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I Am A 40yr Old Female Go Tore Her Acl

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Posted on Sat, 6 Feb 2021
Question: I am a 40yr old female go tore her acl skiing 1 week ago. Attached is the mri report. I have several questions:
1) what are the risks associated with surgery?
2) what are the positives and negatives of rehabilitation without surgery?
3) what are the positives and negatives of rehabilitation with surgery?
4) If you do not do surgery, is leg strengthening required for a long period of time?
5) recovery periods and extent with surgery and without surgery
6) what is your overall recommendation for a 40yr old active woman - do to surgery or not and why?



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Follow up: Dr. Dr. Praveen Tayal (0 minute later)
I am a 40yr old female go tore her acl skiing 1 week ago. Attached is the mri report. I have several questions:
1) what are the risks associated with surgery?
2) what are the positives and negatives of rehabilitation without surgery?
3) what are the positives and negatives of rehabilitation with surgery?
4) If you do not do surgery, is leg strengthening required for a long period of time?
5) recovery periods and extent with surgery and without surgery
6) what is your overall recommendation for a 40yr old active woman - do to surgery or not and why?



Sent from my iPhone

IMG_5301
.jpg
doctor
Answered by Dr. Dr. Praveen Tayal (7 hours later)
Brief Answer:
Surgical repair is the best option.

Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached report. As per the report you have a complete rupture of ACL. This cannot heal properly without a surgery.
1. Risks associated with surgery depend on the associated problems like blood pressure, cardiac problems, etc. There can be infection or delayed healing with post operative stiffness of the knee.
2. Without surgery the knee will remain painful and unstable. The recovery will not be complete and may take 12 weeks.
3. Surgery is the best option for an early and complete recovery. You may need some physiotherapy after the surgery to deal with joint stiffness.
4. If you do not go for surgery then leg starightening may be needed for 4-6 weeks.
5. With surgery usually it heals and recovers in 3 weeks. Otherwise recovery may take 12 weeks and may not be complete.
6. It is best to go for surgical repair to lead a normal life.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
Surgical repair is the best option.

Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached report. As per the report you have a complete rupture of ACL. This cannot heal properly without a surgery.
1. Risks associated with surgery depend on the associated problems like blood pressure, cardiac problems, etc. There can be infection or delayed healing with post operative stiffness of the knee.
2. Without surgery the knee will remain painful and unstable. The recovery will not be complete and may take 12 weeks.
3. Surgery is the best option for an early and complete recovery. You may need some physiotherapy after the surgery to deal with joint stiffness.
4. If you do not go for surgery then leg starightening may be needed for 4-6 weeks.
5. With surgery usually it heals and recovers in 3 weeks. Otherwise recovery may take 12 weeks and may not be complete.
6. It is best to go for surgical repair to lead a normal life.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (3 days later)
Thank you for your response. I have additional questions.

1) what are the pros and cons of using your own graft vs an external graft for the acl surgery? Which would you recommend for this situation and for the long-term? How do recovery times and intensities change between the 2?
2) is there a specific kind of physical therapy that is recommended? Using weights or not using weights, massage etc? Does this differ pre and post surgery?

Thanks.
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Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Thank you for your response. I have additional questions.

1) what are the pros and cons of using your own graft vs an external graft for the acl surgery? Which would you recommend for this situation and for the long-term? How do recovery times and intensities change between the 2?
2) is there a specific kind of physical therapy that is recommended? Using weights or not using weights, massage etc? Does this differ pre and post surgery?

