Aa
How bad is this? 13 year old female athlete
Findings:
The menisci are intact with no tear.
ACL not seen in keeping with full-thickness tear. Amorphous material layers along intercondylar spine of tibia. PCL intact. MCL intact. At the LCL there is a subtle linear hyperintensity suspicious for small partial-thickness tear measuring 8 mm. Mild edema surrounds it. There is partial LCL tear. There is small joint effusion.
No focal marrow signal abnormality.
Articular cartilage is preserved.
Impression: Full-thickness ACL tear with joint effusion. Probable small partial LCL tear.
The menisci are intact with no tear.
ACL not seen in keeping with full-thickness tear. Amorphous material layers along intercondylar spine of tibia. PCL intact. MCL intact. At the LCL there is a subtle linear hyperintensity suspicious for small partial-thickness tear measuring 8 mm. Mild edema surrounds it. There is partial LCL tear. There is small joint effusion.
No focal marrow signal abnormality.
Articular cartilage is preserved.
Impression: Full-thickness ACL tear with joint effusion. Probable small partial LCL tear.
I just watched a video explaining what may need to be done,,drilling through the bone, taking piece of tendon from the front ligament and reconstructing the torn torn ligament. I am beside myself right now. I have one further question. In your expert opinion, should she refrain from sports, specifically school basketball and Phys. Ed. class all together until we see orthopedic surgeon? By playing, even cautiously, as she has been, is there a chance of further injury? Doctor didn't even bother calling us in to advise and we didn't bother making appointment because we would have to wait a week before getting in to see him.
P.S. You suggested I read a post. I don't know where to find it. Can you cut and paste it for me in this thread?
Dear Phil. Once again, you are most helpful. Sounds like you have had many bad experiences with doctors and have taken charge of your own health by doing the research and fighting for what you need. I am very critical of doctors myself, always questioning and I think that ticks them off. I will take my daughter to several highly experienced and educated orthopedic surgeons as necessary until I get the one who can answer all my questions, has done hundreds of procedures (as you say) and whose goal and philosophy line up with our own. The state of our health system, you have to do the research, make phone calls on your own, and empower yourself with knowledge. I agree 100%. Thank you for your insights and for helping so many people on here. I truly appreciate it.
Suanne, she needs to be examined by an orthopedic physician. While she may not need surgery immediately, the diagnosis must be made and a treatment plan should be suggested -- even if you decide to defer treatment. Surgery will be recommended, so be ready with your questions. Write down the answers.
Ask why do I need surgery?
Are there alternatives to surgery?
What type of surgery are you recommending?
Find out the purpose of the surgery and how it relates to the diagnosis of your diagnosis. For example, is the procedure designed to relieve pain? Reduce symptoms? Improve function? What will rehabilitation be like? Can I expect pain managementt during rehab?
Make sure you understand the anatomy of the area being surgically modified. Your surgeon may be able to draw a picture, show you a plastic model of the knee. or refer to other items for study like videos, or websites that can help you better understand the procedure.
There are two types of ligament grafts with ACL surgery -- using an existing tendon from your own body (autograft), or processed tissue taken from another body (allograft). Autograft is statistically the best choice for this particular procedure by there are risks and increased pain from the source site -- what are the risks and benefits of autograft or allograft? Will pain be treated for my autograft? What is the risk of infection?
Ask your surgeon if any instrumentation (screws, plates, rods) will be used, if you will need a bone or ligament graft and how large your incision will be.
What are the benefits of having the operation?
What are the risks of having the operation?
All surgeries come with risks for bleeding, infection, reactions to anesthesia, and other negative outcomes.
Be sure you understand all of the possible complications before you consent to have any surgical procedure.
Talk to your surgeon about any side effects after the surgery, like swelling, pain and how these will be managed.
What if I choose not to have this operation?
What would happen if Ichose not to have the surgery. Will my condition get worse? Will If have more pain?
Where can I get a second opinion?
What has been your experience with this procedure? How many have you done? (you want a number over 700 for best results).
Where will the operation be performed?
What w;il my quality of life be if I choose surgery vs. if I don't choose surgery.
I hope I've left you with plenty of questions to ask the doctor. Press for answers -- doctors are good and 'handwaving' away problems -- "trust me -- I'm a doctor."
Make sure you are satisfied with the answer or go somewhere else.
Remember to study your knee anatomy.
Best wishes.
Ask why do I need surgery?
Are there alternatives to surgery?
What type of surgery are you recommending?
