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Sports Medicine

ACL injury with question

01/06/2009

Question:

Hi, I am currently at age 21. I have hurt my right knee about 5 years ago when I was playing basketball, which I was told that it was a ACL torn injury. I have not done any MRI but I have done some research. I believe that my injury really is ACL torn. When I walk normally, sometimes I`ll feel my knee goes out of the socket. During quick direction change, I can turn it out of socket as well, or on landing. I do not plan to have a surgery due to financial issues at this moment. How can I help prevent my knee from getting worse? Should I stop playing basketball? If I do surgery later in the future, will it be already too late for me? In addition, I have been doing this exercises, that is intended to strengthen my muscle just above or at the knee area. It is an exercise that requires me to lean my back on the wall with a body ball, and I lower my upper body by slowly bending my knees (so it`s like a squat). However, I often get pain like sting or numb in my knees, especially the injured knee, should I continue doing it? I also asked a few different doctors, and they all gave me different answers and one of them told me that it would be too late for me to recover from this injury. Again, due to financial difficulty, I cannot take a MRI test, but will it be helpful? I hope I wrote everything clearly and expressed my situation thoroughly. Thank you for your time.

Answer:

If your knee periodically gives way on you - and particularly if it swells or locks - you are at higher risk of developing arthritis in that knee in the future. Once you have insurance, a knee MRI scan would certainly be much more informative than knee X-rays, not only to confirm or clarify the diagnosis - specifically, is just the ACL torn, or have you additionally sustained a meniscus or other cartilage injury? - but to also determine the current status of your knee joint surfaces (that is, have any wear-and-tear changes developed as yet?).

An alternative or additional cause for your symptoms could be patellofemoral pain, or a problem involving your kneecap. Wall slides with our without an exercise ball are often helpful for a variety of knee problems, but need to be done in an optimal way to maximize benefit, which may require guidance from a physical therapist or athletic trainer. If knee pain prevents you from performing certain exercises, controlling your pain with anti-inflammatory medication, ice application, various knee sleeve designs, and/or a steroid (cortisone) injection may be helpful.

In general, your knee symptoms need to guide positions and activities. The intent of an appropriate and comprehensive treatment (which may or may not include surgical intervention) and rehabilitation program would be to maximize your functional levels, and minimize your knee pain/instability symptoms and the extent to which you need to limit your activities.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University