Table of ContentsView AllTable of ContentsWhat Is a Partial ACL Tear?When Surgery Is ConsideredPartial ACL ReconstructionNon-Surgical TreatmentFrequently Asked Questions

Table of ContentsView All

View All

Table of Contents

What Is a Partial ACL Tear?

When Surgery Is Considered

Partial ACL Reconstruction

Non-Surgical Treatment

Frequently Asked Questions

The anteriorcruciateligament (or ACL) is one of the primaryligaments, or connective tissues, in the knee joint. An ACL tear can be either partial or complete. Complete tears usually require surgery, but some partial tears are treatable with non-surgical techniques. If you have a partial tear, your healthcare provider may assess the need for surgery based on how unstable your knee is. If your knee is stable, you may not need surgery.

The decision to have surgery can be a difficult one since ACL reconstruction involves significant rehabilitation and other operative risks.

This article discusses partial ACL tears and how your healthcare provider may help you decide if you need ACL surgery.

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Photo of a woman therapist examining a man’s knee.

The ACL is important because it allows for normal movement andmechanics of the knee joint. It connects your thigh bone (femur) to your shinbone (tibia) and keeps your tibia from sliding too far forward. It also performs other functions to maintain the stability of your knee when you rotate it. When it is injured, it is called a sprain.

ACL injuries most commonly occur when landing a jump, making a sudden change in running direction or falling. When theACL is torn, you may notice problems in the way your knee functions. Some common symptoms of an injured ACL include:

A partial ACL tear is also called a grade 2 sprain. Grade 2 injuries are rare and occur when the ligament stretches enough to become loose and damaged.

It is not always clear if partial tears should be treated surgically since in many cases it is possible to recover after nonsurgical rehabilitation. The decision often depends on your pain level and whether or not your knee is unstable.

By contrast, a grade 1 sprain is when the ligament is slightly stretched and damaged but the knee is still fairly stable. A grade 3 sprain is a complete tear of the ACL. With this injury, the knee joint becomes unstable and surgery is almost always necessary to correct it.

Your healthcare provider will consider a few different factors when deciding if your partial ACL tear requires surgery.

If the need for surgery isn’t clear, you may receive anarthroscopy. During this procedure, a surgeon threads a tube with a camera through a small incision so that they can visualize and diagnose problems inside a joint.

For an ACL injury, however, arthroscopy can be very subjective. Healthcare providers may have differing opinions on the scope of the problem and the “right” remedy.

While grade 3 injuries often require complete reconstruction, a grade 2 injury may be treated with partial reconstruction. During this procedure, the ACL is reconstructed using tissue obtained either from somewhere else in the body or from a donor. The new ligament is created to replace the damaged ligament.

This surgery can be a good option for people with partial ACL tears. Studies have shown that most patients undergoing partial reconstruction will have improved knee stability and function.

After this procedure, you will likely have to wear a knee brace for a few weeks. Physical therapy may be needed for several months to help restore function to your knee. Research suggests that many people who have had this type of surgery can return to sports and similar activities after about six months.

ACL Surgery: What to Expect on the Day of Surgery

Most patients with partial tears can recover without surgery. Recovery time typically takes about three months.

When surgery isn’t recommended, several non-surgical treatments can help people with partial ACL tears. These treatments often includebracingand the use of crutches to help protect the knee during recovery.Physicalrehabilitation therapy can begin once the swelling goes down.

The goal of nonsurgical treatment is to maintain the strength of the muscles surrounding the joint and to try to optimize the stability of the joint. A custom sports brace may be fitted for patients who want to return to athletic activity.

Surgery Isn’t For EveryoneNonsurgical treatment can be a good choice for older patients or those who have a low activity level.

Surgery Isn’t For Everyone

Nonsurgical treatment can be a good choice for older patients or those who have a low activity level.

Summary

Trying to determine the extent of the injury can be difficult. If a partial ACL tear is suspected, an orthopedic surgeon can help assess the degree of instability and whether ACL reconstruction might be a reasonable treatment.

The Difference Between a Sprain and a Strain

A Word From Verywell

Whether or not surgery lies in your future, physical therapy almost certainly will. It’s the surest way to help you regain strength and motion in your knee.

Therapy programs are often divided into three phases. Phase one focuses on returning motion to the joint and surrounding muscles. Phase two centers on a strengthening regimen designed to protect the ligament. Phase three pivots on ensuring that the knee is strong enough to sustain a return to normal, functional activities.

Complete recovery can take many months, so make sure to work closely with your physical therapist and follow up with your healthcare provider as needed.

Frequently Asked QuestionsProbably not. An X-ray will reveal the presence of a broken bone, but not a torn ligament. A thorough physical exam, along with a review of your medical history, is usually enough to make an ACL diagnosis.All things depend on how well you follow the advice of your healthcare team, including your physical therapist. But it’s fair to expect that it will take at least six months before you can resume play.

Probably not. An X-ray will reveal the presence of a broken bone, but not a torn ligament. A thorough physical exam, along with a review of your medical history, is usually enough to make an ACL diagnosis.

All things depend on how well you follow the advice of your healthcare team, including your physical therapist. But it’s fair to expect that it will take at least six months before you can resume play.

