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Is surgery necessary for a ligament tear?

Thursday, 24 September 2009
Answered by: Dr Mathew Varghese
Head, Department of Orthopaedics, St. Stephens Hospital, New Delhi
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Q. I am a 24 years old man who had a ligament tear in the right knee about 1.5 years back. Though I can walk properly and can run slowly but cannot run hard because if I do so my knee buckle and I fall down. I have not had a surgery till now because I am studying and cannot take rest. I don’t have pain or swelling. Can I go for the surgery later? What is the total cost of the treatment?

A.  You have not mentioned which ligament is torn. If it is anterior cruciate ligament injury, which is a usual case, then you can usually buy time with exercises. Static or isometric exercises for the quadriceps can be learned from any physiotherapist and as long as you are not stressing your knee you can manage very well without surgery. In fact, up to the 1980’s a ligament tear of the knee was treated conservatively with exercises.

The need for surgery depends on the activity of the patient and the demands that he needs to put on his knee. If you have a sedentary life you may be able to manage. However, recurrent falls, recurrent instabilities may make you vulnerable for early degeneration of the knee, and in such situations it is wiser to get operated.

In your case, you are young have a long life ahead and you will be active for quite some years more. You can plan for surgery at a convenient time of your choice; till that time be regular with exercises.

The cost of surgery depends on where you are getting it done and which technique the surgeon uses. If it is reconstruction using endobuttons and special screws then the cost would be about Rs.15,000/- for the implants alone. Hospital costs would be additional. In an average hospital it would cost between Rs.25,000/- and Rs.45,000/-. In Government hospitals you need to pay only for the implants. In case the surgeon does not use this technique then this cost can also be eliminated.

A.  You have not mentioned which ligament is torn. If it is anterior cruciate ligament injury, which is a usual case, then you can usually buy time with exercises. Static or isometric exercises for the quadriceps can be learned from any physiotherapist and as long as you are not stressing your knee you can manage very well without surgery. In fact, up to the 1980’s a ligament tear of the knee was treated conservatively with exercises.

The need for surgery depends on the activity of the patient and the demands that he needs to put on his knee. If you have a sedentary life you may be able to manage. However, recurrent falls, recurrent instabilities may make you vulnerable for early degeneration of the knee, and in such situations it is wiser to get operated.

In your case, you are young have a long life ahead and you will be active for quite some years more. You can plan for surgery at a convenient time of your choice; till that time be regular with exercises.

The cost of surgery depends on where you are getting it done and which technique the surgeon uses. If it is reconstruction using endobuttons and special screws then the cost would be about Rs.15,000/- for the implants alone. Hospital costs would be additional. In an average hospital it would cost between Rs.25,000/- and Rs.45,000/-. In Government hospitals you need to pay only for the implants. In case the surgeon does not use this technique then this cost can also be eliminated.

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