In our modern society, it almost seems that ACL knee surgery is a rite of passage for many athletes. It seems like many professional athletes that serve as role models have had an ACL repair. Yet is the surgery all that effective? Research in the past has questioned whether getting the ACL repaired was any better than physical therapy. Now a new study continues to question ACL surgery effectiveness.
The ACL is a major stabilizer of front-back motion in the knee. It can be torn when the knee is traumatized and these tears are very common in women’s sports like soccer or men’s sports like tackle football. There are about 200,000 ACL surgeries annually in the U.S.
In the past, several studies have questioned whether getting an ACL surgery is helpful. When the surgeries are performed, a startling 29% of patients retear that or the other ACL within the first 24 months. Muscle atrophy is also very common after one of the most common types of ACL surgeries (hamstrings graft). In addition, 2/3’rds of teens who get ACL surgery have arthritis by the time they’re 30.
The new study looked at 100 patients who had ACL surgery versus and 43 patients who opted not to pursue surgery. The patients who opted for surgery were younger and more active (participated in more competitive sports) than the non-surgical group. Despite these differences, the non-surgically treated group was more able to get back to recreational sports in the first year. After two years, 30% of both patients with and without surgery had lost strength in the leg and 20% reported that they never got back to their pre-injury level of sports. The bottom line, there were few meaningful differences between these two groups over the first few years.
The upshot? The new research continues to support that getting an ACL surgery is not something that guarantees any kind of higher or better function for the knee. In addition, there’s a host of reasons as stated above not to get the surgery. In the end, we do not frequently recommend ACL surgeries to the vast majority of our patients, opting instead to use newer autologous biologic injections to heal the ACL.