We all hear how ACL injuries are season-ending for professional athletes. But what if an athlete could return to sports without ACL surgery?
There have been many articles showing that patients can return to activity, including sports, without ACL reconstruction. A recent study by Hetsroni et al in the August 2013 journal of Knee Surgery, Sports Traumatology, Arthroscopy showed that a quarter of recreational skiers with ACL injuries can be treated non-operatively. However, most people go on to have continued episodes of instability causing additional injury if they return to sporting activities without surgery. So what are the risks of playing without an ACL and how do we know who can and can’t play without surgery?
The ACL is the main stabilizing ligament in the knee. It prevents excessive rotation of the knee joint that can occur with cutting and pivoting motions such as those in football, soccer, basketball and other similar sports. When the ACL doesn’t work, these rotational forces are transmitted to the other knee structures resulting in tearing of the meniscus and damage to the joint surface cartilage. Cartilage is the Holy Grail of orthopaedics and sports medicine. We do a very good job a reconstructing the ACL but our results with cartilage repair are adequate at best.
Joe Namath was the first famous athlete to return to sports without ACL surgery, which in his day was usually career-ending. What Broadway Joe proved is that a torn ACL, despite bracing, results in severe damage to the knee joint. Research shows that 90 percent of people with a torn ACL have significant problems or re-injury and only 10% of the patients did ok without surgery. These problems include persistent giving way, swelling, locking and pain.