It is believed that approximately 200,000 people suffer ACL tears each year in the United States. Should only elite athletes undergo surgery after ACL injuries? What factors influence the treatment options for these common injuries? This Ask Dr. Geier question addresses some of the concerns about surgical versus nonsurgical treatment and return to sports after ACL surgery.

David writes:

I am a 20 year old male. I just had an injury three months ago. There was evidence of an ACL tear, but my doctor says that I don’t need surgery if I don’t want to play soccer professionally. Do you think that I need surgery? Do you think in this case I can play soccer again?

Most athletes, even recreational athletes, undergo ACL reconstruction after suffering an ACL injury. While there are a few studies that show some success with nonoperative treatment, many athletes cannot return to cutting or pivoting sports after these injuries.

The anterior cruciate ligament is a ligament in the center of the knee largely responsible for providing front-to-back and rotational stability. Without an ACL, the athlete’s knee can buckle or give way when she lands from a jump or plants her foot to change directions.

Also watch:
Video: ACL reconstruction surgery

In my opinion, it is not the level of sport (professional versus amateur) that influences treatment decisions as much as the
desires of the patient in terms of activity. If a patient who tears her ACL wants to keep playing a sport that involves cutting and jumping like soccer, she might consider surgery. Even with a custom ACL brace, it is difficult to predict her ability to play with a potentially unstable knee.

Wearing a brace to return to sports after ACL surgery

Also read:
Ask Dr. Geier – Running after ACL surgery
Ask Dr. Geier – Recovery From Knee Surgery

I think most sports medicine orthopedic surgeons would offer ACL reconstruction to an active individual who wants to return to sports after ACL surgery. Any patient who suffers an ACL tear should discuss treatment options and their pros and cons with the orthopedic surgeon.

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