Thirty years ago, I had a partial ACL injury. I opted to avoid surgery and just do the rehab program. Of course, over time, I stopped doing the exercises. And I’m no longer involved in competitive sports, so my activity level isn’t what it used to be. I always wondered if I made the right decision. What’s the current thinking about this type of injury and the way to treat it?

Despite many, many studies on this topic, there isn’t one single definitive answer to the question. As more surgical techniques are developed and as the current techniques are improved, patient results also improve.

Today, advanced technology makes it possible to make the diagnosis sooner and with greater accuracy. CT scans, MRIs, and even new clinical tests are available. Surgeons can perform an arthroscopic exam to see exactly what’s wrong and to make the most accurate diagnosis.

The location of the tear and the degree (partial or complete) of injury make a difference in the treatment. A sprain or even a partial tear can still be treated successfully with nonoperative care. The ligament doesn’t repair itself but pretty good results are possible as scar tissue fills in to stabilize the injury. At the same time, the patient completes a rehab program to strengthen the muscles around the knee further protecting the joint from instability and reinjury.

The long-term results of ACL injuries vary based on the age of the patient at the time of the injury/repair, the type of treatment (surgical versus conservative care), and the type of procedure when surgery is done.

But from what has been reported, it looks like partial tears treated nonoperatively had at least a 50-50 chance of good or excellent results. And those statistics are the same as for a surgical repair from 30 years ago. So, given the data we have from patients like yourself, it looks like you had potentially equal results not having the surgery as you might have had with surgery.

Today’s patients may have the same treatment choices, but the overall results are better. And patients who opt for the conservative (nonoperative) approach still have the option of converting over to surgical reconstruction at a later date with equally good outcomes.