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01-08-2013, 01:29 AM
  #253
Capsman
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Quote:
Originally Posted by MoJoSauce View Post
Now I know I am not an orthopedic surgeon, but I spent a lot of time in Orthopedic offices when I tore my ACL at 14. Saw the skins team doctor, as well as Wizards/Caps doctor (ran into Antwaan Jamison several times in the office).

There is no such thing as a partial ACL tear. Its either torn or its not. Ligaments are avascular, they don't magically heal without a surgical repair. You can stabalize the ligament with therapy through muscle strengthening but that partial nick wont go away.
To add something to this, the others are correct in saying that there are indeed partial tears. You are correct in that the ligament does not regenerate itself. The distinction between partial and complete ACL tear is important, though, to help determine whether or not surgery is needed. Really the best way to categorize these injuries are whether it will interfere with the sport of choice and whether lack of repair will lead to osteoarthritis. An associated meniscal injury is a no-brainer for reconstruction because without it the knee will eventually go to hell (whether a high functioning athlete or not). A complete tear is also likely to develop osteoarthritis at some point, but repair can be delayed in some cases (unlikely delay for the high functioning athlete). The partial tear is a bit trickier, as most do not need surgery and rehab will suffice; that is unless there is instability. This is where Dr. Andrews' exam comes into play. He will do a bunch of tests like the Lachman, ligament arthrometer, pivot test, etc to determine how unstable (if at all) the joint is. That may determine whether and when surgery will be needed. You pretty much have to weigh the quicker recovery of rehab alone against the risk of further tearing it. He may decide that it would take almost the same type of injury that would rupture a good ACL to rupture his partially torn ACL and recommend no surgery. Or if the knee testing shows significant instability surgery when the inflammation goes down would be recommended. Treatment of partial tears is still being researched in the literature and I'm sure Dr. Andrews is not only aware of the latest but is involved in these studies. So I have no idea what will happen, lol.

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