Ligament Damage

[MOHL4008]

Hello, my 15 year old daughter injured her knee about 2 months ago. According to her ortho surgeon she damaged the PLC, PCL and LCL??? All on the outside of her knee. She has an external fixator in place and the ortho surgeon was initially talking about doing ligament replacement surgery. Now he is advising leaving the fixator on for another month (that would make 3 months total) to see if enough scar tissue builds up around the knee to avoid having to do surgery. Does this sound right? I would appreciate any advise or input. Thanks.

[krunchie]

Check prolotherapy - see my post about my experience and research


I am ski instructor by the way !

I suggest you look at how prolotherapy has fixed Bode Miller, JJ Johnson, Eric Schlopy and Bryon Friedman of ligamentous knee and back injuries. Big news in feb 2006 because they went to a well respected doctor who has in fact lost his US licence but that is another story - they went against advice from their team trainers - because they don't know anything about the treatment - went to Mexico and BINGO - fixed..I have done a ton of reasearch on prolotherapy (and the doctor these guys went to ..he is in fact one of the pioneers and has written many papers that are still used today by ORTHOPEDIC SURGEONS in the USA and UK...and taught many practitioners BUT that fact has been conveniently omitted from the press reports !!!!!) because I had a chronic back problem with stretched ligaments...I am fixed...if you have time here is my story...BUT BEWARE....Prolotherapy is only as good as the doctor who diagnoses and treats you..it requires very accurate diagnosis and incredible skill, experience and a STEADY HAND...you have got to get a very long needle into the ligament in some very inaccesible places.....especially at the point it connects with the bone..I was very lucky that I picked the only doctor in the UK who had been doing it non stop for 35 years and had had the treatment himself 40 years ago...which was why he studied it !!

here you are.....


In response to anyone asking about experience with prolotherapy.
yes I have ! I am a ski instructor. I am now 44 but had the first treatment almost 2 years ago
The treatments were not painful - just a sensation of the needle going in - this depends entirely on the therapist and even then..there is a risk of hitting a nerve. The local anaesthetic and gas
worked fine for me each time.

The treatment has been utterly successful and I would like to share my story - because there are some CAVEATs....read on.

I had a chronic lower back problem (basically slack SI ligaments and lumbar ligaments on lower right side...very common indeed) which I had been having treatment for from 2 osteopaths for it would not heal - osteopaths who had cured me of all other issues over the preceding 5 years - I was very confident in these guys so when they couldn't fix me I looked further.

I had xrays and MRIS done so I could see if there were any other reasons for my pain other than lax ligaments - the xrays and mris looked perfect - the traumatologists, osteopaths and orthopedic surgeons etc all looked at them and said the same - you look perfect...PERFECT...it's just a bit of hypermobility..it will go away...well after 28 months of NOT going away I was not going to just accept their answers...not just because they had letters after their names and nice white coats...oh no...not me....

I found prolotherapy on the internet and spent 1 year researching it every day - I asked many osteopaths, orthopaedic surgeons - ones who were personal friends AND by going to see specialists at clinics in the UK and Spain and France....nobody that I spoke to had even heard of it !

Well...I can tell you that I wish I had not spent 1 year researching it because I wasted a year of my life by having to tolerate the pain - the prolotherapy was effective very quickly - I wish I had just gone to the doctor I found the first day I read about it !!! BUT...I was lucky....the doctor I saw has been a prolotherapist for over 30 years, had had the treatment himself 40 years earlier and as a result studied it - I was lucky to find someone with this experience first time.
I have since learned - through more research and discussions with my doctor - that it is very clear that the success of prolotherapy depends on 3 IMPORTANT THINGS..

1) The skill and experience of the therapist - the therapist needs to be VERY skilled, sensitive and accurate

2) The actual solution the therapist uses - they are NOT all the same - each therapist has his preference - therfore one with more experience can judge what works better.....for example...the solutions used in the US are often NOT as effective as the solution my doctor uses because many doctors are unwilling to use enough of the one of the irritant substances - which also happens to be an antisceptic - because it has, in a very small numbers of cases, caused temporary but painful side effects - this is apparently very very rare and often due to the inaccuracy of the therapist - as I am informed. The effectiveness of the treatment is clearly
governed by how much irritant solution is used in each treatment - the more used the quicker and more pronounced the healing BUT there is a limit to how much the body will tolerate. Do not forget the healing process is the response to the local irritation caused by the needle and the irritant solution used in prolotherapy.

3) ACCURATE diagnosis....I knew what my problem was because I had felt it develop over some years and remember exactly what caused the original trauma - I had had lots of treatment with osteos, physios, etc during 15 years of sport - I could feel what the problem was - after a few little injuries you can recognise what type of problem you have and if it's getting better or not.

I was lucky to have theprivate health so I just kept going to see different people - including the main professional winter sports injury clinic in Barcelona - until I was satisfied I had the info. I went to see the prolotherapist in London with all my mris etc...he just laughed and said.."I have seen your problem every day of the week for the last 35 years - almost everyone has this problem - I dont need these mris but thanks I will look at them for you...oh yes..as i suspected...you cannot see any problem...well you won't ! The SI ligaments will not show any damage on an MRI..the slightest stretching or damage to these can be very painful but you can't see it. Do you want me to treat you now or do want to mess around for another year ?"
He examined me and clearly demonstrated to me that one side of my pelvis was far more mobile than the other...my previous osteopaths had both diagnosed exactly the same thing - and explained which ligaments would be treated.... I started there and then...I had far fewer treatments than recommended - I was in the gym within 48 hours...skiing within 2 weeks...I am a ski instructor....I had to travel from Spain to the UK for treatment.
I had 3 treatments between nov 2005 and feb 2006....the problem was 95% resolved by the 3rd treatment...but ideally I should have had a treatment every 3 weeks for about 6 months ...it would have solved it even sooner...I have since had 5 more sessions between may and oct 2006...the function of the joint was stabilised within 4 weeks of first session..my osteopath in Spain was astonished at the change and increase in stability of the right side....bearing in mind he had treated me for 5 years before and had had to realign my pelvis every visit..every 2 weeks...since prolo he has never had to do that. The mobility/movement in the joints is now almost equal on both sides. That has been confirmed by the 2 osteopaths in Spain who are not connected to my prolotherapist.
The pain had gone completely by the 3rd treatment..it had reduced to about 20% of original pain after the first treatment.
If I had to sum it up...I would say I am now 100% functional and pain free for 90% of the time..before I was in pain 90% of the time.
the other 10% I feel a slight sensation of stiffness - not PAIN - and this continues to reduce and occur less often..even without further treatment...however..I stress...I would prefer to have had more treatments close together to be sure of eliminating the problem and strengthening the ligaments as much as possible..I will have another 3 or 4 treatments very close together when I can afford it just so I don;'t have to think about it for another 30 years !!

Is that enough of a postitve vote for prolotherapy when administered correctly and appropriately ????

Good luck...back pain is horrible..and in most cases TOTALLY curable...DO NOT accept back pain advice from doctors who have NOT suffered it themselves !!!! And do not accept it as part of growing old and something you have to live with. Ask your prolotherapist lots of questions..how long have they been doing it, what solution they use etc....they are not all the same - but when you find the right one - you will be very happy !

[CTT]

Hi,

Yes - that does sound right. There are a variety of treaments for ligament injury which involves stimulating the development of scar tissue. When scar tissue is deposited the ligaments tighten offering more support to the joint. Later on the physios are likely to work the thigh muscles which will become strengthened to assist support and stabilisation of the knee.

By trying this first the option for ligament replacement is still present in the event of future problems.

Best wishes to your daughter.