What are the treatment options for knee instability?
When an injury to the ACL is sustained, non-surgical treatment may include:
- RICE: rest, ice, compression, elevation. This will help with pain and swelling.
- NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen or naproxen can also help alleviate pain and reduce swelling.
- Knee Brace to immobilize the knee
- Physical therapy can also help stabilize and strengthen the joint.
- Platelet rich plasma (PRP) and stem cell treatments may aid in the healing of a partial ACL tear. Conversely, there is no clear evidence that suggest such treatments will heal a fully ruptured ACL. Dr. Williams can discuss the effectiveness of biologics with the patients who may benefit from PRP or other stem cell treatments.
Dr. Williams typically recommends surgery for patients with ACL tears and ACL insufficiency. Doctor Williams uses several factors, including activity level, age, patient’s health, and associated injuries, to determine a patient’s suitability for ACL reconstruction. Patients with multiple knee injuries can benefit from surgery to help eliminate anterior knee instability. ACL surgery may require reconstructing the ligament using tissue from the patient’s own body (autograft tissue) or from a donor (allograft tissue). In most all cases, ACL reconstruction is done as an out-patient; this means most patients will be able to go home the same day. Regional and/or local anesthesia is used for the ACL reconstruction. The surgery takes about an hour or less; all associated injuries are addressed at the time ACL surgery to ensure a complete functional recovery.
How long is the recovery after ACL insufficiency surgery?
Dr. Williams will recommend a personalized rehabilitation protocol that will begin immediately after surgery. Patients usually need two crutches for one week, and then one crutch the second week after surgery. Full weight bearing is allowed one week after surgery. Physical therapy typically begins 7-10 days after the procedure. Patients will be seen 1 week, 6 weeks, and 6 months following surgery. Most patients may return to normal activities of daily living 3-4 weeks after surgery. The full recovery takes six months as the ligament must mature to full strength over that time. After six months, full functionality is the norm, and athletes can resume regular sporting activities as long as they demonstrate a return of near normal strength to the ACL reconstructed knee.