Find out the purpose of the surgery and how it relates to the diagnosis of your diagnosis. For example, is the procedure designed to relieve pain? Reduce symptoms? Improve function? What will rehabilitation be like? Can I expect pain managementt during rehab?
Make sure you understand the anatomy of the area being surgically modified. Your surgeon may be able to draw a picture, show you a plastic model of the knee. or refer to other items for study like videos, or websites that can help you better understand the procedure.
There are two types of ligament grafts with ACL surgery -- using an existing tendon from your own body (autograft), or processed tissue taken from another body (allograft). Autograft is statistically the best choice for this particular procedure by there are risks and increased pain from the source site -- what are the risks and benefits of autograft or allograft? Will pain be treated for my autograft? What is the risk of infection?
Ask your surgeon if any instrumentation (screws, plates, rods) will be used, if you will need a bone or ligament graft and how large your incision will be.
What are the benefits of having the operation?
What are the risks of having the operation?
All surgeries come with risks for bleeding, infection, reactions to anesthesia, and other negative outcomes.
Be sure you understand all of the possible complications before you consent to have any surgical procedure.
Talk to your surgeon about any side effects after the surgery, like swelling, pain and how these will be managed.
What if I choose not to have this operation?
What would happen if Ichose not to have the surgery. Will my condition get worse? Will If have more pain?
Where can I get a second opinion?
What has been your experience with this procedure? How many have you done? (you want a number over 700 for best results).
Where will the operation be performed?
What w;il my quality of life be if I choose surgery vs. if I don't choose surgery.
I hope I've left you with plenty of questions to ask the doctor. Press for answers -- doctors are good and 'handwaving' away problems -- "trust me -- I'm a doctor."
Make sure you are satisfied with the answer or go somewhere else.
Remember to study your knee anatomy.
Best wishes.
Thank you Phil. You seem to really know your stuff and your information is extremely helpful. I am the mom of this child not the patient. Her injury happened several months ago in a bball game. Jumped up to block shot and landed wrong on her leg...on crutches for a week. Swelling, some pain etc. After a week (did not have MRI yet) she was walking, swelling was gone and seemed to have full range of motion back to her knee. Since then she has been playing only school basketball(less intense play) but favours the other leg when doing lay ups and can not run at full speed. Doesn't have pain she says, there is no swelling but I think she is worried about re-injury and therefore plays cautiously which is a good thing. My question is, how can she function so well with a full tear of the ACL? Thought something like this would be debilitating until repaired. A referral has been made to a top notch orthopedic surgeon whose specialty is the knee. I will ask that this be pushed up as soon as possible. I am going to research everything I can about the knee so that I ask the right questions when we meet with the surgeon. Once again, thank you so much for your help. Wish I could help you. One thing I can tell you about that you may want to look into for you and your son, is something called Wobenzym N and Wobenzym Plus. Have been giving it to my son the Plus for a back injury and I just started taking it for joint pain...I have seen an improvement in my son's health in just one week of taking these...no pain, says he feels stronger in his back and sleeps better. Supposedly high potency enzymes that target injury site of inflammation and pain. Anything that may help us function better is worth a try. Best regards, Suanne.
I'm sorry, I hit the send button without meaning to, and there is absolutely no way to edit a post on this site for whatever reason -- a reason why many people no longer participate.
I wasn't finished with my statement...
I began to say there's a pretty good Wiki page on the knee, but their images are often unclear regarding important features of interest -- they supply too much information. A better source of information on the ACL is available here:
A good primer on the knee can be found here:
http://emedicine.medscape.com/article/1898986-overview
and information specific to ACL injuries here:
http://ehealthmd.com/acl-tears/what-anterior-cruciate-ligament
There are of course, many other websites available.
As I said, my son went through this surgery at age 15 due to a football injury. He then damaged his ACL again in college and chose not to have the surgery a second time, as he would have lost a year, about 20 pounds of muscle, and playing college ball is very competitive. When you're a tight end under 250#, you take quite a beating on the field these days with linemen who weigh 350# in your face.
Another point of concern -- the meniscus are fibrous ligament sockets meant to seat the femur into the tibia and prevent any bone against bone contact in the knee. With a missing ACL / PCL, the menicus can wear prematurely, causing pain and further damage. This possibility must be considered in any decision to have surgery.
While the surgery for ACL repair is simple and performed via arthroscopy, the rehabilitation can be long and requires both persistence, patience, and never pushing into pain. The new ligament must be given a chance to heal. You may also need a custom knee brace to be worn whenever you participate in activities that challenge the knee.
You, your parents and your doctor should all be involved in the decision to repair this important ligament.
