What is the treatment for a torn ACL Ligament

[fluffypurrcat]

Hi, I dont' think I am going to get any responses to my knee MRI question, so I am going to rephrase a couple of questions to see if I get any other type of help or responses from anyone who knows what I am talking about or has gone through the same thing. I appreciate ANY HELP AT ALL PLEASE!!!
            I am a 56 year old woman with chronic back pain, an on the job injury from Sept 1999. I have DDD, FAcet Disease and probably SI joint disease as well, with herniated disks, and bulging disks on 4 different levels. I take Methadone along with other meds for this pain. NOw on to the current problem.

I somehow injured my left knee at least a year ago, but several injuries including falling into the tub at night when it was dark, slipping on wet grass and falling on my knees, along with at least one other fall makes it hard to pinpoint the exact cause of this injury and pain. My left knee has been hurting and swollen on the inside front of the knee at least since March of 1999, ( I complained to my husband and took photos to make sure I wasn't imaginiang things.) Finally this past April a neurosurgeon who was examining my back looked at my knee and after attempting to move it in different ways said he thought I may have a torn Meniscus, and should see an Orthopedic about it. After an Xray in May ruled out anything, my regualar dr. finally got an MRI this last week.
The results of the MRI are posted in an earlier post about two days ago, so I won't repeat it all here, but this is the jist of it and my question.

It basically says I have some changes in the Medial Patellar facet, ( articular thinning, and some suprapatellar bursal fluid as well.) Also some bone contusions, Bone marrow abnormality within the medial femoral condyle and medial plateau which suggest a anterior cruciate ligament tears.Looks like a tear from the femoral attachment which has re-adhered. ( These are the main things, you would have to read the rest of it to get anything else I did not mention here.)
       I read on another site regarding knee injuries that a ACL tear won't heal completly by itself. I have had this pain, so I figure this injury is about a year or more old. I have constant pain, some pain worse than other days. my knee has not locked on me, but it hurts a lot when sitting, and even more when lying down then standing. I get a sharp stabbing pain sometimes otherwise it is a deep aching bone type ache, feels like the flu in your knee. It is also hard or hurts more to walk down stairs or downhill.  I have never gone to the dr. for this, so of course I never used ice. I have soaked in a really hot tub of water as heat allways helps with my back . Also since this knee pain, my left hip is getting very painful, which I never had a problem with before.
Now that I have the results of my MRI , I can get a referral to see an Orthopedic dr. to see what he thinks. In the meantime, can anyone tell me what they think about my injury to my knee, and how do Dr.s deal with torn ACL or an injury like myne? What can I expect? I am tired of being in pain and am glad that I finally got this MRI. I knew my knee had been hurt somehow, that it wasn't just my imagination, I only wish I could have seen a dr. sooner. Is my injury too old to do anything about?                  Please anyone can you give me any ideas at all? Some answer is better than none at all!   thank you.                  fluffypurrcat

[fluffypurrcat]

Dr. Vinod, thank you again for the response to my question. I did see my regular dr. today, who is the one who ordered the MRI for my knee so she could see if it was appropriate for a referral for the Orthopedic dr. based on my pain and her examination of my knee.
         I have a couple of questions and I will try to make them short.She said that based on the MRI report I do have several things going on with my knee and she said that MRI's are only " A TOOL"  and they don't see everything, and sometimes not correctly. Is this true? I know my MRI mentioned that they could not see the proximal femoral attachment very well. Why would they have a hard time seeing this part of my knee with such an advanced tool as the MRI ? Also it said it looked like from the contusions, etc, that I have had a ALC tear and that I have a tear from the femoral attachment that has " re-adhered ?" My dr. did not explain this well, except to say that it was the ALC tear, and I read that ALC tears, partial or complete can not adhere by themselves, or what is the explanation for this? Does this mean there is still damaged tissue, tendon in this area that is responsible for all my pain and movement problems.?

        She did say that she was sure the dr. would do a Arthoscopy to see what is going on, so what ever is going on will be repaired at the same time. How will the dr. determine what the damage is before doing the Arthoscopy besides the use of the MRI?  I know you can't answer every question, but I appreciate your expert opinion, and it gives me great relief and peace of mind while I wait for my Ortho appt. Thank you again Dr. Vinod.                                       fluffypurrcat

[Dr Vinod]

Hello!

Please reveal everything to your operating surgeon. It is for your benefit. Even if it is 2008 it is an old problem as quite an amount of time has passed.

You are absolutely right, with age the healing is slower. But if you do not suffer from Diabetes etc then your healing will be proper with rest and following all instructions properly.
Go slow, but perfectly, my suggestion would be even if you are from a small town, do proper research, go to a good orthopedic surgeon and go for the procedure after he explains to you all pros and cons.

Take care!

[fluffypurrcat]

Thank you very much for taking the time to answer my question. I wanted to know what to expect before I go to the dr. I meant to say that my injury to my knee has been at least since March of 2008, (last year, ) not 1999! 1999 was the year I injured my back, I will see my regular dr. for the referral to the Orthopedic Dr. tommorow, Tuesday, but it may take a lot longer till I actually see the Orthopedic. I live in a somewhat small town and sometimes it takes longer to see a specialist.

              I am not afraid of getting any surgeries to get this fixed, as I have been through a lot of them on both feet, I just want to get rid of this pain. Does my age make the healing any slower or any type of complications? The one thing I do know from my last three foot operations, is that my body builds up scar tissure EXTREMELY FAST. Would this be a deterrant to surgery, or should I just not mention it ? After I told the Neurosurgeon, he seemed to think that was a deterrant for spinal fusion, or at least that is the impression I got. Mayby I should not say anything about scar tissue building up quickly.

         Now I can look up some of the imformation you gave me on what type of repair I may be facing. Thank you again Dr. Vinod for helping me, I really do appreciate it.

                                                    fluffypurrcat

[Dr Vinod]

Hello!

Anterior drawer test is done by your Orthopedician to detect injury to the anterior cruciate ligament. It is confirmed by an MRI as you have done already.
If you would have known immediately for minor grades immobilization in a cylinder cast would have been enough.

You need to go for ligament repair and if not possible then a ligament reconstruction. Tendon or fascia lata is used to reconstruct the ligament. Synthetic ligament can also be used.
Ice your knee for pain and take intermittent anti inflammatory drugs and the drugs you take for your spine problem would be enough.

Take care!