Multiple Knee Ligament Injury

[buckelpiste]

I damaged my knee on the 1st April this year, in a skiing accident.
According to the Doctors the MRI Scan shows the ACL is snapped, the PCL is torn hanging by a thread so small it may as well be snapped, and the medial collateral ligament is completely detached top and bottom. During the accident, apparently my knee dislocated and then relocated. At first, there was massive internal bleeding and swelling. Now, 2 months later the bruising and bleeding is almost gone, there is still some swelling and heat.

To start with the Doctors said it was too swollen to operate on, that I should have physiotherapy treament, get the swelling down and then they would have another look.
Now, the specialist is saying that we should wait longer. He wants to see it again in another 2 months time and if it is still unstable then he will think about operating. The specialist seems to be very resistant to an operation. He thinks it will be stable enough without one.
If the ligaments are ripped, broken and actually torn out, will my knee ever be stable?
Is waiting really the best option?

[Heidi]

Hi

They are right that you have to let swelling go down before an operation. I think the usual time for acl surgery is about 6 weeks post injury. This time is also used for getting full range of motion and building strength in the knee if possible as this has been shown to improve results post surgery.

The use of surgery is dependant on each individual, their circumstances and the stability at the knee. However, if all three ligaments are ruptured (or near enough) this would normally affect the stability quite considerably as 3 of the 4 main stabilising ligaments are compromised.

It may seem quite stable at the moment as there is still swelling which has this effect.

If possible I would get another opinion on surgery. What does your physio think?

[buckelpiste]

Hi Heidi,

My physio believes without a doubt that I need an operation.
He recommended another specialist to go to for a second opinion. I have an appointment in a couple of weeks (He's on holiday at the moment - waiting sucks!)

The surgeon that I've already seen says that it might be stable enough without surgery. He reckons that plenty of people ski without any ligaments at all. I find that hard to believe though. I'm a ski instructor and (used to) ski at a high level and of course I want to get back to skiing like that again.

[Heidi]

The fact that you are so active and that this is required for your job indicates again that surgery is necessary.

Ligament ruptures are sometimes left, but this tends to be in inactive, or elderly people.