Anterior Cruciate Ligament, or ACL tear, is one of the most common knee injuries, but also one of the most feared ones. Since ACL is a tough tissue that keeps the knee together, it is normal to think of it tearing as a big injury that may take a lot of time to heal. There is an ongoing debate over whether to operate on the ACL or not, and there are a lot of cases where patients who choose not to operate end up healing perfectly!
In the search for an answer for whether the patients with torn ACL need the surgery or not, the study has been conducted by the team of a physiotherapist Richard B. Frobell, Ph.D., at the Lund University in Sweden. The team assigned 121 young, active adults to two treatment options. Many of the participants of the study were non-professional, but highly competitive athletes.
Both of these groups were subjected to the highly structured rehabilitation program, the point of which was to improve the coordination and the balance. One group underwent the ACL surgery at some point within the 10 weeks of the injury, and the other group delayed the surgery until it was absolutely necessary, or until the problem went away completely.
After two years, two groups were reviewed and both had good results, which shows that both treatments were good and none was better than the other. However, an interesting information arose; a staggering 60 percent of the patients who delayed the surgery found that the never needed it after all!
Five-year Follow Up
The researchers of the Frobell study have published their five-year follow-up in 2013, which confirmed the results they concluded in 2010. The findings which have been published in the British Medical Journal in 2013 are more or less the same as those from 2010, which may come as a surprise to some people, as the team has reported that there was no difference in the risk of osteoarthritis.
However, Richard Frobell, who is also a clinician at the orthopedic department at the Helsingborg Hospital, explained that half of the patient from the study who have been assigned not to undergo the reconstructive surgery ended up having it in the five years since the commencement of the study, as they have been experiencing instability.
The patients in the non-operative group, are moving on to the next stage of the study and will follow up ten years after the injury to the anterior cruciate ligament.
So, How Long Does It Take to Recover?
The Frobell study has tackled this very issue, however, one study is not enough to come to a good enough conclusion for this question. As with every injury, it really depends on from person to person how long they will need to recover, and with an injury such as the ACL one, it is very difficult to determine the exact timeframe for the complete healing.
Lee Herrington, a Chartered Physiotherapist who got qualified at the Manchester University in the United Kingdom in 1990, who was awarded an MSc in Sports Injury Therapy from the Manchester Metropolitan University, is the lead clinician at the Knee-Rehab UK rehabilitation clinic and has worked with a myriad of athletes over the years. Some of his famous patients include the players from the Great Britain Rugby League and Wigan Warriors Rugby League Club. Mr. Herrington says that the patients who choose to recover with physical therapy and exercise will all experience different healing times.
The time needed to return to the sport or another activity largely depends on the readiness and dedication of the individual to train, and the diligence of their therapist who has to monitor and correct the activities they perform. The recuperation time requires a lot of repetitions and hard work, but Herrington reports that six to ten works of dedicated hard work are the least amount of time you will have to spend for the recovery.
Of course, this will vary from person to person. An individual with already strong muscles around the knee will most likely need less time to recover, in comparison to those who do not carry enough strength in the legs. The severity of the injury will play a big role as well. Interestingly enough, there are some reports that show that people with partially torn ACL need actually more time to recover than the patients with the complete ACL tears. However, this information should be taken with a grain of salt, as there are simply not enough professionally conducted studies that show relevant results.
All in all, torn ACL is still a very new topic in the medical community, and more time has to pass and more studies have to be conducted until we can safely set the timeframe of the healing process. Until then, all we can do is be very dedicated and meticulous when it comes to rehabilitation, and to choose a good physiotherapist who will have enough experience with these injuries, as they will be your biggest ally in the recovery process.