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 DO YOU REALLY NEED
ACL SURGERY?
A COMPLETE TEAR, YES, A PARTIAL TEAR, NO
First Determine Whether It Is A Complete Tear.
Ross Hauser, M.D.
"The MRI says I have a complete tear,
I guess I need surgery"
Maybe not. "MRI studies have not been shown to be accurate in the
differentiation of complete and partial ACL tears." This is from "the
bible" of
MRIs and sports medicine.(1) If athletes would just hold off
on surgery until evaluated and treated with
Prolotherapy,
there would be a lot less of them needing pain pills,
knee replacement surgery,
and wheelchairs and canes later in life.
Rest or Surgery, Some Poor Options
In the surgical mode of options, the best case scenario for a torn ACL
is that athletes are told that a
tendon
can replace the
ligament and the rehabilitation of this new structure takes a full
year. Perhaps then, the athlete will be able to compete again at a later
date. The other option of course in this mode of options is do nothing,
rest the injury to see if the ACL responds.
Left untreated ACL injuries have terrible consequences and, if treated
with surgery there are bad consequences. Unfortunately for the athlete
unaware of Prolotherapy, they must choose between the lesser of two
evils.
The Untreated ACL
Studies have shown:
a. up to 86% of these knees "gave way" within four years.
b. only 14% of athletes were able to return to unlimited athletic
activities.
c. after ten years, up to 78 percent of the knees treated without
surgery showed
Osteoarthritis.
d. ACL deficient knees are plagued by long term swelling and stiffness.
Realize that the conservative treatments the athletes received in the
above studies were Rest, Ice, Compression, and Elevation (RICE
treatment),
anti-inflammatories,
cortisone,
physical
therapy, and other conservative therapies.
They did not receive Prolotherapy.
What about ACL Surgery?
There are various surgical techniques employed in the ACL
reconstruction: repair through the patellar defect, arthroscopically-assisted
techniques, and the mini-arthrotomy technique. The problem is that the
orthopedic surgeons' views on excellent results is different than the
athletes' views. The athlete is thinking "I'm going to be back to my
sport as good as new as soon as the surgery is over." The orthopedist is
thinking, "This athlete doesn't have a chance to be back on that ball
field, but the surgery will help stabilize the knee." Poor communication
is at the crux of this. The final goals and desired outcomes are never
discussed.
Prolotherapy and ACL Tears. What is Realistic?
In a partial tear, Prolotherapy can be done exactly where the ACL
attaches onto the tibia and femur, thereby stimulating the ligament on
both ends to proliferate and strengthen. It is only then, by the
strengthening of the ACL, will the athlete truly be healed.
Prolotherapy can cure a partial ACL tear, but not a complete tear.
A complete tear requires surgery. Prolotherapy is still helpful in this
situation, because the other
ligaments around the knee, as well as the
joint capsule itself, were at least stretched during the forceful event
to the knee that totally disrupted the ACL. Strengthening the
surrounding
connective tissue will help disperse the load on the rebuilt
ACL.
1.
Stoller, D. Magnetic Resonance Imaging in Orthopaedics and Sports
Medicine. Second Edition. Philadelphia, PA: Lippincott-Raven, 1997, 330. |
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