ACL Repair vs Reconstruction: Benefits, Risks & Recovery

Fixing An ACL Injury

The knee consists of 4 ligaments, including the anterior cruciate ligament (ACL), collateral ligaments, and posterior cruciate ligament. The ACL ligament helps to control excessive forward movements of the knee. During excessive movement, the ligament can be torn. Treatments for ACL injuries are usually conservative initially, but surgery is required in more severe cases. Knowing the benefits and risks of each procedure is helpful when deciding between repair and reconstruction.

ACL repair vs reconstruction

After carefully examining the knee, the healthcare provider will advise on the best surgical treatment. Surgeons will either perform ACL repair or reconstruction. Replacing the affected knee ligament with a graft is called ACL reconstruction. The graft comes from another part of the patient’s body or a tissue bank. During an ACL repair, the torn ligament is reattached, preserving the elements of the ligament. Each surgery has different risks and benefits.

Seeing the benefits

With both surgeries, patient satisfaction and the ability to resume activities without interference are the main advantages. With ACL repair, there are better results with functional outcomes. The benefits of ACL reconstruction include knee stability and no risk of re-rupture.

Complications and re-rupture risk

With any surgery, the most common complications include infection, bleeding, blood clots, and adverse reactions to anesthesia. Specific risks associated with ACL reconstruction include ongoing or worsened knee pain and stiffness, and failure of the graft to heal. Compared with ACL repair, ACL reconstruction usually results in decreased muscle strength. With ACL repair, the chances of re-rupture are higher, especially in young patients.

Making the right choice

Although ACL reconstruction is more popular than ACL repair, the latter is typically a better option. Research shows ACL knee repairs tend to have better results than ACL reconstruction. The intensity of muscle strength after ACL knee repair provides better outcomes for the patient. However, the time to resume sports activities after both procedures is thought to be similar.

Recovery time

Every patient’s recuperating time varies and depends on many factors. Both repair and reconstruction have similar recovery timelines. The patient will usually use crutches for the first 1-4 weeks and then walk with a brace for another 4-6 weeks. Resuming sports activities may take 7-9 months or more, depending on the patient’s condition.

Choosing repair or reconstruction

Orthopedic surgeons can help a patient determine what procedure should be performed. The decision is based on the location of the tear, pain level, and the patient’s age and health. Both surgeries can fix ACL injuries, but the risks and benefits of each should be weighed carefully before proceeding.