A Surgeon’s Perspective on Lindsey Vonn’s ACL Tear

As an orthopedic surgeon, lifelong athlete and coach, I completely understand Lindsey Vonn’s decision to compete in the Olympics, even with an ACL tear. Once you’ve competed at her level, that drive never leaves you. The chance to take part in a once-in-a-lifetime experience can outweigh a lot of the medical caution we typically advise.

Competing with a torn, unreconstructed ACL is biomechanically possible, but it comes with meaningful risk and performance limitations. I appreciate Vonn’s transparency. Many athletes compete injured without revealing the extent of their malady.

In an elite alpine skier like Lindsey Vonn, whose neuromuscular control, strength and experience are extraordinary, racing without an ACL can be feasible in ways it would not be for most athletes. Downhill skiing, while incredibly fast and demanding, involves more predictable movement patterns than cutting and pivoting sports such as soccer or basketball, where ACL deficiency is far less tolerable.

However, an ACL-deficient knee must rely heavily on secondary stabilizers — the meniscus, articular cartilage, surrounding musculature and proprioceptive control — to maintain stability at high speeds. This compensation significantly increases the risk of meniscal and cartilage injury. Unlike ligament damage, these structures do not regenerate well, and injury to them can permanently shorten the functional lifespan of the joint and accelerate degenerative arthritis.

“I’d give her the go with serious bracing and realistic expectations.”

With serious functional bracing, careful preparation and very realistic expectations, I would give her the go-ahead. This isn’t about pretending the knee is normal, it’s about managing the risk intelligently so she can make an informed choice.

This makes Vonn’s choice a calculated, informed risk, but not a low-risk one.

“If she has to live with a lifelong knee issue, she’ll also have the Olympic experience to remember forever. Her decision is a well-informed one, and she is mature enough to evaluate the potential trade-off. That’s what she has chosen.”

The question is not whether she can race. The question is whether she is willing to knowingly accept the potential long-term cost to her knee in pursuit of a lifelong dream.

Once an athlete, always an athlete. That level of passion and competitiveness can overcome a lot of obstacles - including injury.

About Dr. Myra Trivellas

Dr. Trivellas is an orthopedic sports medicine surgeon who specializes in treatment of shoulder, knee, and hip conditions and injuries at Hoag Orthopedic Institute (HOI). Dr. Trivellas played Division 1 lacrosse at Yale for four years and is still an active lacrosse coach. She attended Pennsylvania State College of Medicine. Dr. Trivellas performed an additional year of research at the Hospital for Special Surgery (HSS) in New York prior to her residency in Orthopedic Surgery at UCLA. Dr. Trivellas completed her fellowship in Orthopedic Sports Medicine & Shoulder Surgery at Duke University, where she provided medical treatment to the Duke Football, Men’s Basketball, and Women’s lacrosse teams.