On an MRI, they found a rupture of the anterior cruciate ligament. The orthopedist I consulted with said that I should have surgery and have a new ligament (made from tendons) put in. My knee only hurts when I squat or kneel for a long time. I read in one of your articles that surgery is not always necessary when this ligament tears. What do you advise me?

Patients with a rupture of the anterior cruciate ligament are divided into two large age groups. The first group consists of young people up to 30 years old, for whom we recommend surgery regardless of their current condition. Prolonged knee instability resulting from the lack of this important ligament almost inevitably leads to degenerative changes, and if they occur very early in life, their consequences can be such that treatment is difficult, requiring multiple surgical procedures and prolonged rehabilitation. The second group consists of patients aged 40 and older, for whom the most important question is not whether they have the ligament, but whether they have episodes of instability in their daily or sports activities. This condition is called manifest instability, and those who have it know that it significantly reduces their quality of life, so surgery is advisable for them. If such manifest instability is not present, it is possible to live entirely normally without surgical intervention, with appropriate exercise. Patients between 30 and 40 years of age are subject to an individual approach, and the decision is made on a case-by-case basis, with an important consideration being the type of sport the patient engages in. If it involves sudden changes of direction at full speed, or if it is a contact sport (soccer, skiing, basketball, tennis…), surgical stabilization would be advisable.

I myself lost my anterior cruciate ligament during an indoor soccer game when I was 37 years old. Since I can do without soccer, and satisfactory physical activity includes running and the gym, I was not operated on, I exercise regularly, and to this day I have no significant problems with that knee. If soccer were my passion, without which I couldn’t live, the outcome would be different.