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Have acl tear and partial mcl tear. Will it get worse after walking without crutches?

Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5931 Questions
Hi. I had an skiaccident (alpin) almost 3 weeks ago. Took MR one week ago and it showed acl tear and partial mcl tear, bone contusion changes with oedema in proximale tibia and laterale femurcondyl. I wear ortose, a kind of kneebrace. I walk in my home without cruches, but when I go out I use them. My question is: Is it normal to get total exhausted after walking with this knee? I feel a bit pain but its managable, the worst is the tiredness. I am also worried about this bone contusion. Can it get worse when I walk on my leg without cruches? I have not seen an ortpedian, but my doctor suggest operation of ACL. I am a 43 athletic welltrained woman. I am 162 cm and 55 kilos.
Posted Thu, 21 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 59 minutes later
Hi and welcome to XXXXXXX
Thanks for posting your query.

MCL tears even if fully torn usually heal and are treated without surgery. You would need crutches and a knee immobilizer for 2-6 weeks. You might need a functional brace after that and some physical therapy to strengthen and regain stability and motion in the knee.

Exhaustion after walking with this knee occurs due to weak ligament and muscles around the knee.So knee exercises are very crucial at this stage to regain the strength of muscles around knee.

‘Bone bruises’ and ‘bone contusions’ are commonly used to refer to areas of localised bony tenderness after a traumatic injury, where there is no X-ray evidence of fracture. These painful injuries are classified as ‘sub-periosteal haematomas’; while they can persist for several weeks, they usually resolve spontaneously with no further consequences.

ACL tears can either be partial or complete. If it's partial, treatment is varied and is a very much debated subject as how to deal with these tears.
If less than 50% of the fibers are torn, then treatment may be without surgery. It would include a lot of physical therapy to regain stability and strengthen and normal function of the knee. ACL heals poorly as ligaments have poor blood supply so it would never really fully heal. There would be an increased risk in the future for a full tear. However, surgery would be a big choice and conservative treatment is always worth a try with small ACL tears as people have recovered this way.
If the tear is more than 50% and there is instability of the joint (giving out) and other large symptoms, surgical reconstruction would probably be the treatment. Full tears are almost always reconstructed if the patient wished to return to sports.

Hope this will help you. Please do write back if you have any additional concerns.

Wishing you speedy recovery...

Dr Saurabh Gupta.
Orthopaedic Surgeon.
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