Is knee surgery necessary for 14-year-old soccer player with torn ACL?

Q: My daughter is 14 and just injured her left knee playing soccer. She felt a pop and had severe pain. We obtained an MRI and the orthopedic surgeon said she tore her ACL and partially tore her MCL and LCL. She was put into a brace, which she will wear for at least four weeks. She will also undergo rehab before surgery. I wanted to know if surgery is really necessary and if it is why not do it now to speed up her recovery process?

A: There are several considerations when dealing with multiple ligament knee injuries.

The ACL is important for pivoting activities. When injured it usually cannot heal itself due to a limited micro circulation of the ligament. The MCL and LCL are important for side-to-side knee stability.

Many times the MCL and LCL can heal well non-surgically with immobilization followed by rehab. Some studies have shown that allowing all structures that can heal themselves to do that followed with regaining range of motion and strength can cut down on the complexity of the subsequent knee surgery and decrease the risk of loss of motion post op.

Also the surgery is approached differently when the athlete is skeletally mature, which your daughter may be approaching. It sounds like your daughter’s doctor’s plan makes sense.

Dr. Harlan Selesnick is team physician of the Miami Heat and Inter Miami. Send your questions to HarlanS@baptisthealth.net