Torn ACL Recovery Time

Introduction:

A common injury in many sports is a torn anterior cruciate ligament, or a torn ACL. It is an important ligament located in the knee and helps to stabilize the joint and prevents the tibia from moving out and in front of the femur. Recovery time is typically  6-12 months, but it can also take up to a year.

About the ACL:

The ACL is one of the four main ligaments in the knee, originating from the lateral femoral condyle (one of the large bumps on the bottom of the femur) and inserting at the middle of the intercondylar area (a rough spot at the top of the tibia). Normally, this ligament helps to stabilize the knee joint. Without it, the tibia would go forward and out of the knee joint.

ACL tear types and recovery time:

There are three grades to ACL tears.

Grade 1 (least severe):

 The ACL is damaged, but it is in one piece and still performs its job of holding the knee bones together. There is some discomfort and pain, but the injury is mild and there is no swelling. This type of tear is low grade and it’s possible for people to live with them, since torn ACLs can’t heal on their own (there’s only microscopic tears inside the ligament). Recovery would take 2-4 weeks without survey and plenty of rest, ice, compression and elevation. Collagen fibers align after 6 weeks, however, so it’s still best to avoid returning to sports too soon to prevent re-injury.

Grade 2:

 The ACL is stretched until it partially tears and is loose. 20-80% of the fibers are torn in this grade; it’s best to put no weight on the leg even if you still feel as if you can. There’s often swelling, bruising, and pain higher than grade 1 tears. The knee might feel unstable when bending or straightening it; there will be lots of limping. This type of injury usually needs 6-8 weeks to recover. 

Grade 3 (most severe):

This grade means that the ACL has torn completely. Since ligaments cannot heal or reattach without surgery, there are concerns about how stable the knee is at this point. In this grade, the knee is loose and there is swelling and discoloration. The ligament has torn into two pieces so surgery is required for reconnection. This type of ACL tear depends on whether or not surgery is chosen, as without it there’s a need for extra physical therapy. Patients will need to know how to keep the joint stable if they choose to do conservative treatment. If a person chooses to do surgery, this entails replacing the ACL with a part of the patellar, quadriceps or hamstring tendon. Usually, this type of ACL tear takes 6 to 12 months to heal fully, with most feeling good by the 9 month mark.

Conclusion:

The ACL is an important ligament in the knee that is also easily injured in sports. There are three grades to this type of injury, each with different recovery times. Grade 1 will take around 2-4 weeks to feel better, with maximum strength at the 6 week mark. Grade 2, the moderate type of ACL tear, requires at least 6 weeks to heal, with most people feeling good at 6-8 weeks. Grade 3 is the most severe type, where the ligament tears in two completely. This grade requires 6-12 months of recovery before returning to activity is acceptable. 

Sources:

“ACL Tear & Injury: Symptoms & Recovery.” Cleveland Clinic, 1 May 2024, my.clevelandclinic.org/health/diseases/16576-acl-tear.

“Anterior Cruciate Ligament (ACL) Injuries - Orthoinfo - Aaos.” OrthoInfo, orthoinfo.aaos.org/en/diseases--conditions/anterior-cruciate-ligament-acl-injuries/#:~:text=The%20anterior%20cruciate%20ligament%20runs,rotational%20stability%20to%20the%20knee. Accessed 1 Dec. 2024.

B;, Petersen W;Tillmann. “[Anatomy and Function of the Anterior Cruciate Ligament].” Der Orthopade, U.S. National Library of Medicine, pubmed.ncbi.nlm.nih.gov/12426749/#:~:text=Abstract,kinematics%20of%20the%20knee%20joint. Accessed 1 Dec. 2024.

Koen, Marlene. “Anterior Cruciate Ligament (ACL) Injury.” Well Health Pro, 2024, physiopretoria.co.za/pain/knee/acl-injury#:~:text=Recovery%20time%20for%20a%20grade,return%20to%20sport%20too%20soon.

Papaleontiou, Andreas, et al. “Conservative vs Surgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review.” Cureus, U.S. National Library of Medicine, 20 Mar. 2024, pmc.ncbi.nlm.nih.gov/articles/PMC11027445/#:~:text=Conservative%20treatment%20options%20include%20progressive,hinged%20knee%20brace%20%5B8%5D.

Image sources:

ACL Tear. ACL Tear & Injury: Symptoms & Recovery., Cleveland Clinic, my.clevelandclinic.org/health/diseases/16576-acl-tear.