Purpose: To document healing of the anterior cruciate ligament

Introduction: Conventional wisdom holds that the anterior cruciate ligament (ACL) does not heal. In an athlete the ACL deficient knee is likely to be symptomatic and lead to functional instability. This has led to the belief that all ACL tears in the active athlete require reconstruction. Some ACL tears in recreational athletes are successfully treated conservatively with activity modification and bracing. A literature search was performed which found three articles on ACL healing. These articles felt that complete ACL tears could heal if patients were properly braced and rehabilitated.

Materials and Methods: At the Carleton University Sports Medicine Clinic we retrospectively reviewed ACL tears diagnosed by the Lachman, pivot shift, and KT-1000 arthrometer testing. We then examined those whose clinical exam became stable by the same three tests. The latest follow up exam was performed by the same examiner (P.P). At the follow up exam, knee function was evaluated with the expanded IKDC form.

Results: Nine patients were found to be asymptomatic and stable after an initial diagnosis of an ACL tear. In follow up the Lachman test had a good endpoint, the pivot shift was normal and the KT – 1000 manual max was less than 3mm. The IKDC results showed 3/9 were grade A, 5/9 were grade B and 1/9 was grade C.

The clinical implication: ACL tears should be treated initially conservatively since in a small percentage of patients, the ACL tear can heal.