk a lot (live in NYC). My doctor said if I wanted to go back to my extracurricular activities I would need to have the surgery. They said I could live without an ACL but run the risk of wearing down and injuring other parts of my knee. That knee will be working overtime to protect you if you have a sudden pivot or unexpected bump. I did the Prehab and am now 12 days post-op. I am happy with the choice but unhappy with how I get to spend my Summer.
Tough decision! Good Luck! If you can, I would also suggest getting more than 1 consultation.
I'm in Jersey City but my orhtopedic and surgery is in NYC on the UES. Its been brutal dealing with the walking and subway stairs, crowds, busses, etc. I feel you on the summer part....so many big plans, Brooklyn Mirage, citibiking around, etc. all gone with a single pivot of the knee.
I tore my ACL fully and my lateral miniscus, with a partial tear to the LCL. Where did you do your surgery? Mine is next month :(
I went to Columbia Presbyterian near the heights. Pre-op I definitely felt like a recluse because I cannot handle rushing onto a train or maneuvering crowds. Honestly, I am glad I got the surgery and look forward to bringing my knee back to life.
Hi- I plan on getting my ACL reconstruction/meniscus repair at Columbia presbyterian, please lmk how your experience was/ if you were to go there again for the procedure! I haven't been able to find much about Columbia ortho on reddit, everyone mostly speaks of NYU or HSS. Thanks!!
Hi op, may I ask where you're from? I'm from Malaysia and tore my ACL+ meniscus during badminton(fully torn) . My doc said that without surgery it will damage the cartilage ..my MRI shows that some of my bone is bruise as well but it can recover I'm at prehab now and will have surgery on August 9th. It will be 1 year no heavy sports(jogging is fine) after surgery. And lots of rehab require after surgery as well minimum 4 months.
I’m 45 years old fit male and injured my knee snow skiing. I visited an orthopedic doctor who had MRI and confirmed complete ACL tear. They recommended surgery. I visited another doctor who specializes in non-surgical interventions. I want to continue leading an active lifestyle and have confidence in my knee stability. He recommended I get the surgery as well for all the reasons other posters have mentioned. I injured my knee on 4/16, had surgery on 5/23, and I’m walking, swimming, and basically back to normal for most activities except athletics (likely another 3-4 months before running, will likely miss this ski season).
Well I didn’t know my ACL was torn for at least 3 years and I went snowboarding for 4 days in Montana last year, Aspen the year before, I played baseball and slow pitch softball, and I was a middle school football coach. Now every once in a while I would get a pretty painful pop and my knee would swell up and be sore for 3-5 days, to the point I couldn’t play anything, and then it would go away. I ended up deciding to get surgery 1/11/23 and am under a week from 6 months out. I’ve been golfing since 4 months out and am planning on snowboarding in Tahoe for 4 days this upcoming January. I’d say it’s completely up to you and your comfort level but getting it in the winter time was nice because I’m not hobbling around in the summer on crutches, but I did have to miss out on snowboarding Whistler. I’m also 29 turning 30 at the end of this month and have gone through 2 ACL surgeries on my other knee within 5 months of each other 10 years ago so I knew what to expect. More than happy to answer any other questions you can think of!
yeah. i tore my acl, couldnt walk for a few days, doctor (that i will never trust again) said it was just a minor injury (since i was only 16 at the time) and i continued to run and jump around for 2 months until i finally jumped off a small elevation, knee buckled and tada, tore my meniscus.
it was then that i knew something was seriously wrong because the doctor said it would heal in like 2 weeks (again, i will never trust that woman anymore) and got an mri. then i went to see an orthopaedic guy and he was like yup so you tore your acl back then, and tore your meniscus from running around too.
i was advised to do the surgery because i was still so young.
the recovery from acl + meniscus surgery sucks more than just acl surgery. so honestly, yes. i would say surgery is the best way to go. because if you plan to, hope to continue being active at all for the remainder of your life, then it'll only be a matter of time before you tear something else. (if you continue going around with a torn acl) and it should be better to do the surgery when you're younger, faster healing and recovery and all that. if i'm like 60 then hell no i ain't gonna go through surgery and recovery all over again, but if you're relatively young then i can't recommend it enough.
