Ask the Expert: Dr. Robert Marx, Orthopedic Surgeon, Answers Your Questions on ACL Injuries

by Dr. Robert Marx
Dr. Robert Marx, Orthopedic Surgeon

Q1: Do I really need to have surgery for my torn ACL?  

Patients who participate in cutting and pivoting sports such as basketball, soccer and football have a very high chance of developing knee instability and giving way without surgery. This often leads to cartilage and meniscus damage. For older, more sedentary patients who are not participating in such sports, non-operative treatment may be an option. If they develop symptoms of instability that are not tolerable, surgery can be performed at that point.

Q2: What do you use for your tibial and femoral fixation? Allograft vs. autograft?  

Interference screws are used most commonly; however there are many devices available for graft fixation.

Q3: How much stronger are bone – patellar tendon – bone grafts relative to other graft sources? How much sooner can one return to play (I have heard as little as 3 months post-op versus a year for allografts with autograft hamstring and quadriceps tendons somewhere in between)? How much tensile strength does the donor patellar tendon lose after the defect is scarred in? By return to play I meant high demand cutting sports with no restrictions.  

Graft selection is controversial. It does not affect time to return to play. Allografts are not recommended for young athletes due to high re-tear rates which have been discovered in recent research. They are more suited to older adults who have less time spend on their recovery and who are generally at lower risk of re-injury due to a lower activity level.

Q4: I heard that ACL injuries are different for females versus males – is this true?  

The injury is the same. However, it is up to six times more common in females.

Q5: My son tore his ACL playing high school soccer. How will this affect him later on in life?  

Hopefully it won’t. Any patient who tears their ACL is at higher risk of knee arthritis, but it is certainly not a guarantee.

Topics: Facebook Notes, Orthopedics
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

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Hospital for Special Surgery
April 22, 2014 at 5:34 pm

Did you know that Electromyography (EMG) is a form of electrodiagnostic testing that is used to study nerve and muscle function? Dr. Joseph Feinberg, Physiatrist, says: “There are two parts to EMG testing: a nerve conduction study and a needle exam for muscle testing. Both may result in some discomfort, but are usually well tolerated without the need for medication beforehand. EMG testing usually takes anywhere from 30 to 90 minutes depending on the condition being tested and findings of the study.” For more information on EMG testing, visit http://www.hss.edu/conditions_emg-testing-a-patient-guide.asp.

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