ACL Tear: Is Surgery Necessary After Years of Pain? - Orthopedics

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When it comes to an ACL (anterior cruciate ligament) tear, the decision to undergo surgery can be complex, especially after experiencing years of pain and functional limitations. Based on your description, it seems that you have been living with knee pain since your accident in 2014, and while you have been able to perform certain activities, you still experience discomfort during specific movements, particularly during pushing or jumping actions.


Understanding ACL Injuries
The ACL is crucial for stabilizing the knee joint, particularly during activities that involve sudden stops, changes in direction, or jumping. An ACL tear can lead to instability in the knee, which may cause pain, swelling, and difficulty with certain movements. It is not uncommon for individuals with ACL injuries to experience episodes of pain or a sensation of instability, even if they can perform some activities without significant issues.


Is Surgery Necessary?
1. Current Symptoms and Functionality: If your knee pain is significantly impacting your daily activities or athletic performance, surgery may be warranted. The fact that you experience pain during specific movements, such as pushing off or jumping, suggests that your knee may not be functioning optimally.
2. Age and Activity Level: At your age, with a history of being active and involved in sports, surgical intervention could help restore knee stability and function. While some individuals can manage ACL tears conservatively (with physical therapy and rehabilitation), others may benefit from surgical reconstruction, especially if they wish to return to high-impact sports or activities.

3. Timing of Surgery: Although you have been living with this injury for a few years, it is not too late to consider surgery. The success rate for ACL reconstruction is generally high, especially in younger, active individuals.

Surgical Considerations
1. Surgical Technique: The procedure typically involves using a graft from another tendon (often from the hamstring or patellar tendon) to replace the torn ACL. The recovery process will depend on various factors, including your overall health, the surgical technique used, and your commitment to rehabilitation.

2. Recovery Timeline:
- Immediate Post-Op: You can expect to be on crutches for a short period after surgery, usually around 1-2 weeks.

- Physical Therapy: Rehabilitation will begin soon after surgery, focusing on regaining range of motion and strength.
- Return to Activities: Most individuals can return to light activities within 4-6 months, but returning to high-impact sports may take 6-12 months or longer, depending on your progress and the surgeon's recommendations.

3. Long-Term Outcomes: Many individuals report significant improvements in knee stability and a reduction in pain after ACL reconstruction. However, it is essential to follow a structured rehabilitation program to maximize recovery and minimize the risk of re-injury.


Conclusion
In summary, while the decision to undergo ACL surgery after years of pain is personal and should be made in consultation with your orthopedic surgeon, it appears that surgery could be beneficial for you, given your ongoing symptoms and desire to maintain an active lifestyle. The potential for improved function and reduced pain post-surgery is significant, and with proper rehabilitation, many individuals return to their pre-injury levels of activity. Always ensure that you discuss all your concerns and questions with your healthcare provider to make an informed decision that aligns with your goals and lifestyle.