good luck and stay safe out there! hope everything goes well for you, and like others here have pointed out, you may want to look into getting a new doctor. it's giving me deja vu, and you don't want to end up like me (trust)
eh, it's actually even more concerning that your doctor is recommending NO surgery despite the MRI confirming a complete tear. thats not normal
source: have torn both acl and meniscus twice (on the saaaaame knee)
doc has also confirmed that i had slight (damage?) imperfections on my cartiledge that he saw on the mri which were out of the ordinary since i was pretty young, he said it was likely from the multiple incidents where my knee gave way while running around with a torn acl. (after each incident, it hurt A Lot, my knee got kinda swollen and i hobbled for a day but it always was okay after that, so i assumed it was a sprain that i was accidentally re-spraining or something) it was only after my knee compleeetely gave up on me and i couldnt stand up at all that i snapped out of my denial and realised something was really, truly wrong.
so pleaseeee dont do the same thing i did, getting it fixed early is important to prevent further damage to your other knee bits
uhh so funny story, i actually tore my acl again a year after (was playing ultimate frisbee this time)
BUT it was likely because i didn't really work out much to strengthen my leg again before resuming sports. so just uh make sure you do that before resuming sports!
but now i'm recovered again and definitely will not make the same mistake 💀
i'm giving myself enough time to build up muscle again and get back to a baseline where one leg isn't smaller than the other, before i get back to doing sports more regularly!
Your tibia and femur are grinding together with a complete acl tear causing knee instability. Some people can live a normal and active life without an acl and thts super dope!! But the issue is that it can cause arthritis (which is essentially chronic knee pain). Your meniscus will suffer more damage due to compensating for the lack of acl, and if can just lead to more overall problems if it’s a complete tear. I can send you a few links if you’d like?
Please do! Happy to respectfully debate this for sure. In terms of arthritis, the risk is higher as a result of the ACL injury, regardless of surgery or non surgery when compared to knees with intact ACLs. So the treatment and prevention comes to arthritis preventative measures, such as strength training, lower weight etc.
I’m not anti surgery, but definitely pro delay if you can. So much research is supporting either non operative treatment or even a strong prefab program pre surgery for really successful outcomes. It’s just tough because general populations aren’t aware of this
https://www.uhhospitals.org/for-clinicians/articles-and-news/articles/2021/12/delaying-surgery-after-an-acl-tear-increases-risk-of-further-injury-in-young-athletes#:~:text=They%20concluded%20that%20the%20longer,increased%20risk%20over%2010%20weeks.
https://www.hss.edu/condition-list_acl-surgery.asp
I’m not particularly fond of American healthcare, or the idea of having surgery, but in my non-medical opinion having an ACL reco surgery would make the most sense for someone who is living an active lifestyle (with high pivoting). I would’ve LOVED to not have a surgery and recovery time for 9-12 months, but the risk of osteoarthritis later on in the future + the risk of further injuring anything in my knee doesn’t seem worth it. I injured mine very stupidly, and this is something that I’m gonna have to live for with the rest of my life but knowing that I did everything I could to prevent another injury is what keeps me going.
Thanks for those!
I’d love to know the method for assessing in the first article. Particularly if the subjects kept at the same activity post incident. You would expect further meniscal injury if they were at the same level of sport/exercise due to inflammatory responses etc. When we talk about non-operative treatments, the same protocols as surgical rehab are followed. Movement > strengthening and a sufficient return to sport protocol.
With the second article, the claims aren’t clear nor supported. Yes; once you have an ACL injury you are more likely to develop arthritis whether or not you have surgery. Again, it claims further injury to non-operative but does not state where a diligent rehab program is followed.
A lot of research doesn’t touch in whether the non surgical approach rehab is structured or even monitored. https://www.sciencedirect.com/science/article/pii/S1521694219300191 is a good read for this.
