What Happens If I Don’t Have Surgery for an ACL Tear?

The anterior cruciate ligament (ACL) is one of the key stabilizers of the knee joint. It prevents forward movement of the tibia and maintains rotational stability. ACL tears commonly occur during sudden stops, changes in direction, or landing from a jump — often seen in sports like football, basketball, and skiing.

After an ACL tear is diagnosed, one of the most frequently asked questions is: “Can I recover without surgery?” In this article, we’ll explore what it means to avoid surgery after an ACL tear and what potential risks and limitations may follow.

1. What Happens After an ACL Tear?

When the ACL is torn, the dynamic stability of the knee is compromised. Patients often report:

• A sensation of the knee "giving way"
• Instability during daily activities or sports
• Difficulty trusting the knee, especially during turns or quick movements

2. What Are the Risks of Not Having Surgery?

• Ongoing Knee Instability: Without a functional ACL, the knee may continue to feel unstable, affecting confidence in movement.
• Meniscus and Cartilage Damage: Repeated instability can lead to secondary injuries, increasing the risk of long-term joint degeneration and osteoarthritis.
• Limitations in Physical Activity: Most people are unable to return to high-impact or pivot-heavy sports without surgery.

3. Is Surgery Always Necessary?

No. Surgery may not be required for everyone. In certain cases — especially for older adults, less active individuals, or partial tears — non-surgical management can be considered. However, even in these cases, close follow-up is essential, as instability may still progress over time.

4. What Does Non-Surgical Treatment Involve?

Conservative management may include:

• Structured physical therapy
• Strengthening of the quadriceps and hamstring muscles
• Balance and proprioception training
• Wearing a supportive knee brace during activities

5. What If I Delay the Surgery?

Postponing surgery may lead to more complex problems:

• New or worsening meniscus tears
• Progressive cartilage damage
• More difficult revision surgery with lower success rates

6. How to Decide What’s Right for You

The decision to undergo ACL surgery should be personalized based on:

• Age and lifestyle
• Activity level and sports involvement
• Severity of the tear and MRI findings
• Presence of other injuries (e.g., meniscus damage)

Conclusion:

Not all ACL tears require surgery, but for active individuals, reconstruction is often the best long-term solution. Delaying treatment increases the risk of further joint damage and may limit future mobility. Consult a qualified orthopedic surgeon to determine the best treatment for your needs and lifestyle.