Thanks for this comprehensive explanation. When plenty of people will adamantly, anecdotally insist on healing ACL one way, you’ve cut through the BS with research. Much appreciated!
Tore mine in 1984 racing MX. Never got it repaired. It was unstable and did do damage to cartilage eventually. I used to run on it for 10 yrs till the early 90’s Eventually i started Mountain Bike racing.Stability was better as my muscles got stronger. In 2022 after no.9 operation i eventually had to have a replacement due to having Bone on Bone arthritis for 8 years(Still cycling). So now my knee is great and i still MTB and Cycle many miles. I was told that my knee would have worn out earlier if i had my ACL Replaced at the time as it would have put more stress on the Cartilage once the Meniscus had disintegrated. Sorry about the epic story. 😊
I have partial acl tear and medial miniscus tear, its been 6 weeks and i started physio 10 days ago should i try conservative first? Im not going into sports just want normal day activities to go on
Yes, conservative is usually the best first option if you don't want to get back to high impact twisting sports. Your physio will assess your progress after 6 weeks and be in a better place to advise if you stick to conservative or should consider surgery.
My left knee injury was worse than the right side but i tore both ACL and MCL in both knees 4 months ago. I’m very active 60 years old. I’m devastated. My knees are not hundred percent stable, but I am still going to wait and see. At the moment I am doing my own strengthening exercises. I Purchased BFR training bands. I am fighting to save myself from going under surgery and dealing with a long rehab.
I tore my ACL partially and done a rehab without surgery. its been 6 months since the injury but still I can observe that my knee is swollen. I am able to walk, climb stairs. Can you suggest why swelling is still there?
Knee swelling can take a very long time to go away - if you're functioning without pain and things are getting better in general, it is usually just part of the normal healing and will go eventually.
It’s been four months since my first MRI reports that showed I tore both my ACL and MCL both knees in ski accident. I really want to get another MRI but my doctor is resisting to give me a prescription. In your opinion when is a good time to do the second MRI to see if there was any progress or not.? I have chosen to go without Surgery .
We usually don't do a second MRI unless the patient isn't progressing. The reason being that the knee can regain full stable function even if the ACL does not look pristine. So at this point it is about whether or not your physical tests that your doctor do are stable and you're progressing with your rehab. An MRI won't add anything to making decisions for treatment hence why your doctor is reluctant to get one.
Hi , i have recently begun the journey of healing conservatively in the hopes of returning to a high level pivoting sport. i have a ruptured ACL + Lateral Meniscus tear. its been roughly 4 weeks since the Injury. in your opinion do you think this is a good option to try to heal naturally and return to this kind of sport ?
The research seems to suggest that surgery is the better option if you have a meniscus tear + ACL tear. But there are always exceptions to the rule and there usually isn't any harm in first trying rehab and seeing how far you get with that.
Sis i have grade 2 lateral meniscus tear and lcl strain with mild buckle I have no problem while walking and straight running even side running But the mild buckle is still there please suggest me
If by buckle you mean it feels unstable then it sounds like you need rehab for the LCL strain - you can find information about the rehab in this playlist: ru-vid.com/group/PLkRW4ITRa6bAQBWyt4wVRMh1bpFIjzwi-
Thanks a lot for all these clarifications. My question is whether an ACL tear requires surgery has also to do with the grade of the tear? For example, I wonder if a grade 1 ACL tear would require surgery or it can simply be controlled through a serious rehab program?
There are cases of full tears being managed successfully through rehab, so the grade does not seem to be the main thing that affect the decision. But I would say that for a grade 1 I would always do rehab for my first option of treatment as it is very likely to not need any surgery.
this may not belong here, but none of my doctors seem to care that my knee started bruising in the joint space without trauma. I have one large and one medium chobdral defect in both the lateral and medial facets of the patellar joint and I’m being denied a partial knee replacement because "I'm too young" so I’m pushing through it to make it worse so doctors take me seriously and it started bruising while swimming no impact. Can I push through that? It's messing up my entire pt routine and life so I need help and not age discrimination.
First, you need to make sure that you've really given physiotherapy a good chance - physiotherapy can't work if you continue to push into pain and aggravate it - you have to first calm the pain down and then slowly build your strength back up. The reason doctors often advise against surgery is because for many situation it doesn't really make a big difference - so it can be also due to that reason. However, if you feel that you have given your knee a fair chance at rehab and it is not responding, then I think you need to get a second opinion from a different doctor and really explain the emotional and physical impact of this.
@@SportsInjuryPhysio Thank you for your reply. I was in physical therapy for a year for my knee, but I have a large chondral defect on the medial facet of the patella and a medium cartilage flap on the lateral facet of the patella. I have gotten multiple surgical opinions for MACI and was told I am not a candidate due to the global cartilage loss. I cannot walk any distance on the right knee. I can't do my PT for my hip well (it's also bone on bone after not being taken seriously for nine years for a torn hip labrum that was causing debilitating pain and now has global cartilage loss) and the knee impairing my swimming as well. I cannot use stairs and it hurts to use the brakes in my car. Doctors don’t take me seriously in the United States because of my age and half of them won't accept my secondary insurance and won't let me pay the difference after my primary insurance. The doctors I have seen dismiss my pain and lack of quality of life. I've tried PRP injections to help lower the inflammation as well as Gel One and Supartz injections, had one scope to debride the initial chondral defect. The original surgeon didn't take x rays so he missed my patella alta and refused to do the MACI surgery until I had a genetic test for ehlers Danlos (doesn't exist) and I got generalized genetic testing for connective tissue disorders, which came back negative. By the time we reviewed my case the cartilage loss expanded. The patella alta is the cause of my bilateral knee pain/chondromalacia patella and cartilage loss. My left knee has a near full thickness fissure in the medial facet of the patella which I was told won't be helped with a tibial tubercle osteotomy either so I feel like I have no options except for nerve ablation but that is off-putting because it’s not curative. I cannot work because of the pain I am in and I want to be able to finish school and go to work and I was told I need a partial knee replacement but all the surgeons I’m seeing tell me I’m too young and they don’t care that I have no life and no quality of life. So I figured just push through the pain and keep making it worse until someone takes me seriously. I I have a new MRI ordered after the right knee started bruising without trauma, during swimming. I believe there was mechanical trauma perhaps because I did not hit it on anything and it was swollen for 48 hours so I am not sure what happened but I can only assume that I ripped one of the flaps off the bone again. The American healthcare system only cares about those with money and is not based around preventative care. I am extremely frustrated and in horrible pain. Ice is nice but cartilage won't regrow.
