Making the Best Choice for ACL Recovery – Surgery or Rehabilitation?
Hi there! If you're here, chances are you’re dealing with an Anterior Cruciate Ligament (ACL) injury. Let me assure you, you're not alone — ACL injuries are one of the most common knee problems, especially for active folks. But with the physiotherapy right plan, your recovery is possible, and you can get back to doing what you love.
Today, I want to share some insights from recent research comparing surgical and non-surgical treatments for ACL injuries. Spoiler: there’s no one-size-fits-all answer, but understanding your options can help you make the best choice for your unique situation.
The Big Debate: Surgery vs. Rehab
When it comes to ACL injuries, a physiotherapist’s main goal is to restore knee stability, reduce pain, and return you to your normal activities. Two primary treatment paths exist:
1. Surgical ACL Reconstruction: This involves replacing the torn ligament, usually with a graft, and is often paired with a structured rehabilitation program.
2. Non-Surgical Treatment: Focused on physiotherapy and strengthening the surrounding muscles to compensate for the torn ligament.
Both approaches have their pros and cons, and the decision often depends on factors like your lifestyle, activity level, and the severity of your injury.
What the Research Says
Surgery and Long-Term Stability
A systematic review found that surgical treatment generally leads to better knee stability compared to non-surgical options. Patients who chose surgery reported less joint laxity (looseness), which can be crucial for athletes involved in high-impact sports (Lien-Iversen et al., 2020). However, surgery also comes with a slightly higher risk of osteoarthritis in the long run — a potential tradeoff worth considering.
Quality of Life and Function
According to a 10-year study, more patients who underwent ACL reconstruction reported an acceptable level of knee function and quality of life compared to those who opted for non-surgical treatment (Persson et al., 2022). This makes surgery an appealing choice for those seeking to return to physically demanding activities.
The Middle Ground: Delayed Surgery
Interestingly, many individuals who initially choose rehab later decide to undergo surgery due to persistent instability. Research indicates that this approach—starting with non-surgical treatment and reserving surgery for when it's truly needed—can work well for certain individuals (Monk et al., 2016).
Which Path is Right for You?
Here’s the truth: the best choice depends on your personal circumstances. Here are a few questions to consider:
Are you involved in sports or activities that require sudden movements or high-impact actions?
How severe is your instability or discomfort?
Are you comfortable committing to a rigorous rehab program, whether or not you have surgery?
If you have an active lifestyle or a job that requires physical exertion, surgery might offer the stability you need. On the other hand, if your lifestyle is less demanding or you’re hesitant about surgery, rehab could be a great place to start.
We’re Here to Help!
At River East Physiotherapy, we’re all about personalized care. Whether you’re recovering from surgery or exploring non-surgical options, our experienced physiotherapists will design a plan that fits your goals and helps you get back on your feet — literally!
Feel free to reach out to us with any questions or to schedule a FREE 15-minute phone consultation with a physiotherapist. Let’s work together to get you moving again.
Written by Dillon Hunter, in collaboration with River East Physiotherapy
References
Lien-Iversen, T., Morgan, D. B., Jensen, C., et al. (2020). Does surgery reduce knee osteoarthritis, meniscal injury, and subsequent complications compared with non-surgery after ACL rupture with at least 10 years follow-up? British Journal of Sports Medicine, 54(7), 592–598.
Persson, K., Bergerson, E., Svantesson, E., et al. (2022). Greater proportion of patients report an acceptable symptom state after ACL reconstruction compared with non-surgical treatment: A 10-year follow-up from the Swedish National Knee Ligament Registry. British Journal of Sports Medicine, 56(10), 862–870.
Monk, A. P., Davies, L. J., Hopewell, S., et al. (2016). Surgical versus conservative interventions for treating anterior cruciate ligament injuries. Cochrane Database of Systematic Reviews, 2016(4).