Howard J. Levy, M.D.: Nonsurgical: Anterior Cruciate Ligament Tear
Injuries and Conditions : Knee : Anterior Cruciate Ligament Tear : Treatment : Non-Surgical : Conservative Treatment of ACL
 
Overview
A damaged ACL may not necessarily require surgery for a full recovery. Differences in the severity and in the type of injury will dictate the treatment, as will the degree of athletic activity that the patient wishes to pursue after treatment. ACL injuries may range from minor sprains to complete tears of the ligament. Some patients, even with quite severe injuries, may choose to not undergo surgery. However, a completely torn ACL cannot rebuild itself and surgery to reattach or reconstruct the ligament is usually recommended. Selected, less active patients may not always require this procedure.

Rehabilitation Program
Medication and Medical Products
Knee: Compression Sleeves Knee compression sleeves give added support, increasing stability and helping to reduce swelling in an injured knee. Patients that have light sprains may be directed to use a compression sleeve during the early stages of rehabilitation. Other patients that have ongoing knee problems or chronic conditions may be recommended to use a sleeve on a daily basis. These sleeves are less restricting than most other knee supports and can be worn under loose fitting clothing.

Knee compression sleeves can be used to treat:

  • Light swelling.
  • Light knee strains.
  • Chronic inflammation.
  • Degenerative joint disease.


    • Knee: Support A knee support is a sleeve-like support that fits firmly around the knee. The support is used to reinforce the joint during motion and provide compression to aid healing and reduce pain and swelling. Patients suffering from knee strains or inflammation will usually be directed to use a support during daily activities.

    The thin and flexible construction of the support allows for normal movement of the knee and also allows the support to be worn under loose fitting clothing. To prevent harmful pressure to certain structures, the support applies differing compression around the knee. The sides of the joint receive intermittent pressure to help stimulate blood flow while the rear of the support fits relatively loose to prevent constriction of circulation. The kneecap is aided in positioning, but remains free of compression to allow its natural movement.

    Knee supports can be used to treat:

  • Strains
  • Sprains
  • Inflammation
  • Chondromalacia patella

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    Knee: Ligament Brace Functional braces are designed to control abnormal motion of an unstable knee. Because ligaments help stabilize the knee, and a torn ligament leads to instability, these braces are also called Ligament Braces. The intent is to allow a previously injured athlete to compete at a higher level than they would otherwise be able to without the brace. The brace is designed to support either a newly reconstructed ligament such as the ACL, or a weakened or injured ligament, which is being treated in a conservative manner. The role of a functional brace is to increase stability to a previously injured knee.

    Type of Injuries:

  • Pre-operative ACL/PCL ruptures/injuries
  • Non-surgical ACL/PCL injuries
  • General knee instability
  • Pre/post joint replacement with ligament instability.




    • Long-Term Expectations for Recovery
  • Patients with minor injuries can expect to fully recover after a month of physical therapy.
  • Patients suffering severe injuries that have resulted in the partial tearing of the ACL will require much longer to rehabilitate, although a full recovery is still possible with intensive physical therapy. These injuries may heal over three or more months.
  • Patients that have not achieved full recovery will need to reduce their level of physical intensity to prevent re-injury to the knee. In some cases, this will mean completely abstaining from certain activities that place particular stresses on the knee.
  • Recovery is more dependent upon the condition of the joint before and after injury and how the internal structures have healed; and significantly less dependent on the number of days, weeks or months since the injury occurred.

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    Possible Complications and Risks
  • Re-injury to the joint is possible if physical therapy becomes too strenuous for the condition of the knee.
  • For injuries involving a severely sprained or damaged ACL, physical therapy may not sufficiently recondition the knee for vigorous athletic activities.
  • For injuries involving a completely torn ACL, patients that continue to have the knee "give-way" or fail to support their weight may further damage other structures in the knee.

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