About the author:

Howard J. Luks, MD

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr. Howard Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision-making principles – all geared to improve your quality of life.

38 comments on “Who Should Consider an ACL Reconstruction? Five Professional Opinions.

  • I work as a house keeper and I fell off the ladder and tore my ACL, my job requires me to be up and down on ladders do you recommend the reconstruction surgery are or not..

  • Dr. Luks

    I did not see any of these doctors mentioning high possibility of having OA in surgicaly repaired knee. To me reconstruction of an ACL is like leaving problems for the future. Almost every ACL reconstructed knee ends with some type of OA. If I am a doctor I would definetely advise any of these 18 year old to forget about going back to high demand sports because they will end up with more problems later. I also think more research should be done to effectively prevent possibility of OA in reconstructed knees. It seams to me that the procedure itself is very invasive since the bones have to be drilled for new ligament to be placed.

    • There’s a risk of developing OA regardless. Not all ACL tears – treated surgically or non-surgically will develop arthrosis. The main function of an ACL reconstruction in an active individual is to prevent a meniscus tear which will increase the risk of arthritis significantly. unfortunately, telling a 16-20 year old to stop playing sports isn’t realistic. NO harm in saying it… but very few if any will heed that advice.

  • Treatment for ruptured ACL. Anyone have opinions on platelet rich plasma therapy? Or is a complete ACL reco the best option to return near full recovery?

  • Hi I got a mid portion tear to my acl my mcl has torn completely, got a tear in my lateral meniscus a pcl sprain and other little bits.
    Do I need a op on it and if so what kind of op?

    These were the findings in MRI scan

    • Tricky injuries… if your exam, not only the MRI, shows that your MCL is a complete (Grade 3) tear then many of us might consider fixing it. But that depends on your physical exam and the comfort level of your physician. I can not lay out a treatment plan for someone I have not examined or spoken to in the office. There is a post or two on my site on MCL and ACL tears.

  • Hi my name is Alessandra and I’m 24. I tore my ACL in a fitness class about a week and a half ago. I had one orthopedic tell me I completely tore my ACL and another tell me it’s hanging on by a few muscle fibers. I live a very active lifestyle and I’m concerned because Doc #2 is suggesting I try PT for 6 weeks before considering surgery. He believes PT will completely fix this almost complete tear. I’m afraid it will partially heal but not fully. I have no other tears and no previous injuries. Doc #1 no longer does surgeries.

    I can’t fully extend my leg, although I’m very close. I have no pain when walking with the brace and minimal instability with the brace. I’m nervous because I don’t want to live restricted physically. I regularly do zumba, yoga, lift, etc. I also occassioanlly do crossfit.

    I’m very conflicted with what to do and would love some advice. What are your professional opinions on surgery vs. PT? Would it be wise to find another orthopedoc and get another opinion?

    • See another doctor if necessary. In young active people the most recent literature shows that an ACCL reconstruction is protective against further injury. Recent science also supports early versus late or delayed reconstruction in young active people. That being said… it is important to see a PT and get your motion and strength back in preparation for the procedure

  • I’m a 17 year old high school senior that tore my meniscus about a month ago. When my doctor went in to repair my meniscus, he saw that my ACL was completely in half. My meniscus is now fixed, but my ACL is still in half. My doctor recommends not doing ACL reconstruction because of various reasons. I am okay with giving up sports, but I’m still going to want to work out and stay fit! (Running on treadmill, Burpee’s, lifting). Are these things I can do with a torn ACL?

  • I am 42 years old and I ruptured my ACL when I was 21, over the years I have had 2 knee scopes, now my knee has become very painful and unstable, wondering if an ACL reconstruction is something I should do or if there is other options, my quality of life and job are being compromised as I am a carpenter

    • Hi Dwayne… that depends on how much arthritis is present now. In a mildly or moderately unstable arthritic knee, an ACL reconstruction could help or hurt. There are too many variables to consider. I would seek out a few good in person opinions.

      Good Luck
      HJL

  • My son is a 17 year old senior who plays football. He hurt his knee and we had a MRI done. The orthopedic surgeon is suggesting surgery and did not offer any other options. We want to seek a second opinion but time is of the essence. His season is about to begin and he would like to play part of his senior year. This is what his report said, there is a complete acute tear of the ACL with associated contusions involving the lateral femoral condyle and posterior corner of the lateral tibial plateau. Is there anyway he can can avoid surgery and just have rehab and wear a brace?

