Introduction

Anterior cruciate ligament (ACL) injuries are quite common, especially among athletes and those who lead active lives. However, they can affect anyone, regardless of age or activity level. When someone suffers an ACL tear, one of the key decisions to be made is whether to opt for surgical repair or to pursue non-surgical treatment methods. This is not a one-size-fits-all choice — it depends on individual factors such as activity level, the severity of the injury, and overall lifestyle. Leveraging extensive clinical experience, Professor Paul Lee and the specialist team at MSK Doctors provide a supportive and professional environment to help patients navigate this important decision with confidence.

Understanding ACL Injuries: What They Are and How They’re Treated

The ACL is a crucial ligament located in the centre of the knee. It acts as a stabiliser, preventing the shinbone from sliding too far forward relative to the thighbone. ACL tears usually happen during sudden twisting, pivoting motions, or awkward landings — often during sports. Common symptoms include pain, swelling, a feeling that the knee might give way, and difficulty putting weight on the leg. Treatment generally falls into two main categories: surgical repair or reconstruction, and non-surgical approaches such as physiotherapy and bracing. Modern healthcare combines expert clinical knowledge with strong research evidence to determine the best path for each patient’s unique situation.

Who Benefits from Surgery?

Surgical repair or reconstruction is usually advised for those with complete ACL tears, especially for people who live very active lives or take part in competitive sports. This group often requires a high degree of knee stability to keep performing at their best. That said, surgery is not without its challenges. While it aims to restore stability and reduce the risk of further injury, it carries potential risks including infection and longer recovery times. Interestingly, this procedure can also benefit children in certain cases. As one study explains, “ACL repair in young children using this technique negates the requirement and potential morbidity of graft harvest and demonstrates the potential for excellent outcome as an attractive alternative to ACL reconstruction, where an adequate ACL remnant permits direct repair” (Smith et al., 2016). At MSK Doctors, Professor Paul Lee and his team carefully assess each patient to offer tailored treatment plans in a supportive clinical setting.

When is Non-Surgical Treatment the Better Option?

Non-surgical treatment suits patients with partial ACL tears, lower activity needs, or those who prefer to avoid surgery and its associated risks. This approach typically involves physiotherapy to strengthen muscles around the knee, improve balance and coordination, and knee braces to support the joint. In some cases, the ligament can heal enough to allow decent knee function without the need for surgery. Non-surgical care often allows for quicker initial recovery, but patients should be aware that some knee instability might remain, possibly limiting intense sports or activities. MSK Doctors weigh all these factors carefully, ensuring treatment decisions are based on evidence and tailored to each patient’s goals.

Comparing Outcomes: Surgery Versus Non-Surgical Approaches

Surgery generally results in greater knee stability and a better chance of returning to demanding physical activities, though it often involves longer rehabilitation and some risks. Newer techniques, such as internal bracing in the surgical repair of children’s ACLs, have produced encouraging results. For example, “normal activities were resumed at four months and excellent objective measures of function, without limb growth disturbance, were noted beyond two years” (Smith et al., 2016). Meanwhile, non-surgical treatment can offer faster recovery initially and fewer risks but may not always restore complete stability, particularly with full tears. The long-term outcome depends on factors such as the quality of rehabilitation, patient commitment, and lifestyle choices. Guided by Professor Paul Lee’s expertise, MSK Doctors provide balanced information to help patients set realistic expectations and maintain knee health over time.

Making the Right Decision: Patient Priorities and Common Questions

Choosing the most suitable treatment always involves considering personal goals, lifestyle, and how much risk a patient is comfortable with. Some common questions include “Can an ACL heal without surgery?”, “What are the chances of regaining full mobility?”, and “How can instability be minimised after injury?” Some individuals do regain good knee function without surgery, but others may need an operation to meet their activity aspirations. MSK Doctors focus on patient-centred care, supporting every person with clear guidance and expert advice tailored to their needs.

Conclusion and Responsible Recommendations

In summary, deciding between surgical and non-surgical treatment for an ACL injury is a personal choice that depends on many factors unique to each patient. Consulting a qualified healthcare professional is vital to receive advice suited to your specific injury and lifestyle goals. For individual medical advice, please consult a qualified healthcare professional.

References

Smith, J. O., Yasen, S. K., Palmer, H. C., Lord, B. R., Britton, E. M., & Wilson, A. J. (2016). Paediatric ACL repair reinforced with temporary internal bracing. Knee Surgery, Sports Traumatology, Arthroscopy, 24(6), 1845–1851. https://doi.org/10.1007/s00167-016-4150-x