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In June 2011, the Journal of Bone & Joint Surgery reported a 49 percent increase in knee surgeries between 1996 and 2006. Of all the surgeries performed, the majority were either to repair an anterior cruciate ligament (ACL) or a medial or lateral meniscus (cartilage).
If you've sustained an injury in one of these areas, consulting a surgeon should be your major priority. Here are some important considerations to decide and questions to ask when you visit the doctor.
Can I still play with a torn ACL or meniscus?
Depending on the size of the tear, some athletes can continue playing with or without a brace. An orthopedic surgeon usually makes this decision.
What happens during meniscus removal or repair?
Don't be afraid to ask your doctor questions about the surgery. It's always a good idea to get a second opinion. Many knee surgeries are now done arthroscopically—i.e., through three small incisions around the joint. Arthroscopic surgery usually takes only a few hours and does not require a hospital stay. If the surgeon removes some cartilage (débridement), rehab time depends on how well your body responds to the surgery. If the surgeon performs a repair (sewing cartilage together), more rehab time may be needed, and you may be on crutches until the tissue heals. Depending on what the surgeon finds, he or she will decide how much rehab is required and whether you need crutches or a brace after surgery.
What happens during ACL surgery?
ACL surgery is more involved, and an athlete has to consider many factors. When talking with your surgeon, ask about the success rate of various graft options. To repair an ACL, the surgeon may have to do a larger incision to remove the graft below your knee for a patellar tendon graft. ACL surgery may involve other structures. Some repairs may involve the meniscus and ligaments.
What happens after surgery?
This is probably what athletes most want to know about, especially if they plan to return to their sport. Depending on what kind of knee surgery is performed, there are different timelines and protocols to follow. ACL surgery has a longer rehab time than removal (cleaning) of a meniscus. A meniscus repair has a longer rehab than a removal. It usually requires being on crutches for four weeks for the repair to heal.
What happens in physical therapy?
It's important for swelling and range of motion be addressed early on. Then, strengthening of the muscles is the next target. A strengthening program prescribed by a doctor and physical therapist will speed recovery.
How do I know when I can return to my sport?
Once you have achieved your strength goals, your MD and PT should allow you to do more sport-specific drills. You should feel confident and strong when accelerating, decelerating, changing direction, cutting, landing and jumping before going hard with any drills. Do not do perform exercises unless they are prescribed by your MD or PT.
Here is a video of the drills:
For more information on the ACL please see the STACK ACL Guide.