To operate or not to operate? That is the question.

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Following an ACL injury or tear an individual is normally confronted with this question. This post, Post 3 in our ACL Series, will hopefully shed some light and give some guidance for someone
presented with this question.

There are many factors to think about and consider before deciding whether or not to get surgery, one being the severity of the tear. Ligamentous injuries can be classified into different grades, one to three, which describe the extent of damage, partial to full or complete tear.
Another factor to consider is whether other structures are involved. Based on the mechanism of injury, other structures like the meniscus or other ligaments of the knee, may be injured as well.

One of the largest factors to weigh when trying to figure out what option to take would be the individual’s level of activity and the demand that will be placed on the knee. An older individual or more recreational athlete may do well with and prefer just doing physical therapy and rehabilitation. However, a younger or higher level athlete may need surgery, followed by
rehabilitation, to ensure that the knee can handle the stresses and demands of the athlete’s sport. (ref. 1)

If it’s determined that the individual will undergo surgery to repair the ACL, the surgeon will use a graft to replace the ligament. There are two types of grafts:

  1. Autograft- where bone or tissue that is taken from a part of a person's own body and transplanted into another (ref. 2)
  2. If selecting to use an autograft, most common sites would be the patellar tendon (knee cap) or a hamstring tendon

  3. Allograft- a tissue graft from a donor of the same species as the recipient but not genetically identical. (ref. 2)
  4. If selecting to use an allograft, the common sites would also be the patellar or hamstring tendon, but it would be from a source like a cadaver.

There’s a lot of discussion and consideration when trying to determine whether you should receive surgery or not, and if so, which type. Find and consult with a doctor, and work together to determine what the best option is for you.

Whether you receive surgery or not, physical therapy and rehabilitation will be a large part of your recovery process and getting you back to doing what you want. Stay tuned to our next post, where we will discuss and dive into what the rehabilitation process will be like.

To learn more, click here:

  1. ACL Surgery
  2. Allograft vs Autograft

Posted in: Knee

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