Up for Debate: Surgery is best for an ACL tear

Surgery might not be worth it.     Photo: Jim Lock/flickr

A landmark study on torn ACLs published in 2010 in the New England Journal of Medicine led to heated disagreement about the effectiveness of going under the knife. Researchers randomly assigned either surgery or physical therapy to a group of 121 active adults who’d suffered an ACL tear. After two years, the groups’ knees were similar in terms of function and pain, showing that there was little advantage to the surgery.

Missing link: Finding a better way to repair wracked knees. While plenty of athletes have come back from an ACL tear at an extremely high level—surgery and physical therapy can usually restore basic knee stability—many never reach peak performance again. In current ACL surgery, injured tissue is often replaced. But some surgeons are experimenting with reconstructing the ligament with new forms of tissue grafts, which could produce better long-term outcomes.

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