The anterior cruciate ligament benefits from a poor blood supply, which associated with the presence of fibrocartilage around its anterior attachment, can explain the poor self-healing potential of this structure when damaged (Petersen and Tillmann, 2002).
Treatment options vary depending on the nature of the injury affecting the ACL: full or partial tear.
In the case of a partial tear, surgery won’t necessarily be required, and treatment can consist of physical therapy designed to stabilise and strengthen the affected knee. The program will essentially be using physical activity at a moderate intensity and adapted to what the patient can do, such as gym activities (squats to strengthen the quadriceps for example), jogging, running, at moderate pace and on soft, stable grounds.
With a full ACL rupture, a reconstruction surgery of the ligament is recommended, in order to bring full stability back into the knee and avoid further damages into the menisci and cartilage that would absorb a greater impact and possibly tear. The procedure is performed using a tendon graft, replacing the entire ligament. The graft can either be an autograft (coming from the patient’s own body), commonly a part of the hamstrings or the patellar tendon, or an allograft (coming from a cadaver). The use of an autograft is usually preferred, as the tissue used being the patient’s own, the risks of rejection are minimal.
Whether the rupture is partial or full, treatment sessions with an osteopath or physiotherapist are beneficial. It won’t directly affect the recovery and healing time, but the aim will be to minimise all the risks of compensations in the lower body, either at the pelvis, in the gait mechanics, and reinforce the range of movement allowed in the knee (especially following surgery with the build-up of scar tissues). The therapist will also help planning when and how is the best return to full physical activity possible.