Also consider Stem Cell Prolotherapy procedures as an alternative to ACL surgery. Look at Regenexx.com, journalofprolotherapy.com, bonemarrowprolotherapy.com, aaomed.org, hacketthemwall.org

True, the surgery group and the PT only group may display the same functionality and pain level. Were these two groups monitored later in life? Numerous studies show that non-surgically repaired ACL's have a much high rate of developing osteoarthritis and putting every other stabilizing structure of the knee in jeopardy years down the road. Bottom line: as an athlete, I would feel 100% more comfortable knowing I had a knew ACL than if I didn't. Also, there are hundreds of thousands of athletes who have the surgery and return to sports as functional, if not more than before. This article may be focusing on simply the general population and not the athletic population. Sure, someone without an ACL who only does rehab can walk up and down the stairs and turn corners pain free....because that is their only goal.

True, the surgery group and the PT only group may display the same functionality and pain level. Were these two groups monitored later in life? Numerous studies show that non-surgically repaired ACL's have a much high rate of developing osteoarthritis and putting every other stabilizing structure of the knee in jeopardy years down the road. Bottom line: as an athlete, I would feel 100% more comfortable knowing I had a knew ACL than if I didn't. Also, there are hundreds of thousands of athletes who have the surgery and return to sports as functional, if not more than before. This article may be focusing on simply the general population and not the athletic population. Sure, someone without an ACL who only does rehab can walk up and down the stairs and turn corners pain free....because that is their only goal.

I agree with this statement. While not for everyone, it is possible to rehab an ACL deficient knee and return to a high level of sports activity. As long as the meniscus is intact one can strengthen the surrounding lower extremity musculature to compensate. I have had a deficient knee for over 5 year and participate in whatever sports I wish, including basketball, snowboarding, long distance running, and climbing with absolutely no instability or pain. I will not even consider surgery at this time because of the outcomes.

My Orthopedic surgeon mentioned this to me when we were discussing what to do with my knee. I tore the ACL when I was a teenager and went on to play hockey and snow ski at the highest levels of performance for 30 years afterwards. I did it by building and maintaining a high level of quad strength(oak trees?!). Problem is that because of the increased instability due to ACL laxity I torn the meniscus in that knee TWICE. Both times during everyday, non stressed positions and movements. Most recently I tore the menicus while leaning over/into a table. I chose to have him reconstruct the ACL since he was going there anyway and am looking forward to playing hockey and skiing as long as possible. An interesting topic.

It is impossible to make such a blanketed statement regarding indication for surgery after ACL tear. There are so many factors that need to be considered- the desired level of activity, the age of the athlete, the degree of the tear, the overall health of the individual. Surgical considerations include the surgical technique used and the type of graft material. Each of these factors effect treatment and outcomes. Surgery is indicated for some, not for others. Best to have this discussion with your orthopedic surgeon and physical therapist before implying that surgery is equal to conservative treatment

Bobbu Hurley, the guard from the Sacramento Kings went the rehab method when he tore his ACL. It gets back to 95% either method.

Please, please, please do not mention the NEJM study without noting that the group that did not receive early ACL reconstruction had a marked increase in meniscal injuries, as alluded to by WKENDWARRIOR. Ignorance of this fact is misleading. The decision to operate or not operate is a difficult decision that should be an individual discussion between each patient & physician, essentially deciding are you more worried about the risks of surgery or the risks of an unstable knee (meniscal tears & osteoarthritis). Every patient is different, some can survive without an ACL, and some cannot.