ACL is an important structure in controlling stability of the knee.
Damage to the cartilage of the joint (both the joint lining as well
as the cartilage disks, or menisci) can occur in combination with
this injury. Sometimes damage can be done at the time of the
injury that tears the ACL. Our study indicates that additional
damage can occur over time. Episodes of instability or "giving
way" of the knee can pinch and tear the cartilage disks (menisci).
The abnormal motion of the joint can also cause increased wear to
the joint lining (chondral surface). Both of these situations
can lead to pain and early joint arthritis.
From this study we feel that patients with knee instability
from ACL injuries would benefit from early rather than late surgical
reconstruction. This would hopefully decrease the amount of
additional damage that the joint would suffer. Other medical
studies have also shown this increase in damage done by continued
all people with ACL injuries have problems with instability.
As we only looked at patients who eventually had surgery due to
ongoing problems, we can not make comments regarding people who
have a torn ACL but are not symptomatic.
general, we would recommend ACL reconstruction to anyone who plans
to return to playing sport, particularly sports that involve "cutting"
or side to side motion and jumping. Even patients who do not
plan to engage in sport should have surgery if they have episodes
of instability or "giving way" in the knee. These episodes
not only are painful and limit activities, but can result in damage
to the knee joint with a risk of future problems and possibly arthritis.