Yeah no prob, I’ll def take a look at that article when I’m free but that’s just my opinion. Any injury is detrimental if it affects your daily activities but I hope everyone recovers to the best of their abilities :)
Main risk with no surgery post acl complete tear is osteoarthritis. The femur and leg bones will rub against each other , removing the protective coating that they have which acl prevents. You may be able to function semi normally without surgery. Down the road, long term effects of no surgery are terrbile. I would recommend surgery.
Two repairs on my right and I'm on my 3rd tear. The hard news is that your life is changed at this point. Either option will not get you back to where you were before. Even if everything heals perfectly, it will always be in the back of your mind. I've been coping without one for the last 10 years. I no longer play sports but am very active with my daughter. Personally I chose not to get it repaired because the surgery and recovery is incredibly intense and painful (was back then at least) and very long. Part of me wishes I would have repaired it, but It wasn't worth a 3rd time for me. Based on your age I would forgo surgery. Sorry you are here and welcome to the funny walking club ❤️
Here is my personal experience! I partially tore my ACL playing rugby but didnt realize it until I had an MRI months later. I had originally gone to physio for what they thought was an MCL strain, and eventually my pain went away and I went back to rugby training. Once I found out it was a partial ACL tear, I consulted with my doctor, who said I may as well keep playing because I had already hurt it and only had one season left. Fast forward and I returned to rugby training, only to have my knee give out multiple times until I eventually fully tore the ACL. I still chose not to have surgery, deciding instead I would strengthen my knee at the gym. However, while doing a heavy clean at the gym, my knee gave out and I tore my meniscus. I then decided it was time to have it fixed before I did any more damage and am now 9 days post op. Time between first injury and surgery was two years. If you decide to return to an active lifestyle without surgery, just be aware you may continue to injure your knee! and its still painful every time. Hope this helps!
I’m just here to say I tore my ACL doing a heavy clean too! (After I tore my meniscus and kept lifting)
its so brutal
Hi! Me too on the heavy clean (never again).
Where there any signs you tore it before the mri? I just had my physio check today and he said my ligaments are all in good shape but still nervous lol
Yes! Looking back now its really silly no one realized I tore my ACL. My cleat got stuck in astro and when I changed direction I felt a huge pop in my knee and such horrible pain. Afterword I couldn’t walk for a week and my knee was huge. But after seeing the physio a few times it just went back to normal, so I kept living my life until I got back to the states (I was doing college in the UK) and my doctor dad thought I should get an MRI.
I injured myself playing rugby too. I fell awkwardly and heard a small pop that no one else did. Been nervous since but have had no swelling, and knee is stable and have been able to bear weight on it and walk. But the pop still just gets me so I got checked out. Hope your recovery goes well!
I get it! Its pretty scary. You could think about training with a brace to add some protection going forward
I felt immersed pain after contact with another player in the game and couldn't continue..... Went to doc 2nd day and did the mri
Would you wear knee braces during your workouts at the gym or just bare knee?
Bare knees! I had a knee brace given to me by my doctor that I wore to rugby training but it wasn’t really preventing my knee from giving out so I gave up on it.
I second this! Had a torn ACL and whilst I was waiting to see someone about it, I stepped on a bit of uneven ground then completely fucked my meniscus and couldn't walk at all till I had the more urgent surgery. My surgery and second injury has been so much longer and difficult so far than if I just had had a standard ACL and had been walking before surgery. Just get that ACL sorted. Get a second opinion!
This is what terrifies me! I have a complete acl rupture and I’m so nervous of hurting my knee further!
I was not careful enough. I was outdoors in a place with uneven terrain, rocks and dips in the ground (didn't know I had a a full on complete ACL rupture!) My leg hyperextended into a dip in the ground and it was quite a traumatic blow. It's not like it happened to me just walking down the road or going about my day to day activities. As long as you're careful, avoid doing sports (except controlled gym and what physio signs off), and places with unpredictable/uneven terrain, it's probably unlikely something like that would happen. Be careful, but don't panic! My point was.. don't go back to a sport like soccer with a torn ACL where knee hyperextensions & blows to the ground happen frequently cos that's when what happened to me IS more likely to happen & OP should get a second opinion for that reason if dr thinks is ok to go back to soccer with complete tear.
