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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suffered Very Painful Trauma. Do You Think I Should Ask The Doc To Do An Arthroscopy?

5 weeks ago, I suffered a very painful trauma to the left knee whilst playing hockey. I think I landed awkwardly on a straight leg which may have hyperextended. There was no contact involved and I did not fall to the ground although I knew straight away that it was a serious knee injury. I have recently had an MRI scan which shows a rupture of the acl from its femoral insertion. As there is little signal change the consultant suggested that it may be an older injury although I don't recall any problems with the knee previously although I have played hockey for many years. I also have signal change around the the anterior part of the medial collateral ligament. The injury is 5 weeks old and clinically it is being very slow to respond to Physio treatment. The consultant is being very hesitant in making any firm plan of action. I am due to see him in an a couple of weeks time. He wants the knee to settle down before he tries to establish how stable my knee is before anything else. My physio was unable to do the pivot test even yesterday due to pain of the medial ligament. Do you think I should ask him to do an arthroscopy ? If I want to play hockey again or play sports with my 2 young children - do you think I should push for an ACL op ? I am female and 46 years of age. Thank you
Fri, 12 Jul 2013
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Orthopaedic Surgeon, Joint Replacement 's  Response
Hi, thanks for writing to HCM.
If the ACL rupture is a "Complete" (full thickness tear) one, then there is no way to manage it conservatively (either with physio or medicines) to make your knee normal.

As you are an active female and involved in playing hockey, I suggest you to undergo "Arthroscopic reconstruction of ACL" to regain normalcy.

For making the diagnosis of ACL rupture, arthroscopy is not at all necessary (as it is an invasive procedure). If in doubt, a repeat MRI scan will give all the details of soft tissue damage inside the knee joint.

Hope this information is helpful. Good day
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Suffered Very Painful Trauma. Do You Think I Should Ask The Doc To Do An Arthroscopy?

Hi, thanks for writing to HCM. If the ACL rupture is a Complete (full thickness tear) one, then there is no way to manage it conservatively (either with physio or medicines) to make your knee normal. As you are an active female and involved in playing hockey, I suggest you to undergo Arthroscopic reconstruction of ACL to regain normalcy. For making the diagnosis of ACL rupture, arthroscopy is not at all necessary (as it is an invasive procedure). If in doubt, a repeat MRI scan will give all the details of soft tissue damage inside the knee joint. Hope this information is helpful. Good day