Do I always need surgery after an ACL tear?

No. Not all ACL injuries need surgery. Non-surgical treatment includes physiotherapy to strengthen the knee, a brace during exercise and pain relief. Surgery may be considered if you play a lot of sport and want to continue, or if your knee keeps causing problems after physiotherapy.

Which graft is used for ACL reconstruction?

The graft is usually taken from another part of your own body, such as the hamstring. Your surgeon will explain the options and their trade-offs for you.

Can a torn meniscus heal or be repaired?

Tears in the outer third of the meniscus, which has a good blood supply, may heal on their own or can often be repaired with stitches; whether a tear can be repaired depends on its type. Otherwise the damaged part may be trimmed away (partial meniscectomy). Rehabilitation takes about 3 to 6 months after a repair and about 3 to 6 weeks after a partial meniscectomy.

How long does a dislocated shoulder take to recover?

It usually takes 6 to 12 weeks, and up to 16 weeks to fully return to some sports. Surgery is sometimes needed to reduce the risk of the same shoulder dislocating again.

How is an Achilles tendon tear treated?

Without surgery, the leg is held in a brace, boot or cast with the toes pointing down, usually for at least 6 weeks, followed by physiotherapy. Surgical repair is another option; some studies suggest it lowers the risk of re-tearing, but this is still debated. Complete recovery can take about 12 months.

When can I return to my sport?

It depends on the injury and on reaching strength and control goals agreed with your physiotherapist, rather than a fixed date. After ACL reconstruction it can take up to a year.

Hunjan Hospital Ludhiana

Sports Injury Treatment

Common sports injuries such as sprains and ligament or meniscus tears: first aid, when to seek help, treatment options, return to sport and risks.

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About sports injuries First aid for sprains and strains When to seek emergency care Injuries that need an orthopaedic assessment ACL tear: rehabilitation first or early reconstruction?Typical recovery after ACL reconstruction Risks and limitations Frequently asked questions Treatment Journey References

About sports injuries

Sports injuries range from sprains and muscle strains to ligament tears, meniscus (knee cartilage) tears, dislocations and tendon ruptures. Most sprains and strains feel better within about 2 weeks with self-care.^[1] Other injuries, such as a torn ACL or meniscus, may need specialist assessment, physiotherapy and, for some people, surgery.^[2,8]

Examination of the injured joint, with scans such as X-ray, ultrasound or MRI when needed
Rehabilitation-based treatment with physiotherapy, and a brace where useful^[4]
Discussion of surgery, such as ACL reconstruction or meniscus repair, when it is likely to help^[2,8]
A graded plan for returning to training and sport

Treatment is planned around your injury, your sport and your goals. Surgery is one option, not the only one.

First aid for sprains and strains

For the first 2 to 3 days after a sprain or strain, PRICE therapy can help bring down swelling and support the injury.^[1]

Protection: protect the injury, for example with a support^[1]
Rest: stop exercise and try not to put weight on the injury^[1]
Ice: apply an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours^[1]
Compression: wrap a bandage around the injury to support it during the day^[1]
Elevation: keep it raised on a pillow as much as possible^[1]

Avoid heat, alcohol and massage for the first couple of days, and avoid strenuous exercise such as running for up to 8 weeks because of the risk of further damage. Severe sprains and strains can take months to get back to normal.^[1]

When to seek emergency care

Go to the nearest emergency department, or call 112, if after an injury:^[11]

You heard a crack when the injury happened^[1]
The injured part has changed shape or is pointing at an odd angle^[1]
The injured part is numb, tingling or has pins and needles^[1]
The skin around the injury looks blue or grey, or feels cold^[1]
Your shoulder looks out of place or you cannot move your arm; do not try to put it back yourself^[10]

Injuries that need an orthopaedic assessment

Arrange a medical assessment if you have:

A knee that gave way with a popping sound and then swelled, or that feels unstable (possible ACL injury)^[2]
A knee that catches, locks or gives way (possible meniscus tear)^[8]
Sudden severe pain and swelling near the heel, sometimes with a popping sound, and difficulty standing on your toes (possible Achilles tendon tear; seek care promptly)^[9]
A shoulder that has dislocated before or feels unstable^[10]
A sprain or strain that is getting worse or not improving with self-care^[1]

ACL tear: rehabilitation first or early reconstruction?

Key points

Structured rehabilitation, with reconstruction later if needed

Rehabilitation plus early ACL reconstruction

Knee pain, symptoms and function at 2 years

No significant difference between the two approaches in one trial^[7]

Need for an operation

About 4 in 10 later had reconstruction; the rest managed with rehabilitation alone^[7]

Everyone has an operation, with its risks^[6]

What it involves

Physiotherapy to strengthen the knee, a knee brace during exercise and pain relief^[4]

Surgery using a graft, usually from your own hamstring, followed by regular physiotherapy for a few months^[3,5]

Points to discuss with your surgeon

How severe the injury is, your age, any wear in the joint, whether the knee feels unstable and your activity level^[2]

Surgery may be advised if you play a lot of sport and want to continue, or if the knee keeps causing problems after physiotherapy^[3]

Evidence note: in a randomised trial of 121 young, active adults with a recent ACL tear, rehabilitation with the option of later reconstruction gave similar results at 2 years to early reconstruction, and adverse events were common in both groups.^[7] Returning to normal activities without treatment risks further damage to other structures in the knee.^[2]

Typical recovery after ACL reconstruction

A general guide. Your physiotherapist will progress you based on strength and control, not on dates alone.

Day of surgery
Going home

Most people can leave hospital on the same day as the operation; your team will advise you.^[5]
First weeks
Early rehabilitation

Regular physiotherapy continues for a few months. Use crutches until your physiotherapist says you can stop.^[5]
4 to 6 weeks
Return to work

Many people return to work after about 4 to 6 weeks, depending on the type of work.^[5]
A few months
Most daily activities

Most activities are usually possible again within a few months.^[5]
Up to a year
Return to sport

It can take up to a year to be able to play sport again.^[5]

Risks and limitations

Both surgical and non-surgical treatment of sports injuries have limitations. These are the main risks to discuss.

ACL surgery can cause blood clots (DVT), wound infection, or damage to a blood vessel, nerve or ligament^[6]
After ACL surgery, the knee may be unstable, painful or stiff, and there may be problems where the graft was taken, such as around the kneecap^[6]
The new ACL graft can tear, which may need more surgery^[6]
If much of the meniscus has been removed, ongoing pain and osteoarthritis may develop later^[8]
Achilles tendon surgery can cause infection, nerve injury, wound breakdown, anaesthetic complications and blood clots, and the tendon can tear again after repair^[9]
After a shoulder dislocation, there is an increased risk of it happening again^[10]
Returning to strenuous exercise too early after a sprain or strain risks further damage^[1]

Frequently asked questions

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