ACL Tear: Does It Requires Surgery?

A frequent injury we see in Pennsylvania (PA) workers’ compensation cases is a tear of the anterior cruciate ligament (ACL) in the knee of the injured worker. In the past, this type of injury automatically required extensive reconstructive surgery to repair the tear. Recently, the website for Andrews Institute for Orthopaedics & Sports Medicine referenced a study performed on skiers, which showed that about 25% of those patients with a torn ACL can avoid surgery, instead just rehabilitating the knee with physical therapy. Dr. James Andrews serves as orthopedic consultant for many college and professional sports teams.

The ACL is one of four ligaments in the knee. The others are medial collateral ligament (MCL), lateral collateral ligament (LCL) and posterior cruciate ligament (PCL). The main function of the ACL is to prevent the shin bone from sliding out in front of the thigh bone. When this ligament is torn, the injured ACL is less able to control knee movement, and the bones are more likely to rub against each other. This can damage adjacent structures and can lead to osteoarthritis in the knee.

Since having surgery for a torn ACL may expose an injured worker to an unnecessary major operation, but waiting too long can cause damage to other parts of the knee and lead to a chronic debilitating condition, there is a need for quality medical treatment in the weeks after the work injury.

How long should an injured worker wait to see if surgery will be necessary? According to Dr. Robert Marx, an orthopedic surgeon in the Sports Medicine and Shoulder Service at the Hospital for Special Surgery in New York City who led the study, unless there is damage to other ligaments or parts of the knee, an injured worker should “wait and be reevaluated at six to 12 weeks unless there is some other obvious reason to do surgery…”

A recent study found knee surgery as effective as a sugar pill. A recent study in the New England Journal of Medicine revealed that arthroscopic partial meniscectomy knee surgery may actually be ineffective in reducing knee pain. According to the study, knee pain is the primary reason a patient decides to have knee surgery. In the study, ½ of the patients had the actual surgery, the other ½ only had incisions made. The patients did not know whether they had the real surgery or not. Both sets of patients reported an almost identical improvement in pain and mechanical function .What really turned out interesting is that almost all the patients who went through the fake knee surgery reported improvements in pain and knee function nearly the same as those who had the procedure. On a 100 point pain scale, both groups reported improvements with pain around 20 to 30 points. The two groups also reported high satisfaction on their real or faked procedures, and most also said they would do the surgery again.

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An employee who suffers a work injury is entitled to receive workers’ compensation benefits. Under the Pennsylvania Workers’ Compensation Act, the employer is required to have workers’ compensation insurance and you are entitled to prompt payment of medical bills related to the work injury, along with compensation for loss of income and/or loss of use of hearing, vision, and most extremities. An injured worker is entitled to these benefits regardless of who is at fault for the injury and regardless of any pre-existing condition. A Pennsylvania workers’ compensation attorney at Calhoon and Kaminsky P.C., can help determine if you are entitled to Pennsylvania workers’ compensation benefits or receiving inadequate benefits by the workers’ compensation insurance company or employer. Call Calhoon and Kaminsky P.C., at (877) 291-9675 for a FREE, confidential and prompt consultation with one of our attorneys with a proven track record of success. We also offer free workers’ comp legal case management. To order your free Book “Seven Deadly Sins That Can Destroy Your Pennsylvania Workers’ Compensation Case”, go to and fill out the complimentary free book request or you can order it through