Active Conservative (Nonsurgical) Treatment of Acute ACL Injury

The treatment of an anterior cruciate ligament injury requires either conservative or surgical treatment, depending on the extent of the injury, the degree of damage to the cruciate ligament, and the stage of injury. Active conservative treatment involves immobilizing the knee in a long-leg or cylindrical cast at 10–20° of flexion for 2–3 weeks, followed by wearing an ACL brace for 4–6 weeks. This approach is suitable for young, active patients who are highly cooperative. If the ACL is not severely damaged and anterior instability is isolated, the injury is acute with Lachman grade 1 instability (a 2–5 mm difference side-to-side). During cast immobilization, swelling subsides. Then, inside the cast, the patient’s tiny leg movements will happen, and the cast will need to be changed, usually weekly. The doctor should also recommend that the patient do QSE and SLR exercises to reduce thigh muscle atrophy. Another method is muscle-strengthening exercises and rehabilitation treatment to help the patient return to their pre-injury state quickly, improving knee joint function and building up functional activity after an ACL injury.