    • That’s risky… I would find a second opinion to have this conversation with. Your son’s history (complaints) and his physical exam matter when trying to address this question.

  • On Aug 5 2017 while kick boxing I did a complete tear of the ACL ,menicus, and legiment tear on one side of my knee. I have been in a lot of pain . I have seen an orthopedic surgeon. I’m scared to have surgery but I’m afraid of what life without it will be like. Do you feel like it is in my best interest to have the surgery I’m not a athlete I’m 37 yrs old I have two young children nine and six and I want to be able to do stuff with them. Your opinion would mean a lot .
    Sincerely.
    Tiffany Termeer

    • We can not answer that question for you… sorry.
      There are plenty of people whose knee feels stable without ACL surgery. Some people continue to have instability despite Physical Therapy, etc.

      Without examining you and talking with you I can not comment on which treatment might be best for you.

  • Hello Howard J. Luks,
    I did MRI. Could you tell how urgent to have a surgery or to see a doctor in your oponion. I do have an appointment with my orthopedic doctor in 5 days. Thanks in advance
    Here is IMPRESSION: MRI right knee.

    1. Mild marrow edema within the medial femoral condyle and posterior
    tibia plateau concerning for areas of marrow contusion.
    2.Complete ACL tear.
    3.Displaced tear of the posterior horn of the lateral meniscus.
    4.Small knee joint effusion with mild nonspecific synovial
    proliferation and small ruptured Baker’s cyst.

  • Are families predisposed to this type injury? If it happens to one of the sibling, should I be concerned about the others playing the same sports?

    • Great question Jay … some in the sports community do believe there might be a risk… HOWEVER… there are many, many variables involved. So we can not simply give you a yes or no answer. We do, however, know that taking 15-30 minutes to warm up and follow the FIFA 11 program can prevent many ACL injuries. https://www.ncbi.nlm.nih.gov/pubmed/28389864

  • Hey Dr. Luks,
    I don’t have much of an active lifestyle but do like to dance every now and then during family gatherings and am greatly concerned about my ACL.

    My MRI impression has stated the following:
    1. Bone contusions at the medial and lateral tibial condyles.
    2. Full thickness tear of the anterior cruciate ligament.
    3. Partial tears/sprain of the medial lateral collateral ligaments at the proximal insertion. Associated soft tissue edema.
    4. Moderate joint effusion extending into the suprapatellar bursa.

    My questions below:
    Is a full thickness tear considered a complete tear?
    If my ACL is torn, should I consider ACL surgery considering the other 3 issues listed in my MRI?

    Thank you very much,
    Anthony

    • Hi Anthony…
      Yes, I full thickness tear is a complete tear.
      Many people live long happy lives without an ACL.
      Whether or not surgery is necessary depends on your lifestyle and occupation… as well as whether or not you experience instability or giving way after physical therapy has restored motion and strength.

  • Hi Dr Luks,

    I’m 23 now, at the age of 14 I had a ACL accident. This was followed by intensive physio as I was still growing and a procedure could potentially hinder bone growth in my left leg (ACL accident leg)

    Years passed since then, I have now decided to proceed with a ski instructors course which is quite challenging however not Ski racing, which is how I tore it in the first place.

    I will commence in November, and until then I will undergo heavy physio.

    Since starting to work out last week, instability and slight throbbing pain has come back (whilst being awfully stiff in my muscles from lack of exercise!!) I will rest for a couple days, then continue again. Hopefully it was a one of episode.

    My question is, after so many years of my body getting used to a full acl tear, is it ok to undergo surgery? Are there any professional trainers out there that do their job regardless of ACL? I’m very unsure at this stage and would love your feedback as your article Has been the best I’ve read so far.

    Thanks a lot, love your work.

    Kind regards,
    Carl

    • Thanks Carl … I am glad that our article was useful!
      It is possible to reconstruct an old ACL tear. But without examining you and seeing your xray and recent MRI studies I can not comment about specific treatment recommendations. See a good ACL surgeon in your area.

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