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An ACL, or anterior cruciate ligament, injury can be excruciatingly painful and highly limiting. While these injuries are some of the most common of knee injuries overall, an ACL tear is difficult to live with, and often, surgery is recommended. But is it necessary? Before you undergo surgery to repair your ACL tear, here are four things you should know about ACL surgery to stay informed about whether it is the best option for you:
#1: ACL Surgery is not a “clean swap” style of procedure.
Many people think that ACL surgery is akin to replacing a car tire: Swap out the old, injured one for a new one, and you’re good as new! Unfortunately, that’s not the case at all.
While strains or sprains to the ACL can typically be healed through rest, once a patient has reached the point of an ACL tear, the primary treatment recommendation tends toward surgery. Far from a simple surgery, ACL surgery is an invasive procedure that involves installing what is essentially a “copy” of the original into the knee.
The copy is taken either from a cadaver or from a tissue graft in the patient’s own body, and then applied at a steeper angle than the original tendon. Unfortunately, the graft doesn’t have position sensors as the original ACL does, and often lacks cells that can maintain its new position and keep it healthy. This causes more compression on the knee cartilage and drastically increases chances of developing osteoarthritis in the area, as well as reducing strength in the repaired knee, leading to a greater likelihood of future injury. The surgery is less a “clean swap” and more of a hopeful imitation that doesn’t possess the same strength as the original ACL tissue.
#2: Recovery from ACL surgery is not a short process, and doesn’t guarantee results.
Because surgery for an ACL tear is considered major surgery, a minimum of six months of recovery time is needed before a patient can return to normal activity. However, since the surgery typically involves a tissue graft that is less strong than the original, and increases the likelihood of future re-injury, many surgeons recommend waiting in recovery for seven to nine months before returning to one’s normal activities.
There’s the lengthy recovery period to consider, but there are additional long-term issues resulting from ACL surgery that patients should understand as well, such as:
*Rotational instability caused by total ACL reconstruction,
*A lack of full recovery, since the knee is never quite the same after losing both position sense and performance,
*An increased risk of tearing the other ACL, or re-tearing the original ACL that has been operated on
Only one in five athletes are able to return to normal play within eight months post-surgery; ACL surgery often shortens professional athletic careers. Additionally, the long-term effects of the surgery can be ominous: two-thirds of teenagers who undergo ACL surgery will develop arthritis by age 30. Patients should be aware of both the window for recovery, as well as potential future complications resulting from this kind of procedure.
#3: Your ACL may be able to grow back on its own, without surgery.
Can an ACL grow back on its own without surgery? You may have heard that it cannot, since that particular myth has been around since as far back as the 1930’s. The idea at the time was that a completely torn ligament was unable to heal itself on its own. A half-century later, in the 1980’s, there were two separate attempts to sew torn ends of ligaments back arthroscopically; most of these attempts failed. But finally in 2012, a research paper was published that examined patients with complete ACL tears, who also had delayed surgery and instead gone in for follow-up MRIs. Researchers concluded, after monitoring these patients, that there were, in fact, some complete tears that did heal successfully on their own.
#4: Surgery is not the only option for healing and treatment of your ACL tear.
It is not uncommon that patients with ACL tears are told that invasive ACL surgery is the only option to fix the injury. But getting your ACL permanently replaced alters the overall mechanics of your knee joints. The primary reason that surgery is so often recommended is that traditional medical thinking has often revolved around the incorrect idea that an ACL cannot heal on its own. Since we know that not to be the case, are there alternatives to having invasive surgery done on your ACL tear? Absolutely.
Orthopedic surgery is not the only option for patients anymore; interventional orthopedics is a field that has been providing nonsurgical alternatives to many traditional orthopedic surgery options available today, to include surgery for an ACL tear. We know that keeping your own ligament, as opposed to an inferior tissue graft that replaces a torn ACL, allows for better alignment of fibers and ability to maintain the position sensors in your ligaments, helping to control the knee muscles during activity. Using your own ligaments means having access to your own cells, keeping your knee structure maintained. So how can you keep the ligament and not go through surgery to replace it?
It’s possible to keep a patient’s ligament through an injection of the patient’s own healing substances; your body was made to heal itself. As a matter of fact, our experience at Centeno-Schultz treating ACL tears with our patented, innovative precise injection treatments has shown that roughly 70% of all ACL tears that would normally be recommended surgery can instead heal in a shorter time frame and more fully than traditional surgery would allow. Our patients have often been surgical candidates before they get to our clinic, and we have found great success with their healing through precise, image-guided injections and follow-up MRIs showing ACL regrowth, allowing our patients to get back to full normal activity.
In 2011, we became the very first physicians in the world to attempt this procedure with injections as an alternative to surgery; we subsequently published the successful results of our studies, showing that injecting the patient’s own products precisely into the torn ACL helped them to avoid surgery altogether. We call this nonsurgical procedure Percutaneous ACL Repair, or Perc-ACL, for short. Our goal is to save your ACL, not replace it, and we have the results to back it up.
Your body is built to repair itself.
Our clinic offers the type of nonsurgical alternative that can help repair your damaged ACL through precise, image-guided injections of your body’s own agents that help fix your tissue. Our procedure is highly technical and requires advanced injection skills using X-ray guidance, carried out only by highly specialized physicians. We have seen completely torn ACLs return to a normal MRI signal with this procedure, as well as an overall reduction in recovery pain, and increased function in the knee.