ACL Tear Treatment in Miami
An anterior cruciate ligament (ACL) tear is a common knee injury that can cause pain, swelling, and a feeling of instability. The ACL is one of the primary ligaments that stabilizes the knee during cutting, pivoting, and sudden directional changes. ACL injuries can occur during sports, exercise, or everyday activities involving twisting or abrupt movements.
At our Miami clinic, we provide a comprehensive, non-surgical approach to ACL tear treatment focused on accurate diagnosis, restoring knee stability, reducing symptoms, and helping patients return to activity while avoiding unnecessary surgery whenever possible.
What Is an ACL Tear?
The ACL is located in the center of the knee joint and helps prevent excessive forward movement and rotational instability of the tibia relative to the femur.
ACL injuries may range from:
- Partial tears, where some ligament fibers remain intact
- Complete tears, where the ligament is fully disrupted
Not all ACL tears require surgery, particularly in patients without significant instability or high athletic demands.
Symptoms of an ACL Tear
Symptoms of an ACL tear may vary depending on severity and activity level. Common symptoms include:
- Knee pain at the time of injury or afterward
- Swelling, often within the first 24 hours
- A feeling of knee instability or “giving way”
- Difficulty with pivoting, cutting, or sudden movements
- Reduced confidence in the knee during activity
- Limited range of motion in some cases
Some patients with partial tears may have subtle or intermittent symptoms.
Common Causes and Risk Factors
ACL tears commonly occur due to:
- Sudden pivoting or twisting movements
- Rapid deceleration or change in direction
- Landing awkwardly from a jump
- Sports such as soccer, basketball, skiing, or football
- Prior knee injury or instability
Non-contact injuries are a frequent cause of ACL tears.
Evaluation of an ACL Tear
Accurate diagnosis requires correlating symptoms with physical examination findings and imaging results. Evaluation typically includes:
- Detailed history and injury mechanism review
- Physical examination assessing knee stability and ligament integrity
- Gait and functional movement assessment
- Review of prior imaging
- MRI of the knee when clinically indicated which may also show concomitant meniscus tear
Imaging findings are interpreted alongside symptoms, as MRI abnormalities do not always predict functional limitation.
Non-Surgical Treatment Options for ACL Tears
Many patients with ACL tears — especially partial tears or low-demand individuals — can be managed successfully without surgery.
Physical Therapy and Rehabilitation
Physical therapy is a cornerstone of non-surgical treatment and may focus on:
- Strengthening the quadriceps, hamstrings, and hip musculature
- Improving neuromuscular control and knee stability
- Restoring range of motion
- Gradual return to activity
Rehabilitation programs are individualized based on goals and activity demands.
Activity Modification and Bracing
Treatment may include:
- Temporary modification of sports or high-risk activities
- Functional knee bracing in select cases
- Progressive return to activity based on stability and confidence
These strategies help reduce reinjury risk.
Medication Management
Medications may be used to help manage pain and swelling and may include:
- Anti-inflammatory medications
- Pain-relieving medications when appropriate
Medications are used to support rehabilitation, not replace it.
Image-Guided Injections for ACL-Related Knee Pain
In select cases, injections may be considered to help manage knee pain or inflammation associated with ACL injury:
- Intra-articular knee injections
These procedures are typically performed using image guidance to improve accuracy and safety.
Biologic and Regenerative Treatment Considerations
In certain situations, biologic therapies such as platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) which contains stem cells may be discussed as part of a comprehensive, non-surgical treatment strategy. These therapies are intended to support the joint environment and surrounding tissues rather than replace or reconstruct a torn ligament.
Bone Marrow–Derived Therapies for ACL Injuries
In select patients, bone marrow–derived therapies may be discussed as part of a comprehensive, non-surgical treatment strategy for ACL injuries.
Bone marrow contains a variety of cells and biologic factors that may help support the joint environment and surrounding tissues. When used appropriately, bone marrow–derived treatments are intended to address inflammation, joint health, and functional limitations rather than reconstruct or replace a torn ligament.
These therapies may be considered in cases such as:
- Partial ACL tears
- ACL injuries without significant instability
- Patients seeking non-surgical management
- Individuals aiming to delay or avoid surgical reconstruction
Careful patient selection is essential. Treatment decisions are based on clinical examination, imaging findings, knee stability, activity level, and individual goals.
It is important to understand that bone marrow–derived therapies are not a substitute for ACL reconstruction in patients with severe instability or high-demand athletic requirements. Outcomes vary, and these treatments are used as part of a broader, individualized care plan.
When Is Surgery Considered for an ACL Tear?
Surgical reconstruction may be considered when:
- There is complete rupture of ACL and its connective tissue sheath
- There is significant knee instability
- The patient desires to return to high-demand pivoting sports
- Symptoms persist despite structured rehabilitation
Many patients are able to manage ACL injuries without surgery, particularly when instability is minimal. It is important to note that there is increasing evidence that surgery can be delayed without any long term effect on the results of surgery, so patients who choose to trial a non-surgical approach first can still benefit from surgery if it does not go as planned.
Who Is a Good Candidate for Non-Surgical ACL Tear Treatment?
You may be a good candidate for a non-surgical approach if you:
- Have a partial ACL tear or stable knee
- Do not experience frequent giving-way episodes
- Prefer a non-surgical approach
- Are willing to participate in rehabilitation
Treatment plans are individualized based on knee stability, activity level, and long-term goals. One study of ACL repair versus rehabilitation with option for subsequent repair showed that 50% of patients who underwent early rehabilitation did not require ACL repair at 2 year follow up!
Frequently Asked Questions
Will I need surgery for an ACL tear?
Surgery for an ACL tear depends on the patient and the degree of the tear. Often, surgery is recommended, but it is not always required even in the case of more extensive ACL tears. Surgery may also help prevent the early developement of knee osteoarthritis.
Is regenerative medicine safe?
When performed by trained specialists using your own biologic materials, regenerative procedures are generally considered safe and may support healing processes. These procedures should always be performed with imaging guidance like ultrasound and fluoroscopy to target very specific structures in or around the knee joint.
How long does recovery take?
Recovery times vary by condition and treatment. Rehabilitation and regenerative care may take weeks to months for optimal improvement.
Is imaging necessary?
Imaging studies like MRI can be very useful in the diagnosis of an ACL tear and to help determine the best plan of care.
Schedule an Appointment
If you are experiencing an ACL tear (or other Orthopedic condition) and want a comprehensive evaluation and non-surgical treatment plan, we are here to help. Contact our Miami clinic to schedule an appointment.