Surgical Treatment Recovery
Long Term Expectations
ACL reconstruction surgery has a 90% success rate in terms of knee stability, patient satisfaction, and return to full activity, which comprise the primary goals of surgery. ACL reconstruction should also theoretically protect the menisci from further injury and slow degenerative changes in the knee joint, although orthopedic research proving this effect is still lacking.
The re-rupture rate of a reconstructed ACL is very low, generally 2-5% at an average of 2 years after surgery. Of equal or greater concern is the risk of subsequent ACL injury on the opposite leg, which increases substantially from 1 in 3,000 to 1 in 50.
Patients who opt out of ACL reconstructive surgery may experience further injury to the knee joint, particularly to the menisci. ACL-deficient patents are at higher risk for later meniscectomy, 20% over the 5 years following ACL injury. Also, 70% of ACL deficient patients have signs of osteoarthritis in the knee.
- Generalized complications such as infection, neurovascular injury, and thromboembolic disease are extremely rare (0.2-0.5%).
- Deep vein thrombosis is another low probability (.1%) complication.
- Graft misplacement complications due to the graft not placed anatomically can lead to motion problems, impingement, and graft failure. Careful attention to detail during surgery must be observed to avoid these complications, and this is increasingly uncommon as surgical techniques and technology have improved
- Other complications include knee stiffness (5-25% incidence), anterior knee pain (10-20%), Patellar tendonitis (20% in 1st year, then rare afterwards), Patella fracture (.3-1.8%).
Concerns with this technique include the poor healing potential of the ACL, although more recent studies suggest it may have better healing capacity than previously believed. Nonetheless this is considered an experimental procedure at this time and may hold promise in the future.
Regardless of surgical or nonsurgical treatment, rehabilitation plays a vital role in getting you back to your daily activities. A physical therapy program will help you regain knee strength and motion. If you have surgery, physical therapy first focuses on returning motion to the joint and surrounding muscles. This is followed by a strengthening phase designed to protect and support the new ligament. The final phase of rehabilitation focuses on a functional return tailored for the athlete's sport. At TriHealth Orthopedic and Sports Institute, athletes have the opportunity to participate in BOOST, a comprehensive return-to-sport program following the conclusion of postoperative physical therapy. This typically occurs 3-4 months after surgery.