Q. Last Sunday after the hurricane I went up on a ladder and fell, hurting my knee.
I went to the emergency room and had X-rays and an MRI scan. I was told I tore my ACL, partially tore my LCL and popliteous muscle and had a fracture of my tibial plateau. I was given a brace and crutches and told to see an orthopedic surgeon. The doctor said the fracture was in place and the brace would allow the LCL, the muscle and the fracture to heal. I may then need ACL surgery. I am a father and play recreational sports and want to know what is best to do for my knee. Why not fix everything now rather than wait?
A. Your fall has resulted in a very significant knee injury. Fortunately, the fracture is well aligned and can heal in a brace.
The LCL is an important ligament for side-to-side stability. This ligament has a good blood supply and usually can heal in the brace as well. The popliteous helps to rotate the lower leg and sometimes can also heal in a brace.
The ACL is important for pivoting activities and when torn, it does not heal. Your orthopedic surgeon’s plan makes sense as to allow all structures that can heal to heal first followed by a physical therapy program to regain motion and strength. If surgery is done too early it may result in more scar tissue, difficulty in regaining motion and actually a slower recovery.
After rehab, the ACL reconstruction can be done with usually an easier recovery and a good chance to ultimately return to sports with friends and your children.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send questions to HarlanS@baptisthealth.net.