What are the outcomes for non elected ACL repair, with regard to any further degeneration of the ACL, if exposed to W.B. and field sports?

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Marcelo Guimarães Silva

Dear Ralph,

I've found some materials which I believe that it can help you.

Sincerely yours,

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977377/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491791/

Article Medial opening wedge high tibial osteotomy: A prospective co...

Ralph Samwell

thank you Marchello

much appreciated

Does a mucoid ACL not require surgery but can be misread as an ACL tear, or a tear can be misread as an Mucoid ACL?

Or that being an athlete with a Mucoid ACL a decision has to be made to operate on the ACL as not doing so due to the wear and tear could lead to instability in the knee? In this case follow up care and further MRI scans should be conducted to determine how stable or unstable the knee has become and then a decision to operate or not?

Hi,

I think that each situation is very particular and requires a specific analyse, mainly to conduct the adequate treatment. In general, a primary role of MRI in the management of the patient with an ACL injury lies in allowing confident diagnosis or exclusion of a tear in patients with equivocal physical examination findings. It should be emphasized, however, that ACL injury management is critically dependent on accurate diagnosis of other coexisting knee internal derangements, in particular tears of the lateral collateral ligament (LCL), posterior cruciate ligament (PCL), and the menisci. In this way, patients with combined LCL/ACL or PCL/ACL injuries often have profound instability requiring aggressive surgical management. In the instance of a coexisting LCL tear, intervention may be hastened as LCL injuries are optimally repaired within 1-3 weeks. An unoperated LCL tear predisposes an ACL graft to early failure. With regards to clinical diagnosis, in general a physical diagnosis is particularly difficult in large patients, in patients with strong secondary muscular restraints, and in patients with an acute injury and soft-tissue swelling and guarding. Partial ACL tears are also difficult to diagnose on physical examination. However, MRI may provide pivotal diagnostic information about the ACL in all of these settings.

I hope this helps.