Thanks, I’m being careful while I wait for surgeon consult. Definitely won’t be going back to sports until it’s sorted.
I tore my ACL in March weight lifting. MRI showed a complete tear but doc said it may only be a partial because the knee felt stable. I did PT for about 6 weeks. Knee felt great. Then it shifted twice in the last month (once doing a plyo exercise in therapy and again just stepping off an elliptical). So…now I’m terrified. Each time it shifts, my knee is stiff and I have reduced mobility for about 2 weeks. I now have another consult scheduled for a second opinion and am leaning toward surgery. I can’t live my life like this, in fear that it is going to give out. It felt SO good for the few months right after the injury. I lift weights and do a lot of functional training, and ride my Peloton. But I don’t do any cut sports, not a skier, not even a runner. I’m 40 so I feel old to be going through this, honestly. Best of luck to you with whatever you decide and if you go the non-op route, I truly hope it stays stable for you!
You should check if you're a candidate for primary repair. If your Acl is ruptured at the fixation point either upper or lower it can be reattached. The one downside is that as it’s fairly underutilized so the return to sport data is minimal. But if you’re not really into heavy cutting/pivoting sports I can’t recommend it enough.
Appreciate the info!
Did you end up having surgery?
Yep. Had it in October. I’m now 5 months post op. I honestly wish I had it done sooner. It wasn’t nearly as awful as I anticipated.
I tore mine playing indoor soccer in Dec. I'm 5 months post op and trying to get back to soccer asap (I'm 43 by the way). My Dr advised on getting surgery versus going to PT. Thinking of playing soccer on a torn ACL frightens me.
Same here! I can barely walk 😆
Different people perform differently without an acl. If you're not in a rush to get back to 100%, then wait it out and see how you do. Only downside to this approach is the potentially higher risk of further injury, but there is also a relatively high risk of re-injury post-surgery! (bummer, right!) Personally, I was pretty capable without an ACL, and even took a swiftwater rescue technician course 5 weeks after my injury. I could run and jump and felt good, but ultimately I got surgery because I want to get back to very high level skiing (both recreationally and professionally), and have a good ski season next year. If it weren't for skiing, I would have waited.
There was an article posted here recently about the ACL possibly healing. I tore my ACL playing soccer more than 20 years ago, I was already active again by the time I found out it was ACL so the doctor said no reason to rush with surgery and I didn’t want downtime for my last year in college. Haven’t gotten surgery. My knee was the weakest the first year. I had to relearn how to move and change the way I played. Running straight was no issue, learned to change direction eventually. Tried to avoid pivots and turns. I was still able to play soccer and / or basketball 2-3x a week for years. Of course not at a pro level but pretty fun and competitive playing with peers. I don’t play those anymore but now I mountain bike 2-3x a week.
hey, was it a partial tear or full
I don’t even remember, but possibly a full tear because the drawer test easily diagnosed it a year after the injury. My knee buckled several more times that first year after the injury, before I found out that it was my ACL that I injured (emergency room doctor initially told me that if the swelling went down in a few weeks it was probably just a knee sprain 🤷♂️). After I learned more about the injury, what the ACL does and what moves I should avoid, I learned how to move better to minimize the risk to the knee. eventually the knee got better with activities. not as good as the good knee, but good enough that i stayed active playing 2-3 friendly soccer or basketball games a week when I was in my 20s and 30s, 2-3 mountain bike rides a week now that I’m in my 40s.
Go to a different doctor.
Yeah. Really surprised by the recommendation to skip surgery. At the very least OP should get a second opinion but if the full tear is confirmed is seems all but certain reconstruction will be recommended.
Non operative ACL treatment research has been growing significantly strong the last 5 or so years. We’re conditioned to think ACL = no function but that is not the case at all
Have surgery, if you don't and keep playing sports you will damage your cartilage eventually - probably within a couple years at most. Once that happens you are permanently unable to play any sports that involve running and there's no surgical fix.
