Question: Hi. My wife XXXXXXX XXXX had fallen from stares in april 16 and her ligament had broken . She had gone for physiotherapy for two months got some relief but still not able to move straight and pain is still there while movement. The report is as below. Please suggest for the right treatment.
42Y / F
20-04-2016 / 01:39 PM
Patient
Referred By Dr XXXXXXX XXXXXXX
Registration Date
S-760
Mrs XXXXXXX XXXX Age/Gender
Reg. No.
Printed On 21/04/2016 / 04:39 PM
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MRI - RIGHT KNEE WITHOUT CONTRAST
MRI of right knee was done on 1.5 Tesla using extremity coil. PD, T2W, GRE and T2W fat-sat sagittal imaging was done. T1W coronal and T2W
fat-sat coronal and axial imaging was also done.(CD containing MRI images given along with the films).
There is non-visualisation of ACL, likely represent chronic complete tear. Buckling of
PCL is noted with anterior translation of tibia with respect to femur.
Mild ill-defined intrasubstance increased signal intensity is seen in proximal fibers of
PCL near femoral attachment, may represent early myxoid degeneration changes.
Edematous / fluid signal are seen on both sides of MCL, suggest grade I injury (sprain).
LCL is intact. Mild edematous signals are seen in relation to it, may represent low grade
injury.
Altered morphology with increased signal intensity is seen involving body ad posterior
horn of medial meniscus, suggesting tear.
Increased signal intensity is seen in body - posterior horn of lateral meniscus reaching
upto inferior articular surface, suggesting tear.
Mild to moderate joint effusion is seen with fluid in posterior recess.
An area of partial to full thickness cartilage erosion, measuring ~ 17 x 8mm is seen at
medial femoral condyle. Mild underlying subchondral sclerosis is seen. Subchondral marrow
edema is seen at medial femoral and tibial condyles, probably post traumatic. D/Dx:-
degenerative. Small focus of cartilage thinning is seen at medial facet of patella. Tiny focus of
subchondral marrow edema is seen at lateral trochlear surface of femur, suggesting
degeneration changes in overlying articular cartilage. No definite cartilage erosion is seen at
lateral tibiofemoral compartment. Small osteophyte are seen at medial tibiofemoral
compartment.
Trochlear groove is shallow in its cranial part, suggesting element of trochlear dysplasia.
Otherwise visualised bones reveal normal marrow signal intensity.
Patellar and quadriceps tendons are unremarkable.
There is thinning of medial patellar retinaculum with edematous signal in its posterior
aspect. Mild edematous signals are seen between adductor magnus tendon and vastus
medialis obliquus muscle.
Mild edematous / fluid signals are seen along myofascial planes of distal posterior fibers
of biceps femoris and proximal fibers of gastrocnemius muscles. Rest of the visualised muscles
reveal normal signal intensity.
Mild circumferential periarticular subcutaneous edema is seen.
IMPRESSION- Non visualisation of ACL, likely represent chronic complete tear.
- Grade I MCL injury (sprain).
- Tear of both menisci.
- Mild to moderate joint effusion.
- Early osteoarthritis of knee.
- Element of femoral trochlear dysplasia.
Clinical correlation is suggested.
Dr. XXXXXXX Lakhyani, MBBS, MD Dr. XXXXXXX XXXXXXX DMRD, DNB
XXXXXXX MRI Consultant MRI Consultant


Two days back she has again fallen while washing clothes. Again the swelling has come at knees and lot of pain is there in knees. Please suggest what to do in this case.

Good evening Sir, Obliged for your prompt and kind reply. Kindly advise can ACL be cured without surgery and surgery is required then how is the success ratio and whether it will be minor surgery or major surgery. How much it will cost and what shall remain the precautionary post surgery factors.

Thanks a lot Sir. Sir one more thing that my wife's knee is dislocating from many years and would set up after some hours. Shall this dislocating problem also be over after this surgery.