Physical therapy as a non-surgical treatment option for ACL knee injury

http://kerlanjobeblog.com/2013/06/26/physical-therapy-as-a-non-surgical-treatment-option-for-acl-knee-injury/

Physical therapy as a non-surgical treatment option for ACL knee injury

The knee is a hinged joint comprised of the femur, the tibia and the patella and is held together by four main ligaments. The anterior cruciate ligament (ACL) is one of these four ligaments and connects the femur (thigh bone) to the tibia (shin bone).  The ACL prevents the tibia from sliding out in front of the femur and provides rotational stability to the knee.

This critical ligament is one of the most commonly injured ligaments. In fact, there are approximately 200,000 ACL injuries every year and at least 100,000 of those are reconstructed through knee surgery. Though many ACL tears require surgery for repair, surgery isn’t necessary in every case.

Knee surgery is required if the patient’s knee is functionally unstable during specific sporting maneuvers or during activities of daily life. Young patients suffering an ACL knee injury also typically require surgery, explains Karen Mohr, Executive Director of the Kerlan-Jobe Orthopaedic Foundation.

Athletes and active individuals are more likely to require surgery. In some cases, an athlete may be able to opt for non-surgical treatment, but, as Mohr explains, “that would not be likely unless they are in a sport that does not demand cutting or changing direction or landing from jumps, such as straight ahead running. If that was the case patient could try non-surgical treatment and see if any instability persists.”

What is the non-surgical treatment option for ACL knee injuries?

Patients who do not require knee surgery to repair a torn ACL may get by with aggressivephysical therapy to strengthen the core and muscles about the hips and lower extremity muscles. In some cases, non-surgical treatment may be the first course of action for a patient, before surgical reconstruction. “It is not uncommon to try non-surgical treatment first, especially if the patient is older or does not participate in a high demand sport for the ACL,” explains Mohr. “The ACL is not known to heal but rather in some cases, the dynamic stabilizers of the knee (the surrounding muscles) can compensate enough that the patient is functionally stable.”

If non-surgical treatment proves to be unsuccessful or if the patient continues to experience instability in the knee, surgery is necessary. The benefit for the patient who undergoes physical therapy before surgery is that they will go into surgery with a stronger knee and greater range of motion, which will help improve their outcome and recovery from surgery

Knee surgery does not necessarily provide a better outcome for patients with ACL tears. Both non-surgical and surgical treatments can be successful for the patient, depending on his or her level of activity.  The goal with both knee surgery and physical therapy is to avoid an unstable knee (a knee that buckles or gives way). If the knee is made stable following the selected course of treatment, that treatment is considered a success.