Originally Posted by BadGalSkier
Oh my, the amount of information that gets around is crazy. At your age you should strongly consider an ACL reconstruction because there is some evidence that an ACL deficient knee may be more vulnerable to meniscus damage in the future. Also, if you are into sports, which you are, that risk is even higher. However, this scientific evidence is really not all that conclusive but rather it is more suggestive. Keep in mind that NO ONE NEEDS an ACL to survive. It's really a personal choice.
Even without an ACL you're going to develop arthritis and meniscus damage because it's unavoidable as we age. Again, at your age I would strongly consider a reconstruction because of the years of abuse that your knees are still going to endure. Most doctors would undoubtedly recommend a reconstruction in a 19 year old because of the many more athletic years to come for a young person.
I'm not a doctor but I have had 4 ACL reconstructions and I'm in medical school (I rarely mention this). Last year I did a million page (maybe a few less pages) research paper on the necessity of ACL reconstruction (my interest came from my own reconstructions) and in the end the evidence suggests that you go with the reconstruction if your knee is unstable. There is no documented medical rule that states you cannot ski or play other sports without an ACL. You don't need to have surgery just because you are disappointed that you have a broken body part. You need surgery if it causes you enough problems to interfere with your life. Remember, people live without gallbladders, spleens, and wisdom teeth and most of them do just fine.
agree with most of what you say in that you give a pretty balanced presentation that indicates she has a decision to be made with the scientific evidence being suggestive, but not conclusive...don't understand "The END" part?? Are you saying that is all you have to say or suggesting she needn't look further?
Hopefully, more research will be done and there will be stronger evidence suggesting not only YES or NO on surgery, but what surgical methods yield the best results (with breakdowns by age, etc). Bad doctors wouldn't want this, but being a numbers guy, what I would really like to see is a National/International database which logs info on all surgeries/major medical treatments and give the patient a way to post follow-ups/status reports (or requests certain info on a periodic basis). Enough ACL surgeries have been performed that we should have more than just suggestive evidence as to which graft choice/surgical technique (there is more than just one being used) is best.
People can point to patient confidentiality issues, but my guess is that the real thing stopping this is doctors/hospitals- the good doctors are already busy, so there is no upside for them and the rest are concerned about the negative affect of ranking in the bottom half of results obtained.
I felt very comfortable with both my ACL surgeons going into the operation, but when consulting with the 2nd doctor who uses a different technique than the first, he said that they have had numerous friendly discussions/debates about which method is best. If two intelligent, well educated doctors who perform hundreds of these things can't come to an agreement, how is an uninformed patient suppose to make a rational choice?
In the long run, a central database is going to be a better, quicker, and more efficient way to optimize health care than trying to study things ex-post-facto, not just for ACL surgery, but for prescribed drugs and other treatments as well.
Originally Posted by huhh
If the doctor recommends surgery, then do it. It's not like your knee would get worse compared to right now.
I voted for surgery because she is 19 and active BUT
Have you had knee surgery? Surgery will likely increase stability BUT surgery does trauma to the knee (including drilling holes in your bones, swelling and muscle atrophy), even when it is very successful. If the OP said she had to rely on her knee in a life and death situation in Feb or March, I wouldn't advise having the surgery now.