Partial anterior cruciate ligament (better known as ACL) injuries are dealt with differently than complete ACL tears. This is because the healing time of a partial injury is usually a lot faster than the recovery from a full tear, but, at the same time, it can be a lot more complicated than it.
Nowadays, ACL injuries are quite common, with over 100,000 registered case in the US each year. Most of the tears happen when you land or plant in pivoting or cutting sports, and you can even injure yourself without contact. Since anterior cruciate ligament is comprised of two parts, or bundles (the anteromedial and the posterolateral, named according to where they are located), it is possible to injure just one of them, as opposed to the complete ACL tear.
Partial ACL Tears
A partial ACL tear is an injury that only involves one part of the anterior cruciate ligament. This basically means that only one of the two bundles were torn, and the other one is left intact. Good news is that many patients who suffer from partial ACL tears can safely go back to their normal daily activities without complaints or instability, but the bad news is that in most cases it will take months to completely recover from the injury.
Additionally, a great number of patients will not be able to go back to sports, since they will feel unstable when they put additional pressure on their knees. However, some people will never experience this but should be careful either way. Every time your knee gives away, you are risking further injury and tearing other knee structures, for example, lateral or medial meniscus, which, if torn, can lead to osteoarthritis.
The partial ACL tear can be treated without surgery; however, this does not mean that the healing process will be shorter or easier. Partial ACL tears can be dealt with non-operatively with rehabilitation and strengthening, and, if needed injections. The main goal is to strengthen the muscles around the knee, especially hamstrings, to give more support to the ACL and let it heal naturally. Also, focused therapy performed by a physical therapist can also be an effective way to let the ACL heal.
There is a new research study that examined athletes with ACL tears who were randomly assigned to either a strict physical therapy program or a surgery to replace the torn ligament. The study shows that a staggering 60 percent of those who did not get the surgery ended up not needing it after all! This goes to show that there is a myriad of treatments alternative to surgery that works just as fine, and lead to a complete healing.
One of such treatments is prolotherapy. A study conducted by Reeves and Hassanein at the Department of Biometry at the University of Kansas Medical Center in Kansas City, USA, has tackled the effects of dextrose prolotherapy when it comes to ACL laxity. According to the authors, “prolotherapy is defined as an injection that causes a growth of normal cells or tissue” (Reeves, Hassanein). Out of their sixteen subjects, six of them had normal knees after six months, nine knees were normal after one year (or six injections), and ten knees measured normal after three years. After their three years follow-up, 45 percent of patients had no pain when resting, 43% experienced no pain walking, and 35% of patients reported they do not feel pain whole using the stairs.
Another possible treatment for partial ACL tears is PRP injections. PRP stands for Platelet Rich Plasma, which is taken from your blood, spun down, and injected to the knee. PRP can be made from an intravenous blood draw, which is then spun down to spin off the plasma and blood components and leave only the platelet fraction. Even though there are ongoing research studies conducted to further examine the benefits of PRP to ACL tears, PRP is still controversial in its role, and we definitely need more research to be completely sure that it works, even though there is evidence that it does.
Finally, there is another somewhat controversial method, and that is the injection of stem cells into the ACL. There have been reports of people with full thickness ACL tears who have been injected with their own stem cells who have reached almost a full recovery.
Things You Can Do
Now that we know that partial ACL tears can be treated without surgery, let’s go over some of the things you can do to protect your knee and make it heal faster. Whichever treatment option you decide on, you should always be aware that you should help your body heal naturally, not only when you’re receiving the treatment.
Wear a cast or a brace. Your doctor will most probably give you a brace or a cast while you are recovering. This brace will protect your knee from further injuries and will stabilize it while it heals. You may also get crutches to use with the brace or a cast. Crutches will keep the weight off the leg you are trying to heal, so they can help immensely.
Rest whenever you can. It is important to rest whenever possible to heal your knee. Do not put weight on it if you don’t have to, and sit with your knee elevated rather than bent to help it repair. Try to keep it raised above your hip while sitting, and above your heart and chest when lying down.
Put ice on your knee. To alleviate the swelling and pain, ice your knee each day. Wrap the ice in a towel to keep it from touching your skin, as it can cause damage, and keep it on for at least 15 and up to 20 minutes. If you do not keep it on for 15 minutes, you are basically doing nothing for swelling and pain, and if you leave it on for more than 20 minutes, the ice can burn your skin.
Physical therapy. Talk to your doctor about this one. After an initial healing stage where you should rest and not put pressure on your knee, it may be a good idea to rehabilitate your knee so the injury does not occur again. See a physical therapist who will assess the situation and help you increase your range of motion, help you strengthen the muscles around the knee, and show you stability exercises that will help you in your rehabilitation process. The physical therapy will most likely be started after the swelling is gone.