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How to manage a ACL (anterior cruciate ligament) tear?

Q: Recently in a minor accident while playing cricket, I twisted my leg at the right knee joint. There extract of the MRI report is as fallows: MR Image morphology of the right knee reveals: 1. Complete tear of the Anterior Cruciate Ligament with surrounding edema. 2. Small area of bone contusion in the lateral femoral condyle; moderate knee joint effusion. Please advise what course of action is required. If this has to be rectified by surgery. If so where best it can be done in India? How long is the recovery process? If surgery is not done, what are setbacks and can these be avoided? My age is 37 years. In addition I have a slip disc problem with 3 discs bulged out (L3-L4, L4-L5 & L5-S1). Will this further agrivate my back problem?

A:ACL (anterior cruciate ligament) is an important knee stabilizer. If it is torn, there is no way it can be repaired. It has to be reconstructed. There are many ways of doing it. Arthroscopic assisted surgery gives a good result with minimal morbidity. Meanwhile, till the surgery, you have to start physical therapy to increase range of motion of the knee and strengthen your quadriceps (thigh) muscles. You are young and you should get operated. Older patients can do without a surgery due to decreased functional demand. If a young patient is not operated for ACL tear, the knee cartilage may get destroyed in the long run. Big cities would have centres which have arthroscopic facilities, and surgery can be performed there. Recovery is quick but physical therapy is a must.


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