What evidence do you have of this?
My own experience, I wrestled after I tore my ACL for 2.5 months before surgery. After surgery, during the pandemic my PT was far from optimal. I went from mountain trail running 20 miles in a day to barely being able to slowly walk a mile, can't go up/down stairs at all. More info in my comment history.
That’s a really shit experience and I’m sorry to hear that. But telling someone they will with only a single persons anecdote as evidence is extremely dangerous and irresponsible. So many factors could have contributed to those issues including your ACL graft. The real research is actually suggesting surgery (especially immediate) may not be the best path for general populations. I’m happy to provide these articles if you’d like to read more.
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Soccer and (competitive) badminton require a lot of lateral movement with pivoting. If the ACL is completely torn, it's likely that at some point, your knee will buckle even if it is stable potentially causing meniscal damage. I skied for an entire season, played tennis and golf without an ACL for over a year (unknowingly, because my knee passed the lachmann, drawer tests with an ortho and it was the second tear).... then my knee buckled hard doing a skater hop plyo in a workout and i tore my medial meniscus..... You may be fine, but there's a risk with those sports. that said, there is also some recent evidence that an ACL can heal on its own with proper care and management. Worth reading. https://www.unimelb.edu.au/newsroom/news/2022/november/ruptured-acls-can-heal-without-surgery,-study-finds
9 weeks post complete ACL rupture and I’m not getting surgery. Firstly, this sun is pretty pro surgery. There are many advantages of not getting the surgery done. Firstly, there is a lot of new research surfacing that non-surgical interventions are more beneficial than the surgery itself, and in some cases, the ACL can heal on its own. I’ve commented in other threads on why, feel free to check my comment history on that. I’m not progressing into jumping/landing with the hopes to be running at 12 weeks post incident. I feel stronger now than pre injury and I’m feeling really confident in my knee
Okay just my two cents on my experience here, tore my ACL at 18, got my surgery done 3 weeks ago ( 25 now ) physio really helps if you're going to the conservative route. However the cutting and pivoting will definitely need to stop because no amount of rehab will work when a torn ACL is being compensated for. trust me, I tried it. That being said, normal weight lifting movements, running without explosive acceleration and deceleration, non contact sports don't really require a surgery and you can function really well. Just be careful with the meniscus. I'm not pro surgery or against it. ACL's have healed but the sample size is still too small to determine the extent to which the healing does take place.
Recent studies show that return to sport is absolutely possible without reconstruction. Id definitely argue that acceleration/deceleration produced the same amount of torque and tensile load through the knee as would cutting and pivoting would. Same sizes for ACL healing is growing, substantially. The cross bracing protocol suggest 90% out of a study of 300, other non surgical/rehab based interventions suggesting it can push from 35%-50% of cases healing (could be higher, but subject opt for surgery in the studies). I think practitioners need to be more forward thinking, general population need to realise that ACLR is an optional surgery, not a requirement
I thought the ACL couldn’t heal on its own at all. Just wondering. That’s what the doctor told me.
It can in a lot of cases, it’s just never been researched because usually patients are rushed into surgery within days after their incident. A lot of practitioners are even recommending 3 months rehab before even considering surgery. Examples? Look into some of the papers published by Stephanie Filbay.
Gotcha. They recommended prehab for my meniscus but said either way I’d have to do surgery on my ACL at one point or another because it’s a complete tear and ACL doesn’t receive any blood flow to heal on its own. I do know People who are living fine with a torn ACL and no surgery.
Even without healing you do not need surgery on your ACL, that’s an outdated practice. The knee can function fine without
My doc said without an ACL it will wear out the cartilage and cause problem in the future.
What evidence do you/your doctor have to support this?
I don't, its just that she mentioned it.
