What type of treatment is available for an injured or ruptured ACL?

The goal of treating an injured knee is to return the patient to their desired level of activity without the risk of further injury to the joint. Treatment may be without surgery (conservative treatment) or with surgery (surgical treatment). Those patients who have a ruptured ACL and are content with activities that require little in the way of sidestepping (running in straight lines, cycling and swimming) may opt for conservative treatment. Conservative treatment is by physical therapy to reduce swelling, restoring the range of motion of the knee joint and rehabilitating the muscle power of the knee. Reflexes are necessary to protect the joint for routine activities of daily living. Building protective reflexes requires rehabilitation directed at 'proprioceptive' therapy. As the cruciate ligament controls the knee joint during direction changes, it is crucial to alter your sports to the ones involving straight-line activity only. Social (non-competitive) sport may still be possible without instability as long as one does not change direction suddenly. Those patients who wish to pursue competitive ball sports or who are involved in an occupation that demands a stable knee are at risk of repeated injury resulting in tears to the menisci, damage to the articular surface leading to degenerative arthritis and further disability. In these patients, surgical reconstruction is recommended. However, studies have shown that this is best carried out on a pain-free, healthy joint with a full range of motion. In addition, there may be the rare circumstance of the ACL healing within a few weeks. Whilst the incidence of this is around 1%, clinical reassessment after a period of prehabilitation is required to determine knee stability. The decision for ACL reconstruction can then be made.