contradicting diagnosis regarding my knee

[mpat]

I am a 50 year old active female.  I took a very bad spill skiing on March 28th at Steamboat.  Saw my first orthopedic after I returned home.  He ordered an MRI which said that I had a nondisplaced fracture of the tibial plateau as well as a partial tear of the ACL.  When I returned for a followup visit the orthopedic disagreed with what the MRI said and does not believe its a tibial fracture but probably bone bruising.  He also believes my ACL is functioning.  Needless to to say that sent me right away for a 2nd opinion. 

The 2nd orthopedic looked at the MRI and said there is a fracture but it's not serious.  He however says my ACL is not functioning and I would need an ACL reconstruction.  He wanted to perform the patellar graft.  That is the type of surgery he specializes in.

At this point because of my age I'm thinking maybe I don't want the patellar graft reconstruction but rather the cadaver graft and I go back to the first guy to discuss it.  He is telling me in no uncertain terms that I do not need this surgery and even if I did it's too soon and he would never do the patellar graft on me.  (I am about 5 weeks out from the injury).

I have now seen two well respected orthopedic guys who both have performed at least 1000 acl operations.  Although I am 50 years old I do want to return to skiing (have been doing it for 40 years and love it).  I am almost afraid to see a 3rd guy for fear he will have yet another opinion!  Right now I guess I am going to try some physical therapy.  I do not have full extension so therefore limp around pretty good.  Haven't been able to figure out if the pain is due to the healing fracture or what.  Trying to navigate thru the egos is interesting as well..... (eye roll)

Has anyone dealt with varying opinions?

[kneepaincure]

Hi mpat, how did things finally work out for you? Which doctor did you go for?

[gadha007]

Hi mpat

I, too, have been at the receiving end of these varied opinions.

While my MRi report said I had a 'significant bucket handle tear of medial meniscus', two out of three OSs outright disagreed with the radiologist's report. They looked at my MRI and said that they can't see the tear (The MRI was difficult to read due to the interference screws from an ACLr distorting the MMRI). A third OS took some more time with the MRI, saw the meniscal tear and also suggested I get a new ACL graft as the current one was incorrectly placed and hence not functional. Finally when I went in for the surgery, it was seen that the meniscus was indeed damaged beyond repair (thanks to the first OS, I ended up not worrying about it for an year).

From personal experience, I feel that the older doctors don't really care for a radiologist's reports and that can sometimes lead to troubles for the patient later down the road.

Just my .02