I am 49 years old and tore the anterior cruciate ligament in my left knee while snow skiing. Two years ago, my older brother, who was 48 at the time, tore his ACL. He was not offered the option of surgical repair. He was told to strengthen his thigh muscles and to quit sports. I have great concern about following in his footsteps. I am active and love sports. Can surgery be done at my age?

The anterior cruciate ligament, or ACL, is an important stabilizing structure in your knee for sports such as skiing and tennis. In the past, when an ACL tear occurred at your age, nonsurgical treatment was advised. This included avoiding sports that require pivoting and abrupt changes in direction, utilizing a brace for athletic activity and physical therapy. Without this ligament, instability and knee buckling can result. Buckling episodes, where the knee gives way, have the potential for causing further injury to the knee joint. In time, arthritis also can develop. A brace can offer some prevention against instability and buckling. Arthroscopic surgery can restore stability to your knee by reconstructing the anterior cruciate ligament. Age is a consideration, but a relatively minor factor in the decision-making process. If you are healthy, with few arthritic changes in your knee, and have a desire to continue sports but cannot because of your instability, surgery should be considered. Each case needs to be evaluated individually.