Options For ACL Repair

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One common sports-related injury is the partial or complete tear of the Anterior Cruciate Ligament (ACL).  If you have recently injured your ACL, you may be curious about your options for healing.  

Non-Surgical Options

Prolotherapy:  If your ACL tear is partial, you may be a candidate for prolotherapy.  Prolotherapy is a non-surgical approach to aid in the healing of many musculoskeletal problems.  A series of injections are given at the tear site, which cause the ligament to become inflamed for a short period of time.  This low-grade inflammation causes fibroblasts to activate and synthesize the beginnings of mature collagen.  In other words, the injections causes the growth of connective tissues which stabilize the joint.   

Research has shown that prolotherapy in connection with regular physical therapy (even if done as an at-home program) results in regrowth of partial ACL tears.  However, this approach is not ideal for all patients, especially if the ACL is completely torn.   

Physical Therapy:  Rehabilitation is a non-surgical option that is frequently explored prior to surgery.  A physical therapist can evaluate your areas of weakness and devise a treatment plan to increase muscular strength, endurance, and coordination.  With your therapist's help, you can learn to modify your activities to avoid placing additional strain on the injured knee.  Even if you decide to have surgery, a physical therapy will help you prepare for and rehabilitate after the surgery.  

Surgical Options

The most common treatment for an ACL tear is surgical reconstruction or repair.  When the ACL separates from the bone with a portion of the bone still attached to the ligament, an ACL repair surgery must be done.  The bone fragment is reconnected to the bone.  On the other hand, ACL reconstruction uses a tendon graft to replace the ligament.  While under regional or general anesthesia, you will undergo surgery in one of two ways. 

Open Surgery:  A large incision is made on the knee to make the repair or reconstruction.  This type of surgery leaves a much larger scar and has increased risks of infection post-surgery.

Arthroscopic Surgery:  During arthroscopic surgery, small incisions are made around the knee.  Then, a small camera is inserted into the knee so the surgeon can see the structures inside.  Two drills are placed in other incisions and small holes are drilled into the upper and lower leg bones near the knee.  The tendon graft is anchored in the tunnel between those drill holes.  

The smaller incisions required for an arthroscopic surgery are advantageous because they typically heal faster.  Despite the smaller incisions, the surgeon is still better able to see the area of the knee with the use of the tiny camera.  Indeed, surgeons frequently do diagnostic arthroscopy and can easily make repairs if necessary mid-diagnosis.  

If you feel that you have injured your ACL, meet with an orthopedic surgeon as soon as possible so you can investigate all your options and begin your road to recovery. 

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