I am not a medical doctor so please don't take any of what I've said as medical advice. I write only to provide information about the knee and give a simple interpretation of the radiology report. My knowledge of medicine comes from self-study. I live with chronic spine disease and have learned that a thorough knowledge of my disease state and treatment options are the best defense against those physicians whose agenda may be motivated by factors other than my best medical outcome.
I wasn't finished with my statement...
I began to say there's a pretty good Wiki page on the knee, but their images are often unclear regarding important features of interest -- they supply too much information. A better source of information on the ACL is available here:
A good primer on the knee can be found here:
http://emedicine.medscape.com/article/1898986-overview
and information specific to ACL injuries here:
http://ehealthmd.com/acl-tears/what-anterior-cruciate-ligament
There are of course, many other websites available.
As I said, my son went through this surgery at age 15 due to a football injury. He then damaged his ACL again in college and chose not to have the surgery a second time, as he would have lost a year, about 20 pounds of muscle, and playing college ball is very competitive. When you're a tight end under 250#, you take quite a beating on the field these days with linemen who weigh 350# in your face.
Another point of concern -- the meniscus are fibrous ligament sockets meant to seat the femur into the tibia and prevent any bone against bone contact in the knee. With a missing ACL / PCL, the menicus can wear prematurely, causing pain and further damage. This possibility must be considered in any decision to have surgery.
While the surgery for ACL repair is simple and performed via arthroscopy, the rehabilitation can be long and requires both persistence, patience, and never pushing into pain. The new ligament must be given a chance to heal. You may also need a custom knee brace to be worn whenever you participate in activities that challenge the knee.
You, your parents and your doctor should all be involved in the decision to repair this important ligament.
I am not a medical doctor so please don't take any of what I've said as medical advice. I write only to provide information about the knee and give a simple interpretation of the radiology report. My knowledge of medicine comes from self-study. I live with chronic spine disease and have learned that a thorough knowledge of my disease state and treatment options are the best defense against those physicians whose agenda may be motivated by factors other than my best medical outcome.
Within the knee are four basic ligaments that maintain the relationship between the femur bone (at the top of the knee) and the tibia/fibula bones (at the bottom of the knee).
Within the knee are the ACL and PCL -- the anterior (front) collateral ligament, and the posterior (rear) later ligament. These ligaments prevent excessive movement forwards and backwards of the upper bone (femur) across the lower bones (tibia and fibula).
Likewise, the two ligaments that prevent lateral movelent (side to side) of these bones within the knee are the LCL and MCL -- (the lateral collateral ligament -- also called the fibular collateral ligament) and the medial collateral ligament). These longer, thinner ligaments prevent side-to-side movement of the knee.
Your MRI reports there's slight damage to the LCL a tear with associated inflammation -- not a major injury, but painful. More serious it notes the absence of an ACL.
Your orthopaedic surgeon will diagnose your injury, and give you recommendation regarding treatment options.
You will want a parent with you, and you will both want to be knowledgeable in your injuries and the anatomy of the knee. There's a pretty good Wikipedia page
My youngest son lives with a missing ACL from a football injury 10 years ago. It sometimes causes pain if he pushes too hard during play, for example, skiing.
The surgery is comes with some risks -- very low -- and is done under arthroscopy.
I'm using medical terms here intentionally -- you'll need to understand them all, as well as the anatomy of the knee in order to make the right decisions about treatment.
Within the knee are the ACL and PCL -- the anterior (front) collateral ligament, and the posterior (rear) later ligament. These ligaments prevent excessive movement forwards and backwards of the upper bone (femur) across the lower bones (tibia and fibula).
Likewise, the two ligaments that prevent lateral movelent (side to side) of these bones within the knee are the LCL and MCL -- (the lateral collateral ligament -- also called the fibular collateral ligament) and the medial collateral ligament). These longer, thinner ligaments prevent side-to-side movement of the knee.
Your MRI reports there's slight damage to the LCL a tear with associated inflammation -- not a major injury, but painful. More serious it notes the absence of an ACL.
Your orthopaedic surgeon will diagnose your injury, and give you recommendation regarding treatment options.
You will want a parent with you, and you will both want to be knowledgeable in your injuries and the anatomy of the knee. There's a pretty good Wikipedia page
My youngest son lives with a missing ACL from a football injury 10 years ago. It sometimes causes pain if he pushes too hard during play, for example, skiing.
The surgery is comes with some risks -- very low -- and is done under arthroscopy.
I'm using medical terms here intentionally -- you'll need to understand them all, as well as the anatomy of the knee in order to make the right decisions about treatment.
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