After an ACL (anterior cruciate) injury, for patients with lower athletic demands or mild instability, activity modification may be an appropriate treatment choice.
By eliminating "at risk sports" such as soccer, basketball, or skiing the patient may be able to eliminate their feeling of instability. However many patients, regardless of age, are unwilling to give up their recreational interests.
They may have instability of the knee, even with "low risk" sports or with activities of daily living. An aggressive physical therapy program emphasizing strengthening of the quadriceps and hamstring muscles can frequently reduce such episodes of instability. It is also very important to maintain knee extension, the ability to straighten the knee completely. These patients will often utilize knee braces upon return to vigorous exercise.
Advantages of this type of conservative management plan include a decreased time to return to athletics and a less intense rehabilitation program then required for surgical repair, while allowing for the option of surgery if it becomes necessary.
Disadvantages include permanent brace wear use when highly active, risk of re-injury, chronic instability, often an inability to return to previous level of play, and an increased potential for further injury such as cartilage (meniscus) tears and possible early arthritis.