What are the different ACL Treatment options?
There are a number of different ACL Treatment options depending on your injury. A complete rupture of the ligament will require reconstruction in a physically active person. The procedure for ACL reconstruction involves replacing the existing torn ACL with a graft taken from either the hamstring or patellar tendon. ACL Reconstruction is a highly successful procedure with a low risk of reinjury. The research has shown that a patellar graft is preferable as it has a lower failure rate compared to a hamstring graft. King et al., 2020 reported a 2.7% reinjury rate after ACL reconstruction with a higher reinjury rate seen in hamstring grafts compared to patellar tendon grafts at two years post op.
Professor Moran chooses the type of graft on an individual basis. He will discuss the best options with you. This decision is determined by age, activity demands, sports and occupation. A hamstring
graft is preferable in younger athletes before growth plates have fused. In some cases this may be where it is not possible to harvest a graft from the patellar tendon. The early bonding of the
graft takes approximately six weeks for patellar tendon grafts and ten weeks for hamstring tendons. Both bone-patellar tendon-bone and hamstring autografts restore objective knee
stability
Sprains of the ACL ligament without discrete tear or rupture and without clinical instability are usually managed conservatively through rehabilitation.
An ACL reconstruction takes approximately 45 minutes in theatre. You will stay in hospital for just one night. You can watch an animation of the procedure of one of the ACL treatment options HERE
What happens after surgery?
Patients are provided with crutches after surgery. They are also encouraged to commence early rehabilitation with exercise and movement. A Physiotherapist will visit you after surgery to
start your rehabilitation. You will be provided with an exercise programme and encouraged to obtain full range of motion within the first two weeks after surgery. During this time we also encourage you to attend your local Physiotherapist. This will help to ensure that you are completing the exercises correctly. Your physiotherapist will guide you through our rehabilitation
programme following our post op protocol.
You will have a review appointment with Professor Moran’s clinical team 3-4 weeks after surgery to review your progress. As we are a specialist practice in the management of ACL
injuries, our specialist team will monitor you at different time points throughout your rehabilitation journey. You will also meet with our specialist team at approximately month 3 or 4 with your first round of isokinetic studies and again at month 7-8 for your final round of isokinetic studies.
From this appointment we will book you in for the first round of Isokinetic testing in SSC Sports Medicine Performance Lab. This is a lab based strength test to identify any
weaknesses between the operated and non-operated limbs. Professor Moran will go through the results of your testing with you and based on these results Professor Moran will make
recommendations for your rehab programme. We then book you in for the second round of Isokinetic testing 7 months after surgery. This test incorporates agility based strength
movements including twisting and turning. This round of testing help determines your readiness for return to play. You can find more details on the ACL testing protocols HERE
Anterior Cruciate Ligament reconstruction is a highly successful procedure in restoring stability and function when coupled with a robust rehabilitation programme. Rehabilitation for full return to play and activity is usually 9-12 months after surgery. The success of the surgery is heavily reliant on each individuals compliance to rehabilitation. Return to play rates following ACL reconstruction here in Sports Surgery Clinic is 87%. The primary goal
of ACL reconstruction is safe return to play, our patient pathway is designed to ensure athletes engage in progressive rehabilitation and will not only return to play but also remain in play 9-12 months after surgery. Returning to play before this time has shown significantly higher rates of reinjury, Beischer et al., 2020 reported that athletes who returning to sport before 9 months after ACL reconstruction were associated with approximately a 7-fold increased rate of sustaining a second ACL injury.
Progressive strengthening is essential to ensure a safe return to activities and is an important consideration prior to committing to a reconstructive procedure. You can also find out more about ACL Injuries by reading our first blog HERE or if you have any questions about ACL Treatment, please get in touch by emailing [email protected].
References
Beischer S, Gustavsson L, et al. Young Athletes who Return to Sport Before 9 Months After
Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those
Who Delay Return Journal of Orthopaedic & Sports Physical Therapy. 2020;50(7):83-90.
doi.org/10.2519/jospt.2020.9071
King E, Richter C, Jackson M, et al. Factors Influencing Return to Play and Second Anterior
Cruciate Ligament Injury Rates in Level 1 Athletes After Primary Anterior Cruciate Ligament
Reconstruction: 2-Year Follow-up on 1432 Reconstructions at a Single Center. The American
Journal of Sports Medicine. 2020;48(4):812-824. doi:![]()
10.1177/0363546519900170
Shimokochi Y, Shultz SJ. Mechanisms of noncontact anterior cruciate ligament injury. J Athl
Train. 2008 Jul-Aug;43(4):396-408. doi: 10.4085/1062-6050-43.4.396. PMID: 18668173;
PMCID: PMC2474820.