Our Experts Answer Your Questions
Our orthopedic surgeons provide information about typical knee issues. If you are having knee pain – because of sports injuries, medical conditions, or for other reasons – the Orthopedic & Spine Institute experts can help.
Q. If I have a torn anterior cruciate ligament (ACL), do I have to have surgery?
A. Shyam Brahmabhatt, MD, replies:
The ACL is one of the main ligaments that stabilizes the knee. It connects the femur (thigh bone) to the tibia (shin bone). This common knee ligament injury tends to occur more often in people who engage in sports such as football, soccer, basketball, or skiing. Because the ACL weakens with age, the risk of tearing it increases in those 40 and older.
Whether or not you undergo reconstructive surgery for a torn ACL depends primarily on your activity level, risk for injuring other structures of the knee, and symptoms (pain and limited stability, strength, and movement). For some people, a lengthy period of rehabilitation (exercise and training) may be enough to stabilize the knee and enable them to return to their pre-injury lifestyle. If your orthopedic surgeon recommends surgery, the techniques we use today are less invasive and in most cases, can be performed on an outpatient basis. Rehabilitation is accelerated, so patients recover more quickly and return to work sooner.
Q. How long does it take to return to my normal activities after ACL surgery?
A. David Craft, MD, replies:
Results vary for each individual, since no two people are alike. I would recommend making a list of all your questions before you meet with your doctor, so he can discuss your particular care with you.
Some questions you may have:
How quickly can I walk without crutches?
How long will it be until I can work out again?
When can I run again?
When can I participate in activities in which I cut side to side?
Q. My doctor says my daughter has chondromalacia patella (pain in her kneecap). What can be done for this condition?
A. Thomas C. Peff, MD, replies:
Common in young girls, chondromalacia patella is the softening and breakdown of the cartilage behind the kneecap. The condition results from structural problems such as being knock kneed, which causes poor joint alignment. This malalignment keeps the kneecap from sliding smoothly in its groove over the femur. Instead, the kneecap grates over the thigh bone, making the cartilage behind it rough and causing chronic joint pain and inflammation.
Treatment for chondromalacia varies and may include physical therapy to strengthen the muscles around the knee, or the use of tape or a knee brace (known as a J sleeve) to stabilize the knee. If the dislocation is severe, we may recommend surgical realignment of the knee.
Q. What is a knee sprain and what do I do about it?
A. Thomas E. Greene, MD, replies:
A knee sprain is an injury to one or more of the four major ligaments in the knee—the anterior and posterior cruciate ligaments or the lateral and medical collateral ligaments (MCL). Sprains are most common in the MCL. We grade sprains according to severity:
Grade 1: the ligament is stretched but not torn
Grade 2: the ligament is elongated and becomes loose (called a partial tear)
Grade 3: the ligament is completely torn into two pieces
Depending on its severity, treatment of a sprain varies and may include reduced activity with a brace, or surgical repair. A sprain can be a very serious injury that takes a long time to heal.