The anterior cruciate ligament (ACL) sits inside the knee, where it works to control movement, especially twisting motions or sudden stops. An ACL rupture happens when this ligament tears completely, often during activities that involve pivoting or jumping. Common ACL tear symptoms include popping sounds, swelling, and the knee giving way. Doctors confirm this kind of injury with exams and MRIs. Because the ACL does not receive significant blood flow, the traditional wisdom was that it could not heal without surgery.
The Traditional Surgical Approach
Surgical reconstruction has been the standard treatment for ruptured ACLs for decades. In this type of surgery, doctors remove the torn ligament and replace it with tissue from the hamstring, patellar tendon, or a donor. The goal is to restore stability so patients can return to sports or perform daily activities. In the US and many other countries, surgery is the most common treatment choice for torn ACLs, but it comes with risks, costs, and a long recovery.
New Research on Non-Surgical Healing
Several recent studies suggest that some ACL ruptures can heal without surgery. In one analysis, about a third of participants who underwent structured rehabilitation showed MRI evidence of a continuous (healed) ACL years after the injury. Other research, including a study involving a novel cross-bracing protocol, found signs of non-surgical healing within as little as three months. These findings challenge the long-held belief that a torn ACL can’t repair itself.
How Non-Operative Healing Works
Many researchers now believe that certain conditions allow a torn ACL to reconnect without surgery. Tear location appears to matter, with proximal tears sometimes healing better. Additionally, therapeutic approaches such as bracing the knee in flexion (while bent) can reduce the gap between the ends of a torn ACL, which seems to help the tissue reconnect. Structured rehabilitation can also play a role by improving muscle strength and stability around the knee.
Who Might Be a Candidate
It’s worth noting that non-operative treatment will likely work better for some patients than others. Age, activity level, and the type of tear can all influence the likelihood of healing. Younger patients in pivot-heavy sports may face a higher risk of instability if they avoid surgery. However, patients with partial or proximal tears and those willing to commit to intensive rehabilitation seem to have better chances of recovery without reconstruction.
Each case requires individual evaluation by a doctor, as the decision depends on multiple personal and medical factors. A licensed medical professional can assess the features of an ACL tear, the patient’s activity goals, and the long-term risks before recommending treatment. Attempting to manage an ACL rupture without guidance could increase the chance of instability or further injury. Professional input can help patients weigh the potential benefits of rehabilitation against the reliability of surgery and create a tailored treatment plan accordingly.
How Long Island Spine Rehabilitation Medicine Can Help
At Long Island Spine Rehabilitation Medicine, our doctors provide non-surgical treatment for spinal and musculoskeletal injuries. Our team of physiatrists offers thorough diagnostics and a wide range of therapies designed to restore function and reduce pain.
Treatments we offer include customized physical therapy, platelet-rich plasma (PRP) therapy, corticosteroid or analgesic injections, pulsed electromagnetic field (PEMF) therapy, acupuncture, and hyaluronic acid injections. Each plan is tailored to your needs. While we recognize that some ACL injuries still require surgery, our approach gives many patients a chance to recover without invasive procedures.
If you are dealing with an ACL injury or knee pain, our team is here to provide the clear answers and targeted treatment options you need. Contact our team now to arrange your consultation.