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Author Topic: Second opion on knee results?  (Read 2933 times)

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Offline EJWell

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Second opion on knee results?
« on: October 22, 2004, 11:09:03 PM »
I injured my knee about 11 months ago doing Martial Arts. I finally decided to go see a orthopaedic doc. and we did a MRI on my knee.

The results on the MRI were that my ACL was slighty thin? The orthopaedic Surgeon, stated that he did not agree and said, "that it is completly torn"? The Doc. stated, "that I would have to have surgery done to repair it".

I was really confused about this because of the MRI results to the conclusion of the Doctors results. How accurate are MRI's on finding torn ligaments?

I also find it kind of odd, because when I first injured my knee it I had consistent pain and weakness, but through time the pain has not really been there anymore and its stronger. Is it possible that the Doctor is saying that's it's torn because he wants to make money or is it possbile that he can determine this by just testing the knee (binding it back and forth).

What Does a slightly thin ACL mean? Can I get it back to normal and continue my active training or do some time of therapy to avoid surgery? I do admit that when I did injure my knee I really didn't heal it but continued to train on it. Would this be the problem why I continue to get pain here and there & never heal or should I just get a second opion on another Orthopaedic Doc?

If you have a completly torn ACL, is it possible to walk on it or what are the common symptoms?

I really appreciate everyones knowledge on my situation...

Thanks
« Last Edit: October 23, 2004, 01:47:31 AM by EJWell »

Offline Linds

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Re: Second opion on knee results?
« Reply #1 on: October 23, 2004, 02:11:39 PM »
 I have never had a torn ACL, but I will tell you what I know.
First of all MRI's are Notorious for picking up things that aren't there, and missing things that are. :P  They are a good test, but.. can't be 100% trusted to tell the whole story.   A good Orthopedic Surgeon would be able to test the stability of the knee with a good thorough examination.  It may be that since your injury the other muscles in your knee/leg have become stronger in order to compensate for the instability caused by the ACL Tear.  They would not be able to access the full extend of the damage until they get in there and have a look see.  I guess then it just comes down to do you trust this Surgeon?  Maybe you would like to get a second opinion before you go ahead and let him cut you?
Hope that helped
Linds
« Last Edit: October 23, 2004, 02:12:57 PM by Linds »
1997 Scope RK
2002 LR RK
2002 Scope and hematoma evac RK
2004 LR LK
May 06 Fall from Horse, partial ACL tear and meniscus injury, Tibial plateau injury
2007 Scope, Plica Excision and Debride LK
2009/2010- Possibly Ankylosing Spondylitis?

Offline sienna

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Re: Second opion on knee results?
« Reply #2 on: October 24, 2004, 04:22:14 AM »
I,too, have never torn my acl (touch wood) but do know a little about it from people I know who have had some experience with it.
From what I can gather, it can repair itself over time.  During this time, exercising it does actually help to heal it.  I do believe though, that if it is torn, it is normally repaired as the torn bits can get in the way of the normal functioning of your knee.

A physical exam can usually pick up a torn acl but what you do about it varies.

If you are unsure about what the os is saying, then take your mri and seek another opinion.  Remember, it is better to have some opinions than to rush into surgery, even if it is 'only' a scope.  

It seems to me that you are a bit dubious about the clash of opinins, so go and get another opinion.  
Keep us posted.
rk posterior meniscus tear. Successfully repaired 10 Sep,03. Now have nerve damage and cps which goes with it.  I want to slap the person who said 'It just takes time....'

Offline AndrewC

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Re: Second opion on knee results?
« Reply #3 on: October 24, 2004, 07:20:19 AM »
Hi

Just to clear up any misunderstandings (and incorrect info)....

The ACL Will NEVER HEAL.

EXERCISING will NEVER help to heal it.

This is why people have ACL reconstruction when they tear their ACL.

Now...to the more intricate stuff, a PARTIALLY torn ACL can be lived with and normal function attained with the correct program of strengthening and physio.

An ACL that is <50% torn is a candidate for non surgery. Up to 70% tears are sometimes not reconstructed but this depends on the age/lifestyle of the patient.

MRIs are also very good at picking up torn ligaments etc.... it is if they are interpreted correctly by the radiologist that impacts on how good the results are.

It is quite feasible that your surgeon found a torn ACL by a physical exam (Lachman drawer test, Anterior drawer test, pivot shift test)......eg/ bending your leg about and seeing if their is play or weakness in the joint that shows a torn ACL.

