An ACL (anterior cruciate ligament) tear is a common injury often caused by sudden stops or changes in direction, particularly in sports like football or basketball. The ACL helps maintain knee stability and allows for smooth joint movement. While surgery is often recommended to repair the damage and restore functionality, some individuals choose to forego surgery, opting instead for rehabilitation and lifestyle adjustments. But what happens when an ACL tear goes untreated by surgery? This article explores six potential consequences of managing an ACL tear without surgical intervention.
1. Chronic Knee Instability
Without surgical intervention, the knee may remain unstable. This can cause it to give way unexpectedly during basic activities like walking, standing or climbing stairs, making daily movements challenging. The lack of ACL support leads to improper knee alignment, which not only causes discomfort but increases the risk of further injury to surrounding ligaments and tissues.
2. Cartilage and Meniscus Damage
An untreated ACL tear places additional stress on the knee’s cartilage and the meniscus (the cushion between the bones). Over time, this excessive strain accelerates wear and tear, increasing the risk of meniscus tears and cartilage degeneration. When these structures break down, the knee’s ability to absorb shock diminishes, causing pain and swelling. This damage is often irreversible and can significantly further impair joint function and cause pain.
3. Early Development of Osteoarthritis
Constant stress on the knee joint, combined with cartilage and meniscus damage, can increase the risk of developing osteoarthritis. This condition causes the protective cartilage in the knee to wear away, leading to stiffness, pain, and swelling. Over time, osteoarthritis can severely reduce mobility, making it difficult to perform everyday activities. In advanced stages, more invasive treatments, such as joint replacement surgery, may become necessary to manage symptoms. It is estimated that there is an 10-11 fold increase in radiological arthritis of the knee after an ACL tear in 10 years.
4. Decreased Physical Activity
Knee instability caused by an ACL tear often forces individuals to avoid high-impact and pivoting activities such as running, jumping, or participating in sports. This limitation can lead to a more sedentary routine as the knee is no longer able to handle intense movements or pressure. Over time, reduced activity not only impacts physical fitness but can also affect overall well-being, contributing to weight gain and cardiovascular issues.
5. Muscle Weakness and Atrophy
Reduced physical activity due to knee instability often results in muscle atrophy, particularly in the quadriceps and hamstrings. When these surrounding muscles are underused, they begin to weaken and shrink, further destabilising the knee joint. As muscle strength declines, regaining mobility through rehabilitation becomes more difficult, prolonging recovery and increasing the risk of long-term disability.
6. Altered Gait and Posture
Chronic knee instability due to an untreated ACL tear often forces individuals to adjust their walking patterns (altered gait) to compensate for the instability. Over time, these adjustments can lead to uneven weight distribution across the body, causing strain on other joints such as the hips, lower back, and ankles. This altered gait may result in poor posture and increased wear and tear on other parts of the musculoskeletal system, potentially leading to further injury or chronic pain in areas beyond the knee.
Conclusion
Leaving an ACL tear untreated by surgery can result in a range of long-term effects that extend beyond just knee instability. Recognising the potential consequences makes it clear that early intervention and treatment are necessary to maintain knee health and avoid further complications.
Consult with Dr LS Wang today to see if ACL surgery is the right option for you and protect your knee from long-term damage and instability.
