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What Does My MRI Scan Report Indicate?

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Posted on Thu, 26 Nov 2015
Question: I am 31 years of age, and have been diagnosed with a ruptured ACL in the knee with torn meniscus. I have been suggested to go through a surgery for ACL reconstruction and Meniscus repair.

MRI report mentions as follows, the scans of which has been attached as well:
- There is a vertical peripheral tear through the posterior horn of the medial meniscus extending from the posterior meniscal root to involve the body of the meniscus. The anterior horn is normal.
- Lateral meniscus is normal.
- Articular cartilage in the femorotibial compartments is well preserved and there is no osteochondral lesion seen.
- There is evidence of an old rupture of the anterior cruciate ligament.
- Posterior cruciate ligament is intact and of normal morphology.
- The medial collateral ligament and lateral collateral ligament complex are normal.
- There is mild anterior translation of the tibia with respect to the femur
- The patell of emoral joint and quadriceps and patella r tendons are normal.
- There is only a trace of joint fluid. There is no peri articular cyst
Comment: Chronic tear of the ACL. There is a peripheral vertical tear through the posterior horn and body of the medial meniscus.

Now my questions are as follows:
1. Is my ACL completely torn or is partially connected which can help it heal?
2. What is the success rate of ACL reconstruction/replacement?
3. How stable is the new ACL? What are the precautions after the ACL reconstruction?
4. As I read, after ACL reconstruction OA sets in. Why does Arthritis sets in after ACL recon?
5. Can Physio heal ACL?
6. Does ACL have blood supply?
7. There are two types of grafts used for ACL, i.e. Patellar tendon or hamstring. What are the drivers to choose and what difference does it make?
8. Is there any other way to heal the Miniscus? Prolotherapy or Platelet Rich Plasma Therapy?

Thanks a lot for answering all these.

Cheers
doctor
Answered by Dr. Praveen Tayal (22 minutes later)
Brief Answer:
Surgical repair is best for you.

Detailed Answer:
XXXXX'
Thanks for posting your query.
1. This seems to be a partial tear. But is more than 50% torn. Spontaneous healing is difficult. Surgical repair will give better results.
2. Success rate varies with extent and position of tear. This cannot be compared. Usually after surgery it heals in almost 80-90% individuals.
3. It is a stable one. You need to avoid strenuous knee exercises and squatting.
4. Every injury in the knee is associated with scarring and irregularity of the surface of cartilage causing OA changes.
5. Physio can help after the reconstruction.
6. Very minimal.
7. Depends on easy accessibilty and thickness of the grafts. It depends on the operating surgeon entirely. Both the grafts are taken up well.
8. No. Best option is surgical repair.
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. Praveen Tayal (3 days later)
Hi

It is a bit difficult for me to go for a surgery at this point and more feasible to go with it 6 months down the line.

1. Is it okay if I go through the surgery 6 months down the line?
2. Is there a risk of waiting for 5 months before I go for the surgery?
3. Can I take some precautions while I wait for the surgery?
4. Can physiotherapy help me before the surgery?
5. Can physiotherapy help me to escape the surgery?
6. Are there any alternate treatments that I can try in the time being?

Thanks for your reply in advance.

Regards XXXXXXX
doctor
Answered by Dr. Praveen Tayal (3 hours later)
Brief Answer:
Details below.

Detailed Answer:
XXXXX
Thanks for writing again.
1. Waiting for 6 months will restrict your activities till then. Avoid any strenuous knee exercise till then and use a knee brace for rest.
2. There is no extra risk as far as healing is concerned. A fresh injury shows an earlier healing as compared to an old injury.
3. Do take rest and use a knee brace while bearing weight on the knee.
4. No. It should be allowed to rest and heal. Only passive exercises are needed to keep the blood circulation intact.
5. No.
6. The only alternative is rest and let it heal on its own.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (3 days later)
Hi Dr. Tayal

Thanks for all the information and few more questions are as follows:

1. During the surgery, while adding the hamstring ligament, the original ACL is kept as it is, or is it removed?
2. What are the usual rehabilitation times for a non-active person i.e. a person not very active in sports? For how long is the bed rest, cast, walk with a support (crutches) timelines? For how long are the restriction for taking the stairs, jogging and running?
3. What is the usual cost of this surgery in XXXXXXX in a private hospital? Just a ballpark/average figure would be enough..
4. Can you recommend some doctors in Delhi/Chandigarh for this surgery?

Regards
doctor
Answered by Dr. Praveen Tayal (4 hours later)
Brief Answer:
Usual recovery time is 6 weeks.

Detailed Answer:
1. Whether to keep original ACL or remove it depends on the condition of ACL. Usually it is kept and repaired.
2. usually cast is kept for 2-3 weeks and gradually you will return to all the normal activities in 6 weeks after surgery.
3. Around 1-1.5 lakh INR.
4. You can contact XXXXXXX Hospital at XXXXXXX
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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What Does My MRI Scan Report Indicate?

Brief Answer: Surgical repair is best for you. Detailed Answer: XXXXX' Thanks for posting your query. 1. This seems to be a partial tear. But is more than 50% torn. Spontaneous healing is difficult. Surgical repair will give better results. 2. Success rate varies with extent and position of tear. This cannot be compared. Usually after surgery it heals in almost 80-90% individuals. 3. It is a stable one. You need to avoid strenuous knee exercises and squatting. 4. Every injury in the knee is associated with scarring and irregularity of the surface of cartilage causing OA changes. 5. Physio can help after the reconstruction. 6. Very minimal. 7. Depends on easy accessibilty and thickness of the grafts. It depends on the operating surgeon entirely. Both the grafts are taken up well. 8. No. Best option is surgical repair. 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