8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Filbay SR, Grindem H.Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture.Best Pract Res Clin Rheumatol. 2019;33(1):33-47. doi:10.1016/j.berh.2019.01.018.Panisset JC, Gonzalez JF, de Lavigne C, et al.ACL reconstruction in over-50 year-olds: comparative study between prospective series of over-50 year-old and under-40 year-old patients.Orthop Traumatol Surg Res. 2019;105(8):S259-65. doi:10.1016/j.otsr.2019.09.009Salesky MA, Oeding JF, Zhang AL, Ma CB, Feeley BT, Lansdown DA.Patients aged 50 years and older have greater complication rates after anterior cruciate ligament reconstruction: a large database study.Arthrosc Sports Med Rehabil. 2021;3(6):e1827-34. doi:10.1016/j.asmr.2021.08.010Johns Hopkins Medicine.Sparing the growth plate in ACL reconstruction.Sonnery-Cottet B, Panisset JC, Colombet P, et al.Partial ACL reconstruction with preservation of the posterolateral bundle.Orthop Traumatol Surg Res. 2012;98(8):S165-70. doi:10.1016/j.otsr.2012.10.001Carulli C, Innocenti M, Roselli G,et al.Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction.J Orthop Traumatol.2020;21(1):1-9 doi:10.1186/s10195-020-0544-0American Academy of Orthopedic Surgeons.ACL injury: does it require surgery?American Academy of Orthopaedic Surgeons.Anterior cruciate ligament (ACL) injuries.

8 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Filbay SR, Grindem H.Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture.Best Pract Res Clin Rheumatol. 2019;33(1):33-47. doi:10.1016/j.berh.2019.01.018.Panisset JC, Gonzalez JF, de Lavigne C, et al.ACL reconstruction in over-50 year-olds: comparative study between prospective series of over-50 year-old and under-40 year-old patients.Orthop Traumatol Surg Res. 2019;105(8):S259-65. doi:10.1016/j.otsr.2019.09.009Salesky MA, Oeding JF, Zhang AL, Ma CB, Feeley BT, Lansdown DA.Patients aged 50 years and older have greater complication rates after anterior cruciate ligament reconstruction: a large database study.Arthrosc Sports Med Rehabil. 2021;3(6):e1827-34. doi:10.1016/j.asmr.2021.08.010Johns Hopkins Medicine.Sparing the growth plate in ACL reconstruction.Sonnery-Cottet B, Panisset JC, Colombet P, et al.Partial ACL reconstruction with preservation of the posterolateral bundle.Orthop Traumatol Surg Res. 2012;98(8):S165-70. doi:10.1016/j.otsr.2012.10.001Carulli C, Innocenti M, Roselli G,et al.Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction.J Orthop Traumatol.2020;21(1):1-9 doi:10.1186/s10195-020-0544-0American Academy of Orthopedic Surgeons.ACL injury: does it require surgery?American Academy of Orthopaedic Surgeons.Anterior cruciate ligament (ACL) injuries.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Filbay SR, Grindem H.Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture.Best Pract Res Clin Rheumatol. 2019;33(1):33-47. doi:10.1016/j.berh.2019.01.018.Panisset JC, Gonzalez JF, de Lavigne C, et al.ACL reconstruction in over-50 year-olds: comparative study between prospective series of over-50 year-old and under-40 year-old patients.Orthop Traumatol Surg Res. 2019;105(8):S259-65. doi:10.1016/j.otsr.2019.09.009Salesky MA, Oeding JF, Zhang AL, Ma CB, Feeley BT, Lansdown DA.Patients aged 50 years and older have greater complication rates after anterior cruciate ligament reconstruction: a large database study.Arthrosc Sports Med Rehabil. 2021;3(6):e1827-34. doi:10.1016/j.asmr.2021.08.010Johns Hopkins Medicine.Sparing the growth plate in ACL reconstruction.Sonnery-Cottet B, Panisset JC, Colombet P, et al.Partial ACL reconstruction with preservation of the posterolateral bundle.Orthop Traumatol Surg Res. 2012;98(8):S165-70. doi:10.1016/j.otsr.2012.10.001Carulli C, Innocenti M, Roselli G,et al.Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction.J Orthop Traumatol.2020;21(1):1-9 doi:10.1186/s10195-020-0544-0American Academy of Orthopedic Surgeons.ACL injury: does it require surgery?American Academy of Orthopaedic Surgeons.Anterior cruciate ligament (ACL) injuries.

Filbay SR, Grindem H.Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture.Best Pract Res Clin Rheumatol. 2019;33(1):33-47. doi:10.1016/j.berh.2019.01.018.

Panisset JC, Gonzalez JF, de Lavigne C, et al.ACL reconstruction in over-50 year-olds: comparative study between prospective series of over-50 year-old and under-40 year-old patients.Orthop Traumatol Surg Res. 2019;105(8):S259-65. doi:10.1016/j.otsr.2019.09.009

Salesky MA, Oeding JF, Zhang AL, Ma CB, Feeley BT, Lansdown DA.Patients aged 50 years and older have greater complication rates after anterior cruciate ligament reconstruction: a large database study.Arthrosc Sports Med Rehabil. 2021;3(6):e1827-34. doi:10.1016/j.asmr.2021.08.010

Johns Hopkins Medicine.Sparing the growth plate in ACL reconstruction.

Sonnery-Cottet B, Panisset JC, Colombet P, et al.Partial ACL reconstruction with preservation of the posterolateral bundle.Orthop Traumatol Surg Res. 2012;98(8):S165-70. doi:10.1016/j.otsr.2012.10.001

Carulli C, Innocenti M, Roselli G,et al.Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction.J Orthop Traumatol.2020;21(1):1-9 doi:10.1186/s10195-020-0544-0

American Academy of Orthopedic Surgeons.ACL injury: does it require surgery?

American Academy of Orthopaedic Surgeons.Anterior cruciate ligament (ACL) injuries.

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