ACL repair surgery offers promising alternatives to traditional reconstruction, with potential benefits including faster recovery and lower surgical morbidity. Patient selection is crucial, as not all ACL injuries are suitable for repair. Recent findings suggesting spontaneous healing of ACL tears have sparked renewed interest in native ACL preservation. However, more comprehensive studies are needed to compare the outcomes of ACL repair versus reconstruction. Patients with ACL injuries are encouraged to seek consultation with an orthopedic surgeon to exaplore the most appropriate treatment options tailored to their specific needs.

What are Anterior Cruciate Ligament (ACL) injuries?

Anterior Cruciate Ligament (ACL) tears are significant injuries affecting knee stability and function. Left untreated, they can lead to further complications and potential career-ending consequences for athletes. Traditional treatment involves ACL reconstruction, replacing the torn ligament with a substitute graft. However, the concept of ACL repair, initially explored in the 1970s and 1980s, has re-emerged with advancements in surgical techniques and biologics.

Advantages of ACL Repair Surgery

Recent experiences from surgeons in the USA and Europe highlight the benefits of ACL repair, including faster restoration of range of motion and potentially improved proprioception. Compared to reconstruction, ACL repair is less invasive, resulting in lower surgical morbidity. Additionally, in cases of failure, revision surgery following primary repair is expected to be less complicated than revision reconstruction.

Disadvantages and Controversies for ACL Repair Surgery

Not all ACL injuries are suitable for primary repair, as success depends on various factors such as tear location, tissue quality, patient age, and activity level. Some studies suggest that only certain types of ACL injuries are amenable to repair, particularly acute or recent injuries. Delayed treatment may result in higher failure rates due to shortening or scarring of the ACL stump. Furthermore, young patients may have higher re-rupture rates following repair, leading to cautious recommendations for patient selection.

Recent Findings Regarding ACL Tear Treatment Options

Recent studies have challenged conventional wisdom by suggesting that ACL tears may heal spontaneously, particularly in proximal tear patterns. While this notion contradicts established beliefs, it encourages a re-evaluation of native ACL preservation and repair as a treatment option. However, the long-term outcomes and comparative effectiveness of ACL repair versus reconstruction remain subjects of ongoing research and debate. We may have to wait a little longer before we can have a definitive answer if ACL repair is suitable as an accepted method to treat selected ACL injuries.

Conclusion

If you have recently suffered an ACL injury or are experiencing knee instability, do visit your orthopaedic surgeon and have an in-depth discussion on the available ACL treatments that could help you speed up your recovery.  Your doctor can assess your individual case and help you determine the best course of treatment for your specific needs and goals. Remember, the road to recovery may be challenging, but with the right treatment and support, you can overcome your injury and return to the sports you love stronger than ever.

Book a consultation with Dr Sean Leo at Orthokinetics if you have any concerns or questions about ACL injury and treatment options.