ACL Tear Repair Without Surgery in Phoenix

Knee joint anatomy showing ACL

There are two cruciate (meaning “cross-shape”) ligaments found inside your knee joint that work to stabilize it. They cross each other to form an X with the anterior cruciate ligament (ACL) in front and the posterior cruciate ligament (PCL) in the back. The ACL prevents the knee from sliding forward and the PCL from sliding backward.

ACL surgery is not generally an emergency procedure unless there is extensive damage to other structures, significant instability, or intense pain. Generally, if there is some joint stability, adults can delay surgery for a month or two. For young athletes, the waiting period may be slightly less and is often determined by a desire to get the injury repaired in the hope of returning to sports quickly. For some patients, delaying surgery and trying physical therapy first may help the healing process. If that fails, there are nonsurgical options, such as Perc-ACLR, to consider prior to resorting to surgery.

Research has also shown that ACL sprains and even complete ACL tears can regrow and heal on their own,2 particularly if interventional orthopedic procedures such as the Perc-ACLR procedure are utilized. These techniques do not require surgery and employ your body’s natural healing agents to repair your ACL injury. So, if your body can heal your ACL naturally, why would you choose surgery?

ACL sprains, tears, and ruptures are all essentially the same thing, and the terms are used interchangeably. Injured knee ligaments are all considered “sprains” and are graded on a severity scale.

• Grade 1 Sprains: The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched but is still able to help keep the knee joint stable.
• Grade 2 Sprains: A Grade 2 Sprain stretches or mildly tears the ligament to a point that the ACL becomes loose. This is also sometimes referred to as a partial tear of the ligament.
• Grade 3 Sprains: This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.

An ACL rupture is another term often used to describe a tear. However, ruptures of the ACL are generally equated with complete full-thickness tears (Grade 3 Sprains) and are often associated with ligament deformity or full retraction.

Statistically, only about half of athletes who have ACL reconstruction regain complete function after rehab and are able to return to sport at the same level. The other half regain knee stability but not normal biomechanics or proprioception equal to the noninjured knee. Functional limitations in daily life are also possible. It is always advisable to get a second opinion on the need for surgery as there are a number of documented complications associated with conventional ACL reconstruction surgery and your injury could have been misdiagnosed. While surgery might be the right procedure for some ACL injuries, the vast majority of people could avoid it.

• Approximately 17 percent of adults will experience anterior knee pain or pain on kneeling, and between 5 percent and 29 percent will experience graft failure and loss of knee joint stability, with younger patients having higher rates. Other potential complications include knee stiffness or loss or range of motion (approximately 5 percent), painful hardware (approximately 6 percent), infection (approximately 1 percent to 2 percent) or patellar tendon rupture/patellar fracture in the case of bone-to-bone grafts.^3-6
• Increased youth participation in high-intensity elite sports has resulted in much higher rates of ACL repair surgery in young teens, however, research is now suggesting that postsurgery complications may be worse in kids than adults. If preserving the natural physical gifts you were born with and “keeping original parts and structures intact” is your goal, you may want to consider a nonsurgical alternative like Perc-ACLR.
• A large analysis of 160 clinical trials demonstrated higher rates of postsurgery complications in young teens undergoing ACL repair and found that the risk for growth disturbances, skeletal deformities, and ligament rerupture requiring a second surgery was much higher in this young (average age = 13), skeletally immature population.⁷
• A 2010 Swedish research study also challenged the concept that surgery is the only way to heal ACL tears. They demonstrated that 60 percent of the athletes (average age = 26) who elected a strict physical therapy regimen over surgery never needed to have the ACL replaced and were still able to play sports.⁸

ACL tears can be classified in many ways, but within regenerative medicine, they are typically grouped into three primary types: partial-thickness, full-thickness non-retracted, and full-thickness retracted tears. Both partial-thickness and full-thickness non-retracted tears may be suitable for treatment using regenerative approaches such as the Regenexx knee Perc-ACL procedure, which promotes healing without the need for surgery. In contrast, full-thickness retracted tears usually require surgical repair to restore proper function.

1. Partial-Thickness ACL Tear
   A partial-thickness tear does not extend through the entire ligament. Imaging typically reveals that a portion of the ACL remains intact, indicating that the tear is incomplete.
2. Full-Thickness Non-Retracted ACL Tear
   This type of tear involves a complete disruption of the ligament fibers; however, the torn ends have not separated significantly. The ligament is fully torn, but the pieces remain aligned and have not recoiled or retracted, making it potentially responsive to regenerative treatment.
3. Full-Thickness Retracted ACL Tear
   In this case, the ligament has torn completely, and the ends have pulled apart—often recoiling like a stretched rubber band that snaps. This displacement generally limits the success of nonsurgical options and typically necessitates surgical reconstruction.

ACL tears