Surgery is elective. Ligament and cartilage tears are not lifethreatening but they have to do with quality of life type issues.
There are individuals that can live a fine life without an ACL. However, most of these individuals wind up changing their lifestyles and avoid active sports or activities that require side to side and twisting type movements. Even so, there are some individuals that may experience additional wear and tear to the knee (cartilage) surfaces because of the inherent looseness in their knee. Other individuals may just find that daily life is not comfortable because the knee just feels unstable to them or they actually experience additional knee events/giving way episodes.
Cartilage tears sometimes require surgery regardless of the condition of the ligaments. A bucket tear can have a flap that sticks out and causes additional cartilage surface irritation and discomfort. Some cartilage tears are relatively minor and an OS may take a wait and see attitude regarding it. However, if the discomfort does not go away or seems to always come back with just a little bit of increased activity - Then surgery is necessary to repair or cut out the cartilage deficiency.
Those that have a severed ACL - An ACL reconstruction is not really age related. It is for active individuals regardless of age. I was 49 yrs old when I had my reconstruction and there are others that I know that were well into their 50s. If you are acitve and want to continue to be so - Then it should be considered.
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