ACL Conservative Rehab vs. Surgical Reconstruction

If you have ever been around sports you’ve probably heard of the ACL or anterior cruciate ligament. The ACL, responsible for preventing anterior displacement on the tibia, usually tears from non-contact pivoting motions. There are two options for an athlete with a full ACL tear, either to undergo reconstructive surgery of the ligament which will put the athlete out for months or look to conservative rehab by strengthening the muscles surrounding the knee in order to compensate for the integrity lost with the torn ACL. Deciding which route to go is the tricky part. Physicians may start with conservative treatment as it yields quicker return to play. Theoretically if an athlete can make up for their lack of ligament stability with muscular strength regarding the quads and hamstrings, then there is no need for surgery. However studies have shown that due to the ACL’s role in proprioception, athletes with ACL deficient knees show decreased reflexes in the hamstrings as well as diminished stability of the knee regardless of conservative treatment when compared to an uninjured knee. Meaning surgical reconstruction may restore lost stability. Another study also indicated higher risk of osteoarthritis in knees with full tears of the ACL that didn’t pursue reconstruction but in cases of reconstruction the risk was reduced