Factors that increase risk of arthritis include severity of the initial injury, injury to other structures in the knee, and level of activity following treatment. Not repairing tears to the ACL can sometimes cause damage to the cartilage inside the knee because with the torn ACL, the tibia and femur bone are more likely to rub against each other.Unfortunately, young female athletes have a significant risk of re-tearing an ACL graft, or tearing the ACL on the other knee after their recovery. This risk has been recorded as being nearly 1 out of every 4 young athletes. Therefore, athletes should be screened for any neuromuscular deficit (i.e. weakness greater in one leg than another, or incorrect landing form) before returning to sport. Epidemiology
There are around 200,000 ACL tears each year in the United States. ACL tears newly occur in about 69 per 100,000 per year with rates in males of 82 per 100,000 and females of 59 per 100,000. When breaking down rates based on age and sex, females between the ages of 14-18 had the highest rates of injury with 227.6 per 100,000. Males between the ages of 19-24 had the highest rates of injury with 241 per 100,000. Sports
Rates of re-rupture among college athletes were highest in male football players with 15 per 10,000, followed by female gymnasts with 8 per 10,000 and female soccer players with 5.2 per 10,000.High school athletes are at increased risk for ACL tears when compared to non-athletes.
There is evidence that engaging in neuromuscular training (NMT), which focus on hamstring strengthening, balance, and overall stability to reduce risk of injury by enhancing movement patterns during high risk movements. Such programs are beneficial for all athletes, particularly adolescent female athletes.Injury prevention programs (IPPs), are reliable in reducing the risk factors of ACL inquiries, referring to dominance theories. The ligament dominance theory reduced peak knee abduction moment but should be more focused on prioritizing individualized, task-specific exercises focusing on an athletes risk profile. It is more beneficial than a generic program. There is an increase in hip and knee flexion angles, such as plyometrics and jump-landing tasks, which reduces the risk of quadriceps dominance. However, there were no changes found for peak vGRF, which measures for "softer" landings. Unfortunately, there was no conclusive data on how IPPs reduces the risk associated with leg dominance theory. Treatment
Treatment for ACL tears is important to:
Reduce abnormal knee movements and improve knee function
Build trust and confidence to use the knee normally again
Prevent further injury to the knee and reduce the risk of osteoarthritis
Optimise long-term quality of life following the injury

Nonsurgical
Nonsurgical treatment for ACL rupture involves progressive, structured rehabilitation that aims to restore muscle strength, dynamic knee control and psychological confidence. For some, the ACL may heal without surgery during the rehabilitation process (i.e. the torn pieces re-unite to form a functional ligament).The purpose of exercise treatment is to restore the normal functioning of the muscular and balance system around the knee.