ACL question, need help quickly

Today I had meeting with doctor and he said that I have "sub total ACL rapture" or something like that. Now to the question. He said that they don't want to operate it yet, maybe not at all. He said that I should have fysiotherapy for 6 weeks and then they decide is it going to be operated. Am I going to be able to ski or do any sports with out surgery or just sit on couch and drink beer? Also my insurance may not pay fysiotherapy before surgery, so is it possible to just do some training by myself and then go to doctor when I'm home in Finland(3.7.2005) thanks for answers!

I am assuming that sub-total means partially torn. As I understand it, an ACL never heals because there is no blood supply to the ligament. However, if the tear is small enough, then scar tissue will fill in and essentially provide you the strength that was lost with the torn fibers. Physical therapy (and generally keeping your leg strong) is important to stabilize your knee once you start doing activity. It apparently takes about 1 year to get all your strength back (or as much as you're gonna get). If you don't feel any laxity or instability, you're likely fine to resume normal activity after this initial healing period. You are at a higher risk for a full tear however.

So, keep your muscles strong, give it a rest, etc. . . . but also keep in the back of your mind that you have a weak ACL when you go back to sports. Just my $0.02 - I am certainly no doctor.

Like Kellie, my guess would be he meant partially torn too. Also, I'm just curious, did you get an MRI or did your doc just assess in his office?


Do some research on "microfracture technique" or "healing response" technique for acl tears. It's a method whereby tiny microscopic holes are drilled into the femur, causing it to bleed, and the increased blood flow supposedly brings in other growth factors and such which actually facilitates "natural" ACL repair. The Steadman-Hawkins clinic does it alot (there's a case study on their website I think if I remember correctly) and fellow maggot Lunch had this done last year with really good results. Apparently, you still need some ACL fibers attached to make you a candidate for it, so it's not for everyone.

And this is really a simplistic, uneducated view of the procedure too, so do your research and ask your doc lots of questions. I'm ain't no doctor or PT and this advice is only worth what you pay for it. ;)

There is blood supply to the ACL, its just not very good. Some incomplete tears will heal, But, even though it "heals" it may not be functional, as the intact fibers may be too stretched to provide any stability.

And microfracture is used to repair articular cartilage defects not as a technique for ACL repair. At least not that I know of. Ty you got a link for that case study?


it is likely that therapy will focus on regaining ROM, reducing swelling if there is any left, regaining quad control and focusing on your hamstrings a lot. As far as being able to be active without surgery......... you are just going to have to see how therapy goes and how stable your knee is after which depends on how badly stretched the remaining fibers are. Good luck.

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Originally Posted by Vinman

And microfracture is used to repair articular cartilage defects not as a technique for ACL repair. At least not that I know of. Ty you got a link for that case study?

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Not yet, but I'll try to dig it up for ya.

I'll also try to get Lunch to offer his experience up, but he rarely posts here anymore...he was tellling me about it on a recent gimps only bike ride we were just on ;) According to him, his ACL was partially torn, and he used the healing-response technique to repair it.

Sorry to hear about your ACL- I myself had a totally ruptured ACL (in addition to MCL and Patellar Tendon ruptures). Now I am at 9 weeks post op.
I was told my OS to do stationary biking to maintaine the flexibility (Range of Motion) until the operation. In some cases OSs delay the operation for a long time (upto 2-3 months) if it is just an ACL injury (all depending on the degree of the rupture). In my case they wanted to operate right away because of the patellar tendon rupture. I had to do 2 weeks pre op stationary bike based training. Biking keeps your flexion at 110-120 deg. I was told that another rule of the thumb is that you should have 110-120 deg. flexion to be operated.

Stationary biking will be your rehab friend both before and after the operation--keep pedalling.

Have you had MRI for diagnosis or was it Lachman test etc. your doc used for diagnosis ?

Yep they took MRI's. Well, I guess I will go biking and maybe some water running. I hope they can operate it straight away when I'm back in Finland. Then I guess it would have enough time to heal for next season. I can now bend it something like 100 degree and theres just a little bit swelling left, actually there wasn't much in begining.

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Originally Posted by Vinman

Ty you got a link for that case study?

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Found it...starting a new thread here as this with it's own topic. It's not really a true case study, more of a commercial for healing-response, but it shows how someone with a complete ACL tear (Bode Miller) had success with using microfracture. More people show know about it perhaps...

Knee was operated 4th of august. They did new acl from some ligaments on back of my leg. I have been training hard and just came back from physiotherapist and she gave me "license to ski" :D damn it feels great. well only in slopes for a start but should be able to ski off-piste quite soon.

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Originally Posted by Ville

Knee was operated 4th of august. They did new acl from some ligaments on back of my leg. I have been training hard and just came back from physiotherapist and she gave me "license to ski" :D damn it feels great. well only in slopes for a start but should be able to ski off-piste quite soon.

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That's the technique I had done last year (will be one year post-op in a few days actually)...hamstring graft. Keep up the rehab and you'll be as good as new before you know it.