Surgery for the PCL involves either an autograft or an allograft reconstruction of the ligament. Either a bone-tendon-bone, hamstring autograft, an achilles tendon or bone-tendon-bone allograft is used to reconstruct the posterior cruciate ligament.

Feelings of instability with certain motions about the knee can occur with a damaged PCL. Occasionally, with a long standing injury, the knee cap can be painful.

Surgery for the common meniscus tear is an outpatient arthroscopic surgical procedure. A couple of portals (holes) are made in the knee so that an arthroscope and the trimming instrument(s) can be inserted. Often a motorized or radiofrequency (electro-thermal) device is used to help trim and contour the torn area of the meniscus to create a smooth surface.

The damaged ACL cannot be sewn back together as it will not heal. A torn ACL will require a reconstructive procedure using transplantable tendons from your body (autografts) such as the hamstring, bone-patella-tendon-bone (BTB) or quadriceps tendons, to reconstruct this torn ligament. Allograft (tissue bank cadaver tissue) tissue is often used with less pain to you and earlier return to function. Both autograft and allograft tendons are acceptable to use for ACL reconstructions.

Surgery about the knee cap can be controversial with no exact reason when to operate or consensus about the type of procedure that should be done.

Symptoms of a damaged meniscus are pain and catching, clicking, or locking during certain twisting knee activities. These mechanical sensations are very commonly felt by the patient. The knee can also have swelling. Generally, meniscus tears do not heal because they have a poor blood supply. However, they can occasionally become asymptomatic.

Symptoms with a damaged ACL will be pain, swelling and a feeling of instability. Often times the knee can buckle underneath you and “give way.” If twisting, stopping, turning sports are attempted with a torn ACL, these buckling and “giving way” episodes will recur – a “trick knee.

Generally, this pain can go away and heal on it’s own. Body mechanics and control of the femur from above with your hip muscles are important. Stretching and strengthening the quadriceps and hamstring muscles are also important.

Symptoms include instability and “giving away.” Occasionally, you can feel the tibia slipping underneath the femur. The inside medial collateral ligament (MCL) can heal on its own and rarely requires surgery. Injury to the outside lateral collateral ligament (LCL) is different altogether. This usually requires surgery, but is a rare injury.

Generally, if the fractured bone is not separated then surgery can possibly be avoided. If the bone is broken in many places or the bone fragments are separated then often surgery may be required to help correct the anatomy of the broken bone. Even if the fracture does not require surgery, a period of immobilization (cast) may be required.

Surgery is between $2000 and $3000 including the operating room fee, depending on what needs to be done. For most patients the charge is about $2500 complete. Payment can be by check, cash, or credit card, and a finance plan is also available.

Still have questions? If so, contact personal injury attorney John H. (Jack) Hickey in Miami, Florida, to schedule a free consultation. Report the accident immediately. If it is a car accident, call the police. If it is an accident at a business or store, tell the manager or whomever works there, and get their full name and title. Go get medical treatment immediately. Do not try to be your own doctor and think that it can wait. Go to an emergency room at a hospital if you have to.

The posterior cruciate ligament is less commonly injured than the anterior cruciate ligament (perhaps a ratio of 1 to 20). Posterior cruciate ligament injuries generally do not require surgery unless there is a great instability of the knee. Many athletes can function at a very high level without a posterior cruciate ligament. Often times in a car accident, when the knee cap (patella) is driven into the dashboard, a posterior cruciate ligament injury can occur.

In general, the prescription of glasses is more accurate than any type of refractive surgery. However, the vast majority of patients do not require glasses after refractive surgery.

No guarantees can be made as to the results of any kind of surgical procedure whether it is done on your big toe or your eye. However, I think it is safe to say that the vast majority of patients have at least 20/40 vision without glasses after surgery, and many of them have 20/30 to 20/20 vision after surgery.

We advocate increasing two kinds of exercise as part of a post surgical lifestyle change: 1) Increase the difficulty of unscheduled everyday activities. For example, try to walk farther - a pedometer is helpful in this regard - climb the stairs instead of taking the elevator; volunteer for small tasks that you might not otherwise choose. 2) Schedule workouts two or three or four times a week simply for the purpose of exercising.

Many patients notice improved vision immediately after the procedure, although it is normal to be somewhat blurred immediately after an operation. The next day, most patients have excellent vision and do not need any glasses or contacts. Patients continue to see gradual increase in their visual acuity during the first five to seven days after the surgery.

If a therapist were needed at home, it would be necessary for home safety evaluation, to ensure safe use of crutches or a walker, and to instruct progression of weight bearing after the initial 6 weeks following surgery. Swimming and stationary bicycling (with no resistance) are recommended after the first 6 weeks from surgery.

o For surgeries with incisions, or arthroscopic lateral releases, we also prescribe an antibiotic, Keflex