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Ask the Expert: Dr. Robert Marx, Orthopedic Surgeon, Answers Your Questions on ACL Injuries

Conceptual Human Man Anatomy

Do I really need to have surgery for my torn ACL?
Patients with a torn ACL who participate in cutting and pivoting sports such as basketball, soccer and football have a very high chance of developing knee instability and giving way without surgery. This often leads to cartilage and meniscus damage. For older, more sedentary patients who are not participating in such sports, non-operative treatment may be an option. If they develop symptoms of instability that are not tolerable, surgery can be performed at that point.

Do you use an allograft or autograft femoral fixation?
Interference screws are used most commonly; however there are many devices available for graft fixation.

How much stronger are patellar tendon bone grafts than other grafts? How soon before I can return to playing high cutting sports? What do you think about allografts?
Graft selection is controversial. It does not affect time to return to play. Allografts are not recommended for young athletes due to high re-tear rates which have been discovered in recent research. They are more suited to older adults who have less time spend on their recovery and who are generally at lower risk of re-injury due to a lower activity level.

Are ACL injuries different in females verses males?
The injury is the same. However, it is up to six times more common in females.

My son tore his ACL playing high school soccer. How will this affect him later on in life?
Hopefully it won’t. Any patient who tears their ACL is at higher risk of knee arthritis, but it is certainly not a guarantee.

Dr. Robert Marx, HSS sports medicine surgeon

Dr. Robert Marx is an orthopedic surgeon at Hospital for Special Surgery. He does arthroscopic and open procedures for knee and shoulder problems as well as knee and shoulder joint replacement surgery. Dr. Marx also performs complex and revision surgical cases.

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.