Is ACL reconstruction necessary for the knee?
Q: My doctor says that I have a damaged Anterior Cruciate Ligament (ACL) (right knee - around 25 to 30%). I have undergone an arthroscopy and at least the incessant locking of the knee has stopped. I have been doing regular exercises with the help of a physiotherapist. I am now exercising with 3 kg weights with various knee exercises. But because of constant strain on my left knee it is paining badly - the only hope there I have is that there is no locking involved in this pain in the left knee - but I am worried and I dont want to damage the healthy knee in the whole process. I feel that my life is crippled by this whole thing and feel restless. I am a very active person by nature. 1) Do you think, if I continue to exercise at the rate I am doing now, I will be able to resume hectic activities? 2) During the arthoscopic surgery my doctor removed cleaned up infrapatellar plica. Do you think the exercises I am doing will damage this part of my joint? 3) Do you think it is advisable to undergo reconstruction surgery. 4) If I decide to undergo the reconstruction surgery what do you think will be time I will require to recover from that surgery? 5) Will you be able to recommend a reliable specialist in India? 6) What will be the cost of such surgery?
A:If you have a damaged ACL, then the stability of the knee is compromised. A good quadriceps (front of thigh muscle) compensates for most of the function. This is the most important muscle for athletes / sports men. To answer your questions: 1. Though exercises are important, it will not help you to return to your hectic activity. 2. No, it is unlikely that your doing exercises will damage the area of infrapatellar plica. 3. The decision to undergo reconstructive surgery entirely depends on your level of activity. If you wish you return to hectic activity, then you may need an ACL reconstruction. Having said that, the knee function is never as in a normal person. 4. If you had ACL reconstruction then recovery takes from six months to one year after surgery. By then you should be fit enough to be able to get back to your sports activities. 5. I am not sure where you live. There are several very competent arthroscopic knee surgeons who can do the job. I would suggest you contact the general orthopaedic surgeon in your area and seek his guidance for the best surgeon in your area. 6. The cost of the procedure also depend on the type of material used for helping in reconstruction. There are special endo-buttons and other similar devices that are used for reconstruction. These devices are expensive and may cost upto Rs.15,000/- the over all surgery may cost upto Rs.30,000/- to Rs.50,000/-. But, of course, this will depend on the type of hospital chosen by you.