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Treatments for ACL Tears and Injuries

An ACL injury happens when you overstretch or tear the main ligament that connects the shinbone to the thighbone. ACL injuries are more likely in athletes and happen when you pivot or twist the knee too far.

You can tear your ACL if you put repeated pressure on the ACL over time, such as while playing a sport or working. However, ACL tears and injuries can happen to anyone.

If you have an ACL injury, early treatment with a tailored treatment plan is key. ACL injuries can cause pain and swelling, and can make the knee unstable. If untreated, ACL injuries can cause further damage to the knee joint.

UPMC offers expert nonsurgical and surgical care for ACL injuries. Your doctor will describe the benefits and risks of both treatment options. They'll recommend a nonsurgical or surgical treatment based on your:

  • Activity level.
  • Age.
  • Interest in returning to your sport.
  • Overall health, as diabetes, smoking, and other health concerns can increase the risk of surgery.
  • Type of injury (whether you have a partial or full tear).

In general, nonsurgical treatment is ideal for less severe ACL injuries and for older people who may not want to undergo surgery. We often suggest surgery if you want to restore full function to the knee, such as if you play sports.


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Nonsurgical Therapies for ACL Injuries

Nonsurgical treatments for ACL tears and injuries aim to:

  • Allow a partially torn ligament to heal on its own.
  • Prevent further damage to the knee joint.
  • Reduce pain and swelling in the knee.
  • Strengthen the muscles around the knee joint to keep the knee stable.

At UPMC, we create a complete nonsurgical treatment plan tailored to each person. This starts with a plan to reduce swelling.

Then, we provide a timeline to gradually increase movement with physical therapy exercises. You can walk with an ACL injury, including a torn ACL, as long as you keep the leg straight.

However, we may recommend not putting weight on the knee at first, depending on the severity of the injury. Your doctor also will instruct you to avoid pivoting or twisting the knee as your injury heals.

Nonsurgical treatments for ACL injuries include:

  • Activity restrictions.
  • Anti-inflammatory drugs.
  • Braces to support the knee, limit the range of motion of the knee, or both.
  • Ice applications and elevation to reduce swelling.
  • Imaging to assess the healing process.
  • Physical therapy.

Can an ACL tear heal without surgery?

A partial ACL tear can heal without surgery. But most fully torn ACLs require surgery to heal.

Some people choose to avoid surgery even if they have a fully torn ACL, since you don't need a functioning ACL for everyday movements like walking. This is why older adults who don't play sports may prefer nonsurgical treatments.

Surgical Treatments for ACL Injuries

Surgery for ACL injuries aim to:

  • Restore the ACL so that it functions as it did before the injury.
  • Fix problems in other parts of the knee joint, if needed. People with ACL injuries may also have damage to other ligaments or cartilage in the knee.
  • Prevent further damage to the knee joint, due to inflammation in the knee.

In ACL repair surgery, your UPMC surgeon will send instruments and a tiny surgical camera through small cuts in the knee. This minimally invasive approach allows you to heal faster and lowers the risk of complications, like bleeding and infection.

The surgeon will take out the damaged part of the ACL and replace it either with an autograft or allograft:

  • An autograft is a healthy tendon from elsewhere in your body, where it isn't needed for movement or function.
  • An allograft is a tendon from a donor. These tendons may not function as well, so this ACL surgery option is less common.

After surgery, you'll need to avoid putting weight on the knee for at least a few weeks. Your care team will instruct you on steps to take to reduce swelling and signs of complications to watch for.

As you heal from surgery, we'll connect you with a physical therapist. Exercises to strengthen the muscles around the knee will take pressure off the ACL as it heals. Physical therapy can also help to prevent another knee injury.

Make an Appointment for a Knee Injury Assessment

Schedule a visit to get a knee injury diagnosis and complete treatment. We can also offer a second opinion about the best treatment plan for you.

Book an appointment with the UPMC Sports Medicine ACL program in Pittsburgh by calling 1-855-937-7678 or completing a form online.

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