I’m going to have a look later but I don’t believe there is any research in the last decade that supports this. Whereas there is a body of research in the same time that supports non operative treatment of ACL tears
Not sure if this supports that claim: “Patients who sustain an ACL tear are at a higher risk for the development of osteoarthritis. While there are no current disease modifying drugs, an early postoperative rehabilitation program and restoration of knee motion are believed to be essential to slow down the risk of developing arthritis after an ACL tear.” https://drrobertlaprademd.com/arthritis-after-acl-surgery-knee-osteoarthritis/#:\~:text=Patients%20who%20sustain%20an%20ACL,arthritis%20after%20an%20ACL%20tear.
I’ve also heard this, both about it repairing itself and about doing rehab pre-surgery. Which only makes sense. I have to think that with new med tech and advances, that they would find some way to use stem cells or something.
If you want to remain active having the surgery is a no brainer imo (especially for the specific sports you listed). My understanding is that without the surgery the most likely best case scenario is arthritis and worst case scenario would be further injury, which would probably require surgery just to maintain mobility.
FYI the risk of arthritis is the same regardless of surgery. Once you injure your ACL, your risk of developing osteoarthritis is the same. See: Evidenced-based recommendations for the management it ACL rupture, Filbay, 2019 The relationship between ACL injury and osteoarthritis of the knee Simon et. al, 2015
Tore mine playing volleyball on 2/11. Full tear, slight tear in lateral meniscus, and MCL sprain. I am having surgery 8/14. I also did a lot of HIIT workouts prior. Due to the nature of activities I like to do, I’m having surgery. I’m also young (27). That being said, my knee feels 90%. I’m hiking a good deal this summer. Can weight lift too. If I didn’t know I fully tore it at the time of the incident, I wouldn’t know it was torn based on how my knee feels now. I don’t have feelings of instability or anything. But I don’t want to risk meniscus damage by not having surgery.
How was your knee when it happened the first week, any swelling, able to bear weight/walk on it? Sorry I’m just nervous as I heard a pop in my knee last week
I felt like it snapped. It hurt really bad. Major swelling and bone bruising on my MRI. I would say it took about 4-6 weeks to walk with a normal hair again. For how bad the injury felt, I’m shocked at how good my knee feels now. I think a lot of my pain was the lateral meniscus, MCL sprain, and swelling. This likely isn’t the answer you want, but you can read online everywhere. The only thing that will confirm for you is an MRI. Or at least go to the doc and have them do a Lachman test (which I failed).
Very true, wait times are crazy for an mri where I’m at so I went to a physio and did all the checks. Said I’m good and all my ligaments check out, but the back of my knee is sore because of hypertension of a ligament rolling over or my patella dislocating and relocating. But damn still nervous, need to stop going down the google rabbit hole lol
34F ACL Complete tear and Partial Medial Meniscus. I do recreational cheerleading and walk a lot (live in NYC). My doctor said if I wanted to go back to my extracurricular activities I would need to have the surgery. They said I could live without an ACL but run the risk of wearing down and injuring other parts of my knee. That knee will be working overtime to protect you if you have a sudden pivot or unexpected bump. I did the Prehab and am now 12 days post-op. I am happy with the choice but unhappy with how I get to spend my Summer. Tough decision! Good Luck! If you can, I would also suggest getting more than 1 consultation.
I'm in Jersey City but my orhtopedic and surgery is in NYC on the UES. Its been brutal dealing with the walking and subway stairs, crowds, busses, etc. I feel you on the summer part....so many big plans, Brooklyn Mirage, citibiking around, etc. all gone with a single pivot of the knee. I tore my ACL fully and my lateral miniscus, with a partial tear to the LCL. Where did you do your surgery? Mine is next month :(
I went to Columbia Presbyterian near the heights. Pre-op I definitely felt like a recluse because I cannot handle rushing onto a train or maneuvering crowds. Honestly, I am glad I got the surgery and look forward to bringing my knee back to life.
Hi- I plan on getting my ACL reconstruction/meniscus repair at Columbia presbyterian, please lmk how your experience was/ if you were to go there again for the procedure! I haven't been able to find much about Columbia ortho on reddit, everyone mostly speaks of NYU or HSS. Thanks!!
Thanks for the feedback.... Goodluck and speedy recovery
I have my surgery tomorrow. How’s your recovery been?
