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Torn Meniscus/ACL

Knee injuries are quite common in accidents. It is common for one to twist their knee while forcibly trying to apply the brakes to avoid a collision or during an unexpected slip and fall.

The knee is a complex joint with many components, making it vulnerable to a variety of injuries. Many knee injuries can be successfully treated without surgery, while others require surgery to correct. The following are some facts about the knee from the American Academy of Orthopaedic Surgeons:

The knee is the largest joint in the body, and one of the most easily injured. It is made up of the lower end of the thighbone (femur), which rotates on the upper end of the shinbone (tibia), and the knee cap (patella), which slides in a groove on the end of the femur. The knee also contains large ligaments, which help control motion by connecting bones and by bracing the joint against abnormal types of motion. Another important structure, the meniscus, is a wedge of soft cartilage between the femur and tibia that serves to cushion the knee and helps it absorb shock during motion.

The four major ligament injuries are described below:

  • ACL (Anterior Cruciate Ligament) injury
    Changing direction rapidly in an accident may cause tears in the ACL. A twisting injury in a motor vehicle crash or a slip and fall are common causes.
  • MCL (Medial Cruciate Ligament) injury
    Injuries to the MCL are usually caused by a direct blow to the outside of the knee. One’s knee hitting the interior in a car accident or the outside of the knee striking the floor during a fall is a common cause.
  • PCL (Posterior Cruciate Ligament) injury
    During an accident the PCL can be injured when a motorist receives a blow to the front of the knee such as when the knee hits the dashboard, or during a slip and fall when the front of the knee hits the floor directly.
  • Torn cartilage
    When people talk about torn knee cartilage, they are usually referring to a torn meniscus. The mensicus is a tough, rubbery cartilage that is attached to the knee's ligaments. The meniscus acts like a shock absorber. Tears in the meniscus can occur when twisting, cutting, pivoting, or decelerating.

Orthopaedic surgeons use a variety of methods to treat knee injuries in athletes. A common method used to treat mild knee injuries is R.I.C.E., which stands for "rest, ice, compression, and elevation." Rest the knee by staying off it or walking only with crutches. Apply ice to control swelling. Use a compressive elastic bandage applied snugly, but loosely enough so that it does not cause pain. Finally, keep the knee elevated.

The most important advice is to seek treatment as soon as possible, especially if you:

  • Hear a popping noise and feel your knee give out at the time of injury
  • Have severe pain
  • Cannot move the knee
  • Begin limping
  • Have swelling at the injury site

If the knee does not respond to conservative measures, then surgery may be warranted.

ACL tears are not usually repaired using suture to sew it back together, because repaired ACLs have generally been shown to fail over time. Kaplan N, Wickiewicz T, Warren R. Primary surgical treatment of anterior cruciate ligament ruptures. A long-term follow-up study. Am J Sports Med 1990;18(4):354-358. Therefore, the torn ACL is generally replaced by a substitute graft made of tendon. The grafts commonly used to replace the ACL include:

  • Patellar tendon autograft (autograft comes from the patient)
  • Hamstring tendon autograft
  • Quadriceps tendon autograft
  • Allograft (taken from a cadaver) patellar tendon, Achilles tendon, semitendinosus, gracilis, or posterior tibialis tendon.

Patients treated with surgical reconstruction of the ACL have long-term success rates of 82 percent to 95 percent. Recurrent instability and graft failure are seen in approximately 8 percent of patients.

It is common to see ACL injuries combined with damage to the menisci (50 percent), articular cartilage (30 percent), collateral ligaments (30 percent), joint capsule, or a combination of the above. Murrell GAC, Maddali S, Horovitz L, et al. The Effects of Time Course after Anterior Cruciate Ligament Injury in Correlation with Meniscal and Cartilage Loss. Am J Sports Med 2001;29:9-14. In cases of combined injuries, surgical treatment may be warranted and generally produces better outcomes. Shelbourne K, Porter D. Anterior cruciate ligament-medial collateral ligament injury: nonoperative management of medial collateral ligament tears with anterior cruciate ligament reconstruction. A preliminary report. Am J Sports Med 1992;20(3):283-286. As many as 50 percent of meniscus tears may be repairable and may heal better if the repair is done in combination with the ACL reconstruction. Warren RF. Meniscectomy and repair in the anterior cruciate ligament-deficient patient. Clin Orthop 1990;252:55-63.

If you have suffered this type of injury, due to the negligence of another person or entity, you may be entitled to monetary compensation. These types of accidents require expert analysis and the resources of an experienced, board certified civil trial attorney. The Law Office of Steven S. Farbman, P.A., specializes in cases involving this type of injury and will make sure the negligent parties are held accountable for their actions. The Law Office of Steven S. Farbman, P.A. is committed to helping people who have been involved in an accident. We understand that being injured in an accident is a difficult time for you. Our office will be there for you in your time of despair. You are more than a file number at the Law Office of Steven S. Farbman, P.A.. You are family. We will protect your rights and aggressively pursue all legal remedies available to you under the law.

Call now for a FREE initial consultation 1(866) FLA-ATTY or click here for a FREE on-line evaluation. These types of cases are subject to a Statute of Limitations. Therefore, it is extremely important you act immediately to ensure your claim is preserved and you do not waive your rights to the compensation you deserve. Our firm works on a contingency fee basis. This means we get paid for our services only if, and when, there is a money recovery for you. You deserve the best possible legal representation, so call us now 1(866) FLA-ATTY.


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