Ask the Expert: Dr. Thomas Wickiewicz, Orthopedic Surgeon, Answers Your Questions about ACL
Q1. My husband recently found out he tore his ACL playing basketball. Does it always mean surgery?
Sports that involve jumping, pivoting and rapid deceleration (such as basketball) require a stable knee. In general, if the individual wishes to maintain an active lifestyle that includes these actions, surgery is often recommended.
Q2. I had surgery on my ACL about 20 years ago after a sports injury. I remember it being pretty invasive and recovery taking a while. Is the procedure still the same?
Today the surgery is arthroscopic and bares no similarity to surgeries of 20 years ago. There are still incisions and some cutting if the person chooses to use their own tissue for the reconstruction. Return to daily life function is fairly quick, but is however tissue specific for the reconstruction. Return to sports is much slower – 6 to 12 months for something like basketball is within the norm.
Q3. My son is a high school athlete and plays on different teams all year around. Any tips for him to avoid ACL injuries?
Injuries to the ACL are classified as contact or non-contact. Contact injuries are inherent in the risk of the sport and prevention can be difficult short of not participating. Non-contact injuries, as are common in women’s sports such as soccer and basketball, have been the subject of much study. The causes for ACL injury are many, and prevention programs are not perfect. But there is some evidence that training programs emphasizing jump-landing techniques, and specific muscle training programs, may help. Some sports programs utilize these. Ask your trainer or coach. Another resource is your physical therapist. Some groups offer such classes
Q4. Are there any signs that might indicate an ACL injury? I’m not in a ton of pain but have noticed that something is “off” in terms of balance ever since soccer practice a couple of weekends ago?
Acute injuries to the ACL are rarely subtle; they are fairly dramatic and often associated with the person sensing a “pop” in their knee, and rapid swelling. If you are concerned, a physical exam, and sometimes an MRI, will determine the problem.
Q5: I’m a 30-40 year old, non-athlete, w/torn ACL. Surgery or not?
If your injury is to the ACL only, with no meniscal involvement, and your life style is sedentary, then conservative care is a realistic option. You should review your lifestyle, expectations and activity profile with the treating physician.
Dr. Thomas Wickiewicz is an Orthopedic Surgeon at Hospital for Special Surgery. He specializes in sports medicine, meniscus surgery, ACL surgery, and shoulder surgery. He spent eight years as Assistant Team Physician for the New York Giants, and he now serves as the Head Team Physician for all Division 1A College sports at St. Peter’s University. Dr. Wickiewicz has published over 100 scientific papers on his extensive research on knee and shoulder surgery and given more than 200 invited presentations.