What impact can an ACL tear have on the rest of my life?


woman holding her knee

About 250,000 Americans suffer an anterior cruciate ligament (ACL) tear each year. Tears are often caused by sudden twisting movements while playing sports such as basketball, soccer, or football.

Symptoms of ACL damage include:

  • pain
  • swollen knee
  • unstable
  • unable to continue activities

Treatment may include surgery and physical therapy, depending on the injury and patient goals.

What are the long-term effects of ACL injury?

People with ACL injuries are at increased risk of developing arthritis in their knees, even if they have surgery to repair the damaged ligaments.

“The dark side of ACL injuries is the increased rate of arthritis in the future,” says orthopedic surgeon Matthew Tao, M.D. “Given that many patients with anterior cruciate ligament rupture are in their teens and 20s, the prospect of developing knee arthritis within 10 to 20 years is depressing and impacts their long-term health and quality of life. It will have a significant impact.”

Knee arthritis involves the destruction of knee cartilage and other parts of the knee joint. Arthritis is more likely when ACL injuries are accompanied by other injuries, such as meniscal injuries.

Effects of knee arthritis may include:

  • pain
  • Decreased quality of life
  • Inability to perform work or life functions
  • High risk of health conditions such as diabetes and heart disease

Physiotherapist and researcher Elizabeth Welsand, PT, DPT, PhD, OCS, is Director of the UNMC Clinical Motion Analysis Laboratory, which studies knee injuries. She says arthritis isn’t the only long-term effect of ACL injuries.

“One-third of patients are unable to return to sport and have decreased overall physical activity,” she says. “Some patients gain weight and body fat. Knowing these risks is important in developing strategies to stay physically active and healthy after ACL injury.”

Is surgery always necessary?

ACL tears often involve surgery, but not everyone chooses that option.

“Surgery is usually recommended for people who cut or rotate on a regular basis,” says Dr. Tao. “But there is good evidence for non-surgical management, and I have treated many patients that way.”

Nonsurgical approaches to managing ACL injuries use physical therapy to:

  • Helps strengthen the muscles around the knee
  • Allow the patient to move in a safe and coordinated manner

What surgical options are there for ACL injuries?

If you need surgery, your options include:

  • Reconstruction aimed at restoring the original anatomy and stability of the knee, or reusing tissue from the patient’s body or cadaver into a new ACL
  • Repair it or keep the native ACL in place and repair the ends to put it back. A new procedure called BEAR uses biological collagen implants to speed up the healing process, says Dr. Tao, with early “good” results.

Dr. Tao warns that successful recovery from an anterior cruciate ligament tear requires more than just surgery.

“I am a strong believer in a multidisciplinary approach to care,” he says. “I tell people with anterior cruciate ligament injuries that postoperative rehabilitation is as important, if not more, than the surgery itself.”

After ACL surgery

The road to recovery after ACL surgery can be long, and a comprehensive recovery plan is very important. Initial goals include:

  • Reduce pain and swelling
  • Restore knee motion and normal walking patterns
  • Rotate and activate the quadriceps

As recovery progresses, it’s important to follow a personalized plan and complete tests to make sure your recovery is on track, Dr. Welsand said.

“Dr. Tao and I use a team-based approach and return-to-sport testing, including muscle strength and hop tests, as well as biomechanical and psychological assessment of knee use during jumping activities. , is used to develop an individualized plan for each athlete to return to normal sport and physical activity,” she says.

The mental side of recovery is also important, says Dr. Tao. If a patient wants to optimize his mental performance, he will refer him to the sports psychology team.

“Ultimately, patients have different goals, but we want to help them get back to activity as safely and efficiently as possible. This is a true team effort,” he said. increase.

ongoing research

A study on optimizing movement after ACL injury has been conducted by Dr. Welsand, Dr. Tao and their team. Eligible participants include those aged 13 to 35 who have suffered an anterior cruciate ligament tear and are planning or have recently undergone surgery.

People with ACL injuries tend to develop movement patterns that avoid pain by “unloading” or removing weight from the injured knee, Dr. Wellsant said. This can weaken the knee and increase the risk of future injury.

“Unfortunately, many people continue to strain their knees after returning to sport, and this pattern of movement is associated with a higher likelihood of secondary ACL injuries,” says Welsand. says Dr. “We are developing a rehabilitation approach to help patients relearn how to load their knees in the first months after ACL surgery.”

Participants receive free rehab from a physical therapist who is certified in orthopedic physical therapy and strength and conditioning. The team will monitor patients to see if they return to normal movement patterns and reduce their risk of knee arthritis.

If treatment is successful, Dr. Wellsant’s team will:

  • We will share the results with the world and introduce a physiotherapy program into the standard of care for patients following ACL injuries.
  • Further develop clinical treatments after ACL injury to prevent knee arthritis and optimize physical activity and sports participation

Dr. Tao said the study could help identify factors in the progression of arthritis and provide potential targets for therapeutic intervention.

“As a surgeon, I love working with these patients and helping them get back into the field, but I also know there is a bigger problem. Our team’s research is very important: if we can mitigate the problem before it happens, we can influence change in the future, which will be of great benefit to ACL patients and society as a whole.”

If you have a sports-related injury and are interested in seeing our sports medicine team, please call us. 800.922.0000.

If you have injured your ACL within the last 6 months, had ACL reconstruction in the last month, or are planning an ACL reconstruction and are interested in participating in a clinical trial of optimized exercise after ACL injury, please visit https://www. Visit ://net.unmc.edu. /ctsearch/study.php?652-21 or call 402.863.9165.



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