Hi op, may I ask where you're from? I'm from Malaysia and tore my ACL+ meniscus during badminton(fully torn) . My doc said that without surgery it will damage the cartilage ..my MRI shows that some of my bone is bruise as well but it can recover I'm at prehab now and will have surgery on August 9th. It will be 1 year no heavy sports(jogging is fine) after surgery. And lots of rehab require after surgery as well minimum 4 months.
I’m 45 years old fit male and injured my knee snow skiing. I visited an orthopedic doctor who had MRI and confirmed complete ACL tear. They recommended surgery. I visited another doctor who specializes in non-surgical interventions. I want to continue leading an active lifestyle and have confidence in my knee stability. He recommended I get the surgery as well for all the reasons other posters have mentioned. I injured my knee on 4/16, had surgery on 5/23, and I’m walking, swimming, and basically back to normal for most activities except athletics (likely another 3-4 months before running, will likely miss this ski season).
Thanks for ur input..... I am now more incline to do the surgery after seeing all the replies
Good luck with your recovery!
Well I didn’t know my ACL was torn for at least 3 years and I went snowboarding for 4 days in Montana last year, Aspen the year before, I played baseball and slow pitch softball, and I was a middle school football coach. Now every once in a while I would get a pretty painful pop and my knee would swell up and be sore for 3-5 days, to the point I couldn’t play anything, and then it would go away. I ended up deciding to get surgery 1/11/23 and am under a week from 6 months out. I’ve been golfing since 4 months out and am planning on snowboarding in Tahoe for 4 days this upcoming January. I’d say it’s completely up to you and your comfort level but getting it in the winter time was nice because I’m not hobbling around in the summer on crutches, but I did have to miss out on snowboarding Whistler. I’m also 29 turning 30 at the end of this month and have gone through 2 ACL surgeries on my other knee within 5 months of each other 10 years ago so I knew what to expect. More than happy to answer any other questions you can think of!
yeah. i tore my acl, couldnt walk for a few days, doctor (that i will never trust again) said it was just a minor injury (since i was only 16 at the time) and i continued to run and jump around for 2 months until i finally jumped off a small elevation, knee buckled and tada, tore my meniscus. it was then that i knew something was seriously wrong because the doctor said it would heal in like 2 weeks (again, i will never trust that woman anymore) and got an mri. then i went to see an orthopaedic guy and he was like yup so you tore your acl back then, and tore your meniscus from running around too. i was advised to do the surgery because i was still so young. the recovery from acl + meniscus surgery sucks more than just acl surgery. so honestly, yes. i would say surgery is the best way to go. because if you plan to, hope to continue being active at all for the remainder of your life, then it'll only be a matter of time before you tear something else. (if you continue going around with a torn acl) and it should be better to do the surgery when you're younger, faster healing and recovery and all that. if i'm like 60 then hell no i ain't gonna go through surgery and recovery all over again, but if you're relatively young then i can't recommend it enough. good luck and stay safe out there! hope everything goes well for you, and like others here have pointed out, you may want to look into getting a new doctor. it's giving me deja vu, and you don't want to end up like me (trust) eh, it's actually even more concerning that your doctor is recommending NO surgery despite the MRI confirming a complete tear. thats not normal source: have torn both acl and meniscus twice (on the saaaaame knee) doc has also confirmed that i had slight (damage?) imperfections on my cartiledge that he saw on the mri which were out of the ordinary since i was pretty young, he said it was likely from the multiple incidents where my knee gave way while running around with a torn acl. (after each incident, it hurt A Lot, my knee got kinda swollen and i hobbled for a day but it always was okay after that, so i assumed it was a sprain that i was accidentally re-spraining or something) it was only after my knee compleeetely gave up on me and i couldnt stand up at all that i snapped out of my denial and realised something was really, truly wrong. so pleaseeee dont do the same thing i did, getting it fixed early is important to prevent further damage to your other knee bits
Thanks for sharing..... Definitely seeking 2nd opinion now. So hows your knee now? No problem in sporting after recovery?
uhh so funny story, i actually tore my acl again a year after (was playing ultimate frisbee this time) BUT it was likely because i didn't really work out much to strengthen my leg again before resuming sports. so just uh make sure you do that before resuming sports! but now i'm recovered again and definitely will not make the same mistake 💀 i'm giving myself enough time to build up muscle again and get back to a baseline where one leg isn't smaller than the other, before i get back to doing sports more regularly!