A slightly thin ACL means it sounds like a partial tear to the ACL and not all of the ligaments structure is present. eg/ you may have torn 40% of the ACL so only 60% of its thickness remains (example only)


Your ACL wil never regrow back to normal....BUT...you can strengthen the leg muscles to compensate for this in a lot of cases. The ligament will generate scar tissue as part of its own attempt at healing but this is not healing like say a cut to the skin would do.

Finally, a completely torn ACL affects different people in different ways. Some find their leg gives way at random times and is very unstable meaning twisting or vigorous sports is out of the question. Some people can get by.....

Have a read up on the link below to get more info on this injury and its symptoms.

http://www.kneeguru.co.uk/html/steps/step_02_cruciates/starting.html

All the best

« Last Edit: October 24, 2004, 07:22:02 AM by andrewc »
Big bucket handle tear to lateral meniscus from sporting injury. Arthroscopy and meniscal repair carried out June 2004. sloooowwww recovery!!

2018 - torn medial meniscus in RH knee, partial extrusion. ongoing issues,

Offline christinaz

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Re: Second opion on knee results?
« Reply #4 on: October 24, 2004, 08:00:22 AM »
I just wanted to add that the reason the acl does not heal on it's own is that it has a very poor blood supply.  That is why years ago when they used to try to suture it back together, it didn't work.  It lacked the blood supply to heal.  When your doctor does a Lachman's test, he is looking for an endpoint.  He will hold it and manipulate it back and forth and you should hear a clunking noise if your acl is intact.  If it is completely torn, there is no clunking noise therefore no endpoint.  An arthrometer is also a good diagnostic tool but can be misleading if your surrounding structures(ligaments and tendons) have strengthend to compensate for the tear.  Your OS will make his decision based on an entire battery of tests including the MRI but he will not do an acl recon unless he deems it necessary, because it is a very involved surgery and the recovery is very hard.  Good luck and hopefully it is only a partial tear.  

Love, Christina
3 scopes rt knee, acl recon pt graft rt knee,  rev acl recon allograft rt knee,  Hardware removal, lysis of scar tissue, ITBS, sublaxation, sensory peripheral neuropathy, DDD, arthritis, RSD, mystery hardware, flexion contracture, disuse atrophy, muscular wasting, constant fatigue, acl recon lt knee

Offline EJWell

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Re: Second opion on knee results?
« Reply #5 on: October 26, 2004, 08:14:26 PM »
Thanks, everyone for your advise....

I wanted to know if it is possible to have a torn ACL without swelling of the knee or a pop of the knee? It is possible I could of torn my ACL through wear and tear from training?

How do I find out if my ACL is just partial torn and not completely torn?

How significant is the Arthroscopic surgery if I have it done and will I be able to get better in 6-8 months.

I will probably get a second opion from another OS, just to make sure.

Thanks. again...

Offline christinaz

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Re: Second opion on knee results?
« Reply #6 on: October 26, 2004, 09:15:23 PM »
First of all, unless you have a complete tear or a nearly complete tear, I wouldn't push for a reconstruction yet.  When I say that acl surgery is involved, I mean it is really involved.  I shudder when I think about tearing mine again because not only do you need to be physically ready for this, you need to be mentally ready.  It is a lot of hard work.  Secondly, acl surgery is arthroscopically assisted.  Meaning you will have a scope and you will also have one to two more larger incisions.  The graft that they use has a bone plug at either end and these plugs are anchored in the bone with screws which means that you will have tunnels drilled into the bone.  

If I were you, I would get a second opinion, especially if you feel you are not getting adaquate information about your injury.  Your doctor should be able to tell you to what degree your acl is torn and acceptable solutions for you.  If you are not getting this info, have someone take another look at it.  Remember, it is YOUR body and you ultimately decide the best course of action for you.  If your doctor is telling you that an acl reconstruction is just simple arthroscopic surgery, find someone else.  It is very involved and the recovery very difficult.  Also, find out if he is saying arthroscopic surgery because he wants to use it as a diagnostic tool.  If the MRI results are unclear, he may do a scope to see the damage for himself.

Anyway, make sure you are informed before making your decision.

Love, Christina
3 scopes rt knee, acl recon pt graft rt knee,  rev acl recon allograft rt knee,  Hardware removal, lysis of scar tissue, ITBS, sublaxation, sensory peripheral neuropathy, DDD, arthritis, RSD, mystery hardware, flexion contracture, disuse atrophy, muscular wasting, constant fatigue, acl recon lt knee















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