Can an ACL Tear Heal on Its Own?

The anterior cruciate ligament (ACL) in each knee is crucial for the stability and proper functioning of the knee joints. It’s also relatively fragile. ACL tears are the most common knee injury, accounting for almost half of all knee injuries. In the United States, about 400,000 people undergo ACL repair surgery each year. 

The providers at all of the locations of Orthocenter provide ACL repair. These injuries are common in people who are active in sports, but they can also happen when a person stumbles over a curb or twists in just the wrong way. Our providers seek to provide the most appropriate care for you and consider your age, lifestyle, medical history, the severity of your injury, and many other factors when we make treatment suggestions.

Historically, physicians and researchers have approached ACL tears aggressively because it was believed these important ligaments didn’t get enough blood flow to heal. Only minor tears were treated conservatively with physical therapy and bracing. New research could be changing that approach. 

ACL anatomy and function 

Before discussing whether ACL tears can heal without surgery, we should talk about what your ACL is and what it does. Your knee joint is where your femur, or thigh bone, and your tibia, or shin bone, meet. Your patella, or kneecap, covers the joint a bit like a tiny shield. 

Your knee is a large joint that allows incredible mobility. If you think about how many times per day you bend and straighten your knee—to sit, lay down, and stand, never mind walking, running, or jumping—you begin to see just how important the proper function of this joint is in daily life.

Four main ligaments work in pairs to connect your femur and tibia. On the insides of your knees, your medial collateral ligaments (MCLs) hold your joint in place; on the outsides, your lateral collateral ligaments (LCLs) do the same. These ligaments allow you to move your knee side-to-side. 

Inside your knee joint, you have a set of cruciate ligaments that cross over each other, forming an X. In the back, you have the posterior cruciate ligament (PCL); in the front, you have the anterior cruciate ligament (ACL). These pairs of ligaments let you move your knee back and forth. 

One of the main jobs of your ACL is to prevent your tibia from moving out in front of your femur. It also keeps your joint stable, as when you pivot quickly. 

Injuries to the ACL

ACL injuries happen when you jump and land with your knees locked, pivot too quickly, and suddenly, something hits your knee from the side, or if you’re older and your ligaments are more fragile when you step off a stair a little wrong. You can see why ACL injuries are so common! 

Ligament injuries are considered sprains. Not all ACL tears are the same. They range from Grade I sprains, which are the mildest, to Grade III sprains, which are considered complete tears because the ligament isn’t attached.

The best treatment for an ACL injury largely depends on the tear's severity. For many years, surgical repair has been the treatment for Grade II and III tears, and it’s often still the best route to recovery.

However, new research seems to indicate that ACL injuries can heal without surgery.  According to a report in the Washington Post in 2023, orthopedic specialists are still quite divided. The study, which followed a small group of relatively young patients with ACL injuries for 12 months, concluded that 90% had evidence of healing after three months of non-surgical treatment.

At Orthocenter, we always treat you as an individual and make suggestions based on your specific and unique situation. Even if bracing and physical therapy turn out to be the best approach for you, it’s still very important to have the guidance of a highly qualified medical professional. 

Schedule your appointment at Orthocenter's most convenient location today. We’re always happy to answer your questions.