Can the ACL Spontaneously Heal After Rupture?
Yes, it can. But it's a highly debated topic.
Historically, it's believed that ACL healing is impeded by 2 main biological factors:
1) Inability of blood clots to form during the initial phase of healing that results in a lack of scaffolding between the 2 ruptured end-points
2) Layer of synovial tissue forming over the ruptured ACL end points impeding tissue healing.
However these 2 full text papers are showing the potential for the ACL to spontaneously heal (in some people) without surgery.
The problem is though we don't know with great confidence yet who these people are (old vs young, males vs females), what sub-type of ACL tear that is more likely to heal (proximal tears vs mid-substance years), or what chance someone has of healing (?1% ?5%, ?15% chance) or whether bracing the knee post injury +/- specific rehab has a direct influence on the chance of healing.
I was lucky enough to discuss this very interesting sub-topic of ACL injury with Sports and Exercise Physician Dr Louise Tulloh and Orthopaedic Surgeon Dr Tim Musgrove.
If you're interested in watching this 1hr interview, simply click here and scroll down to episode 4.
If you're interested in learning more about ACL rehab, consider signing up to Learn.Physio online ACL Masterclasses here