Initial treatment
If there is concern for a possible broken bone or other urgent concern, then the patient should go to the emergency room for evaluation. However, if the athlete is not in too much pain, it is considerably less expensive to simply see an orthopedic surgeon or family doctor the next day. Initial treatment is usually simply rest, ice, elevation, crutches and pain medication. Some doctors recommend a knee immobilizer to hold the knee straight, but generally these just tend to make the knee quite stiff if used more than a few days.
Nonoperative versus Operative treatment
For most young athletic individuals, most surgeons would probably recommend reconstruction. For patients over 30 with minimal athletic demands, the patient may choose to forego surgery and simply wear a brace for athletic pursuits. Sometimes this is satisfactory, but sometimes the patient has problems that warrant surgical consideration. ACL reconstruction is rarely done after age 50.
Operative Options
Usually the surgeon should wait until the swelling has resolved and full motion has been achieved BEFORE going though with surgery. If the knee is swollen and stiff, then it tends to make it much harder to do the necesary physical therapy after surgery.
The two most commonly used techniques of ACL reconstruction are "Bone Patellar Tendon Bone" and Hamstring Reconstructions. Click here for a more detailed description of reconstruction techniques outlined by the American Academy of Orthopedic Surgeons.
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