Thanks.
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Follow up: Dr. Dr. Praveen Tayal (34 minutes later)
Also, Does the extent of the tear matter? If an acl is only partially torn vs very torn is there a difference in its usability?
Thank you.
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Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Also, Does the extent of the tear matter? If an acl is only partially torn vs very torn is there a difference in its usability?
Thank you.
doctor
Answered by Dr. Dr. Praveen Tayal (4 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
Using your own graft material is better as body tissue accepts it in a better way. Recovery time and intensities are same for both.
Physical therapy depends on the tone and muscle strength of different muscles. This can be decided only by a physiotherapist after a direct examination. Usually non weight bearing therapy is done initially and then gradually the exercise is increased.
If acl is partially torn then it can heal without surgery also. After proper healing usability is same.
Please accept my answer in case there are no further questions.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hello.
Thanks for writing again.
Using your own graft material is better as body tissue accepts it in a better way. Recovery time and intensities are same for both.
Physical therapy depends on the tone and muscle strength of different muscles. This can be decided only by a physiotherapist after a direct examination. Usually non weight bearing therapy is done initially and then gradually the exercise is increased.
If acl is partially torn then it can heal without surgery also. After proper healing usability is same.
Please accept my answer in case there are no further questions.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (9 hours later)
Thank you Dr Tayal for your prompt response.

In your initial response, you said that there is COMPLETE rupture of the ACL. Does my MRI report say it is COMPLETE. Please reconfirm.
I am able to walk nicely without any pain. Does that mean PT may be enough ?
Should I take another MRI after PT to decide whether or not to go for surgery.
Thanks.
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Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Thank you Dr Tayal for your prompt response.

In your initial response, you said that there is COMPLETE rupture of the ACL. Does my MRI report say it is COMPLETE. Please reconfirm.
I am able to walk nicely without any pain. Does that mean PT may be enough ?
Should I take another MRI after PT to decide whether or not to go for surgery.
Thanks.
doctor
Answered by Dr. Dr. Praveen Tayal (4 hours later)
Brief Answer:
Details below.

Detailed Answer:
Hello.
Your MRI report mentions "rupture of midsubstance ACL with displacement of fibres anteriorly." This is suggestive of a complete tear of ACL with displacement.
You can get a repeat MRI scan done after physiotherapy. In case it does not heal then surgery can be planned later.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
Details below.

Detailed Answer:
Hello.
Your MRI report mentions "rupture of midsubstance ACL with displacement of fibres anteriorly." This is suggestive of a complete tear of ACL with displacement.
You can get a repeat MRI scan done after physiotherapy. In case it does not heal then surgery can be planned later.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Praveen Tayal (3 hours later)
Thank you for your patience and concise responses.

Does the acl actually heal on its own? My understanding is there is no blood supply to the acl so it does not repair itself. Is that true? The only ‘repair’ per say is by strengthening other muscles around it and potentially also not playing sports such as tennis and skiing.

Thank you very kindly.
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Follow up: Dr. Dr. Praveen Tayal (0 minute later)
Thank you for your patience and concise responses.

Does the acl actually heal on its own? My understanding is there is no blood supply to the acl so it does not repair itself. Is that true? The only ‘repair’ per say is by strengthening other muscles around it and potentially also not playing sports such as tennis and skiing.

Thank you very kindly.
doctor
Answered by Dr. Dr. Praveen Tayal (5 hours later)
Brief Answer:
You understood correctly.

Detailed Answer:
ACL is difficult to heal on its own that too when it is displaced. That is why surgical repair is recommended in such cases.
It has minimal blood supply. Only the muscles around it can be strengthened.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dr. Praveen Tayal (0 minute later)
Brief Answer:
You understood correctly.

Detailed Answer:
ACL is difficult to heal on its own that too when it is displaced. That is why surgical repair is recommended in such cases.
It has minimal blood supply. Only the muscles around it can be strengthened.
Regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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I Am A 40yr Old Female Go Tore Her Acl

I am a 40yr old female go tore her acl skiing 1 week ago. Attached is the mri report. I have several questions: 1) what are the risks associated with surgery? 2) what are the positives and negatives of rehabilitation without surgery? 3) what are the positives and negatives of rehabilitation with surgery? 4) If you do not do surgery, is leg strengthening required for a long period of time? 5) recovery periods and extent with surgery and without surgery 6) what is your overall recommendation for a 40yr old active woman - do to surgery or not and why? Sent from my iPhone IMG_5301 .jpg