ACL Tear to Repair:

Best Techniques, Expected Outcomes, and Return to Sport

I am sure you know someone who has suffered an ACL injury. It is one of the most common injuries in sports and can occur from both contact and non-contact injury.

The ACL, or anterior cruciate ligament, is one of the most important stabilizing ligaments within the knee. Injury to this ligament can lead to significant mobility restrictions, impact performance, and safety bot in and out of an athletes sport.

In some cases, there is a way to rehabilitate the knee to avoid surgery. Although, in the case of a complete tear, surgery is often warranted to optimize outcomes for an athlete. While traditional ACL repair has been the standard of care for many years, recent surgical

advancements have provided new and more promising outcomes for an athlete. While traditional ACL repair has been the standard of care for many years, recent surgical advancements have provided new and more promising outcomes for individuals looking to get back to sport and activity following surgery.

Types of ACL Surgery and Which One You Should Consider

– Primary ACL Repair with Sutures:

This is a surgical procedure where they suture, or stitch, the two ends of the ACL back together. This is an available option for when blood supply to the tissue is optimal, as it aids in the healing of the tissue.

– ACL Reconstruction:

This surgical procedure takes tissues wither from the patient’s own body or a cadaver tissue to reconstruct the ligament entirely. Commonly, grafts are taken from the patellar tendon, the hamstring tendon, the quadriceps tendon, or the achilles tendon (in a cadaver).

– Bridge-Enhanced ACL Repair (BEAR): Training Is a procedure that uses a collagen-based material to promote the healing between the two ends of the damaged ACL. This is best used in a partial tear, rather than a complete tear of the ACL.

Which repair has the best outcomes?

As in many cases with physical therapy care, it depends. A few things can help to determine what surgical approach is best for each individual.

Wether the tear is a partial or complete can help to determine which approach is most appropriate. Also, the healing potential of the individual helps to determine if a repair rather than a reconstruction will provide the most optimal outcomes.

Prior level of activity can help to assess healing potential as strength of the muscle they may be taking the graft from in a reconstruction is essential for healing.

Regardless of the surgical approach, be sure to discuss options with your surgeon and your performance physical therapist to ensure the right choice is made for you based on your goals.

Prehabilitation and Its Impact On Recovery

Dd you know you don’t have to wait until after surgery to start making progress? As Doctor of Physical Therapists, we are trained to work with athletes and individuals who are getting surgery prior to their surgical date.

By normalizing range of motion and beginning muscle activation and strengthening can significantly improve outcomes after surgery. Check out our blog HERE about the importance of prehab prior to surgery.

Return To Sport After An ACL Surgery

The number one question I always get from my athletes who have sustained an ACL injury and surgery… “When can I get back to playing?”

This is a great question, and again… it depends. Some determining factors in an athlete’s timeline to return to sport include healing timelines, physical condition, and the demands of their sport.

The first step in rehabilitation and preparing an athlete to get back to their sport is to normalize the knee range of motion and start building strength in the leg muscles (specifically the quadriceps and the hamstrings). Typical strengthening can take anywhere from 8 to 10 weeks of consistent strength training.

Then, around 14-16 weeks we are able to begin the plyometric training to continue strengthening the ligament and supporting musculature of the knee.

Most athletes will make a full return to sport between 6 to 12 months after surgery depending on surgery type, recovery timeline, range of motion, strength, and even mental preparation of returning to the sport that led to the injury.

How do performance physical therapists assess readiness to return to sport? At UNITE.rehab.perform we use a specific set of assessments to determine if an athlete is ready to return to their sport. We ensure strength, power, and stability are less than 10% different between surgical and non-surgical sides.

Interested in getting back to your sport or activity? Check out more information HERE from our blog about how to know you are ready to return to your sport!

The Importance of Working With A Sports Performance Physical Therapist

Oftentimes, traditional physical therapy will only get you back to full function. Meaning they will make sure your range of motion is “within normal range” and strength seems to be equal side to side.

At UNITE.rehab.perform we understand, for an athlete, it goes much further. We ensure you are back to sport specific exercises, building functional strength through different exercises, and focus on the metabolic systems (cardiovascular training) depending on your sport.

We want you to be prepared both physically and mentally to get back to your sport or activity feeling more confident and stronger than before!

Your goal is our goal!

– Dr. Victoria Riester, PT, DPT

Don’t leave it to chance.

Let Denver’s premier team of sports physical therapists and performance coaches lead the way!