ACL Tears and Meniscus Damage: Treatment Options Explained

Artificial ligament rupture/meniscus tear

Hello, Doctor.
I was injured in a car accident in 1991, resulting in the replacement of the anterior cruciate ligament (ACL) and lateral ligaments in my left knee with artificial ligaments.
An MRI in April 2017 revealed that the ACL in my left knee has ruptured again, and there is damage to the medial meniscus.
I do not experience any significant abnormalities during regular walking, but I feel slight pain after walking quickly for about 20-25 minutes.
I would like to ask you: 1.
Is it necessary to remove the ruptured artificial ACL? Will leaving it in the body increase the wear on the knee cartilage? 2.
If I only maintain the ability to walk without engaging in any running or jumping activities, and use supportive devices such as a knee brace, can I avoid surgery? Thank you!

DAVID, 50~59 year old female. Ask Date: 2017/12/22

Dr. Shi Guozheng reply Orthopedics

Not removing the ligament will not affect the wear of the cartilage.
Depending on your age, if you are not engaging in vigorous activities, surgery may not be necessary.
Rehabilitation to strengthen the muscles can help reduce knee joint instability.

Reply Date: 2017/12/22

More Info

Hello,
Thank you for your inquiry regarding your knee condition, specifically concerning the anterior cruciate ligament (ACL) tear and meniscus damage. It’s understandable that you have concerns about your knee health, especially given your history of injury and surgery. Let’s address your questions one by one.

1. Should the ruptured artificial ACL be removed? Will it increase cartilage wear?
In general, if an artificial ACL (or any implant) is ruptured, the decision to remove it depends on several factors, including the stability of the knee, the presence of symptoms, and the overall condition of the surrounding tissues. If the artificial ligament is not causing any pain, instability, or other complications, it may not be necessary to remove it. However, if it is causing mechanical issues or if there is a risk of it contributing to further joint damage, your orthopedic surgeon may recommend removal.

As for the concern about cartilage wear, a ruptured ACL can lead to increased stress on the knee joint, potentially accelerating cartilage degeneration. However, if you are able to maintain a stable knee and avoid high-impact activities, the risk of accelerated wear may be minimized. Regular follow-ups with your healthcare provider and imaging studies can help monitor the condition of your knee over time.

2. If I only want to maintain walking function and avoid surgery, can I do so with the help of supportive devices like knee braces?
Yes, it is possible to manage your condition conservatively, especially if your primary goal is to maintain walking function without engaging in high-impact activities like running or jumping. Using a knee brace can provide additional support and stability, which may help alleviate discomfort during activities. Physical therapy can also be beneficial; a physical therapist can design a tailored exercise program to strengthen the muscles around the knee, improve flexibility, and enhance overall function.

In your case, since you mentioned experiencing mild pain after walking for 20-25 minutes, it’s essential to listen to your body. If you experience pain, it may be a sign to modify your activity level or take breaks as needed. Additionally, low-impact exercises such as swimming or cycling can help maintain fitness without putting excessive strain on your knee.

In conclusion, while surgical intervention is an option, many individuals with similar conditions successfully manage their symptoms through conservative measures. Regular consultations with your orthopedic specialist will be crucial in determining the best course of action for your specific situation. They can provide personalized recommendations based on your knee's stability, pain levels, and overall function.

If you have further questions or need clarification on any points, please feel free to reach out. Your knee health is important, and taking proactive steps can help you maintain a good quality of life.

Best wishes for your recovery and ongoing management of your knee condition.

Similar Q&A

Understanding the Relationship Between ACL Injury and Meniscus Damage

Hello, Dr. Shi: After reading the relevant responses, I have one more question to ask. Ten years ago, I suffered a torn anterior cruciate ligament (ACL) due to a car accident, but the hospital did not perform a repair. Now, due to pain while squatting, I underwent an MRI, which r...

Dr. Shi Guozheng reply Orthopedics
The anterior cruciate ligament (ACL) has been torn, accompanied by a meniscal tear. Due to the prolonged duration, repair surgery may be ineffective. The ligaments in the joint have been damaged for a long time, and the instability of the joint may lead to early onset of osteoart...

Understanding ACL Tears: Diagnosis, Treatment Options, and Recovery Insights

Hello Doctor, three years ago I slipped while playing basketball and went to a clinic where an X-ray diagnosed me with a ligament strain in my knee. I didn't experience pain for about a year, but last year I started to feel something stuck in there along with a dull sensatio...

Dr. Shi Guozheng reply Orthopedics
1. Anterior cruciate ligament (ACL) tears require a physical examination to assess for any signs of joint laxity, followed by imaging studies for a definitive diagnosis. If the degree of laxity is not significant, surgery may not be necessary. 2. Cartilage damage is irreversibl...

Understanding Meniscus Injuries: Recovery and Surgical Options

The doctor diagnosed an abnormality in the meniscus and recommended a one-month rest. However, I am currently experiencing severe knee pain and cannot bend or straighten it. Would surgery help? Thanks.

Dr. Chen Yongxue reply Orthopedics
Hello, In response to your inquiry regarding your knee meniscus injury, meniscus damage can generally be categorized into two main types: traumatic and degenerative. Traumatic meniscus tears can be managed through various approaches depending on the nature of the tear, includin...

Preparing Mentally for Knee Surgery: What to Expect After an Injury

I fell while riding my motorcycle and injured the ligaments on the right side of my left knee joint and the ligaments in the front. There is also a possibility of a meniscal tear. I previously had blood drawn from the joint cavity, and I may need knee surgery in a few days. The d...

Dr. Luo Zhaozhong reply Orthopedics
From the previous notes, it is evident that your prior physician managed your case very well. Generally, my approach involves conducting a thorough examination to determine whether there is a tear of the anterior cruciate ligament (ACL) and whether the meniscus is ruptured. In th...