Athletes who wish to return to their sport are mostly advised to undergo an ACL reconstruction once the joint swelling and inflammation has subsided, which usually takes about 5 to 8 weeks. ACL reconstruction is one of the most superior treatment options for torn anterior cruciate ligament, especially for athletes and sports players. But before deciding upon the surgery, it is crucial to analyze anatomical and psychological aspects of the patient as such factors play an important role in the success of an ACL reconstruction surgery. This is why it is important to make a decision based on adequate and exhaustive research and discussion with your healthcare provider.

Allowing the patient to return to unrestricted physical activity after ACL reconstruction surgery is one of the most challenging decisions for an orthopedic surgeon. Several factors need to be taken into account before giving patients a green signal to return to their normal lives and sports. Any type of negligence in the matter can worsen the condition of the operated joint. This is one of the reasons why returning to sports after an ACL reconstruction is a controversial matter in itself.

Statistically speaking, 80 to 95% of athletes who undergo ACL reconstruction can return to their sport after several months of physical therapy, rehabilitation, and customized strength training and a huge chunk of these athletes are even able to return to their preoperative sport skills. However, it should be noted that every patient’s case is different, and many psychological, anatomical, and biomechanical factors determine the return of an athlete to his sport after an ACL reconstruction.

Functional results of ACL Reconstruction Surgery

Numerous factors like gender, age, lifestyle habits, general health, body mass index, and the presence of other medical issues play their part in determining the success or failure of ACL reconstruction surgery. The presence of these factors might affect or delay the results of the procedure in some ways. But in normal circumstances, a patient would see the following results as the joint keeps on recovering

• Lesser occurrences of the knee giving way
• Lesser knee effusion
• Reduced pain
• Reduced levels of kinesiophobia

Prevention of Re-injury after ACL reconstruction surgery

Injuring the knee severely after an ACL reconstruction, or undergoing a second ACL reconstruction can lead to disastrous complications. It could severely affect your knee stability, and strength, and could even put you at risk of developing osteoarthritis. Such outcomes could make it extremely difficult for you to return to sports.

To target possible risks and complications, it is important to understand all risk factors thoroughly. One of the most critical things to keep in mind is that returning to sports too early, or using too much force before complete recovery could worsen the damage and re-injure the anterior cruciate ligament.

For optimum and safe recovery, some specific exercises can be included in the rehabilitation plan. Side to side quadriceps symmetry and single-leg plyometric tests are two common ones that could help achieve strength symmetry and preoperational functioning respectively. Other than this, after ACL reconstruction, there would be some sports criteria that you will have to meet before resuming. It is not advisable to resume sports before meeting these criteria as 15 to 20% of recovered athletes who don’t pass the test could suffer from re-injury.

Does timing determine the prevention of re-injury?

You should wait for at least 9 to 12 months before returning to sports after an ACL reconstruction surgery. Delaying sports for around 9 months gives the joint time to become fully functional. This time is sufficient to restore the joint to its original strength. Going back to sports after you have completely returned to your preoperative strength, flexibility and mobility could significantly lower the risk of re-injury to the operated ligament.

As the physical health, the extent of injury, and circumstances of all patients vary, the recovery rate is different for all too. This is why some patients might have to wait longer before returning to sports. Many athletes hold off sports for around 18 to 24 months after the surgery as it could take them a little longer to go through the recovery process.

How to finally return to sports

Patience is of the essence when recovering from a major surgery like ACL reconstruction. Successful ACL reconstructions performed by experienced orthopedic surgeons combined with a customized rehabilitation plan would restore the strength and functioning of the knee to its original state in due time. While you can walk around and stand in a couple of weeks, full recovery is a long process. It could take around 6 to 8 months to return to routine life and job, excluding sports., and 9 to 14 months to return to sports.

It’s always best to start an activity post-surgery after discussing it with your surgeon as working the knee too much or extreme movements could worsen the situation.

Arthroscopic ACL Reconstruction Surgery

Arthroscopic ACL reconstruction is much more successful than open reconstruction surgeries and gives you a better chance of returning to sports after complete recovery. The surgery repairs a torn anterior cruciate ligament by minimally invasive techniques. The procedure is performed with lesser, smaller incisions, does not require stitches, and speeds up the recovery process significantly. However, the surgery requires expertise and precision, and postoperative care requires diligence and patience. Lack of any of these could compromise the result of the procedure.

Who should consider arthroscopic ACL reconstruction?

Arthroscopic ACL reconstruction is a gold standard treatment option for those who wish to return to their sport. This procedure is best suited for the following groups of patients.

• Younger patients will be at risk of re-injury or disability if the torn ligament is not repaired.
• Patients that are experiencing severe instability and are unable to perform basic tasks like walking or standing independently.
• Patients who have exhausted nonsurgical treatments but have still not seen any noticeable improvements in functioning and strength of the knee.
• Patients who are physically fit enough to undergo surgery.
• The patient is willing to diligently follow the entire rehabilitation and do regular physical therapy post-surgery.

Delaying or avoiding ACL reconstruction surgery after an ACL tear is never a good idea. It just gives the torn ligament time to wear down even more and after a point damage the surrounding tissues. Therefore, it is important to get surgery in time. If you have doubts about the procedure, feel free to ask your healthcare provider so that you can make an informed decision.