Injury of the anterior cruciate ligament (ACL) is very common, especially among athletes. Most surgeons agree that surgery is needed to repair the damage. Whether or not to have the operation is a decision each patient must make with the advice of his or her surgeon.
Some things to consider along the way include your activity level, knee stability, and the mechanism of injury. Let's look at each one of these a little more closely.
Surgery is recommended most often for high-level athletes who want to return to their preinjury level of sports activity. Early intervention prevents further damage to the knee and reduces the overall recovery period.
Knee stability is next. Giving-way of the knee is a sign of ACL deficiency and knee instability. A stable joint is one that doesn't give way or buckle. The joint must remain stable when stressed or required to respond to rapidly changing loads during activities.
Patients who suffer an ACL injury during noncontact sports are most likely to need surgery. In such an injury, the person was not involved in a collision with another player or object. Instead, the ligament tore as a result of an action such as pivoting, jumping, or cutting.
This suggests the internal load exceeded the tensile strength of the ligament. Muscular strength, coordination, and control around the joint were not enough to prevent the rupture.
If you are not involved in sports or other high-stress activities, and your knee isn't buckling or giving-way, then you may not need surgery. A good rehab program of strengthening and neuromuscular control may be all that's needed.
But if you had a noncontact injury and you intend to get back as quickly as possible, then reconstruction may be the best choice.