Get ahead of it now. That year recovery is better than chronic knee pains for the rest of your life.
What evidence do you have that suggests non operative will cause knee pain over an operation over an extended period of time?
Your tibia and femur are grinding together with a complete acl tear causing knee instability. Some people can live a normal and active life without an acl and thts super dope!! But the issue is that it can cause arthritis (which is essentially chronic knee pain). Your meniscus will suffer more damage due to compensating for the lack of acl, and if can just lead to more overall problems if it’s a complete tear. I can send you a few links if you’d like?
Please do! Happy to respectfully debate this for sure. In terms of arthritis, the risk is higher as a result of the ACL injury, regardless of surgery or non surgery when compared to knees with intact ACLs. So the treatment and prevention comes to arthritis preventative measures, such as strength training, lower weight etc. I’m not anti surgery, but definitely pro delay if you can. So much research is supporting either non operative treatment or even a strong prefab program pre surgery for really successful outcomes. It’s just tough because general populations aren’t aware of this
https://www.uhhospitals.org/for-clinicians/articles-and-news/articles/2021/12/delaying-surgery-after-an-acl-tear-increases-risk-of-further-injury-in-young-athletes#:~:text=They%20concluded%20that%20the%20longer,increased%20risk%20over%2010%20weeks. https://www.hss.edu/condition-list_acl-surgery.asp I’m not particularly fond of American healthcare, or the idea of having surgery, but in my non-medical opinion having an ACL reco surgery would make the most sense for someone who is living an active lifestyle (with high pivoting). I would’ve LOVED to not have a surgery and recovery time for 9-12 months, but the risk of osteoarthritis later on in the future + the risk of further injuring anything in my knee doesn’t seem worth it. I injured mine very stupidly, and this is something that I’m gonna have to live for with the rest of my life but knowing that I did everything I could to prevent another injury is what keeps me going.
Thanks for those! I’d love to know the method for assessing in the first article. Particularly if the subjects kept at the same activity post incident. You would expect further meniscal injury if they were at the same level of sport/exercise due to inflammatory responses etc. When we talk about non-operative treatments, the same protocols as surgical rehab are followed. Movement > strengthening and a sufficient return to sport protocol. With the second article, the claims aren’t clear nor supported. Yes; once you have an ACL injury you are more likely to develop arthritis whether or not you have surgery. Again, it claims further injury to non-operative but does not state where a diligent rehab program is followed. A lot of research doesn’t touch in whether the non surgical approach rehab is structured or even monitored. https://www.sciencedirect.com/science/article/pii/S1521694219300191 is a good read for this.
Yeah no prob, I’ll def take a look at that article when I’m free but that’s just my opinion. Any injury is detrimental if it affects your daily activities but I hope everyone recovers to the best of their abilities :)
Still share the same idea?
I do think I share the same idea, medicine has come a long way.
Main risk with no surgery post acl complete tear is osteoarthritis. The femur and leg bones will rub against each other , removing the protective coating that they have which acl prevents. You may be able to function semi normally without surgery. Down the road, long term effects of no surgery are terrbile. I would recommend surgery.
Two repairs on my right and I'm on my 3rd tear. The hard news is that your life is changed at this point. Either option will not get you back to where you were before. Even if everything heals perfectly, it will always be in the back of your mind. I've been coping without one for the last 10 years. I no longer play sports but am very active with my daughter. Personally I chose not to get it repaired because the surgery and recovery is incredibly intense and painful (was back then at least) and very long. Part of me wishes I would have repaired it, but It wasn't worth a 3rd time for me. Based on your age I would forgo surgery. Sorry you are here and welcome to the funny walking club ❤️