About the author:

Howard J. Luks, MD

A Board Certified Orthopedic Surgeon in Hawthorne, NY. Dr Luks specializes in the treatment of the shoulder, knee, elbow, and ankle. He has a very "social" patient centric approach and believes that the more you understand about your issue, the more informed your decisions will be. Ultimately your treatments and his recommendations will be based on proper communications, proper understanding, and shared decision making principles --- all geared to improve your quality of life. Please read our Disclaimer

48 comments on “ACL and MCL Tears: Na Vorro Bowman

  1. Bowman had surgery today. The timing of this surgery tells me that the surgeons felt the mcl could not heal on it’s own and that intervention during the timeframe that a repair could be done medially was chosen. I realize this is speculation but I can’t think of another reason why they would wait 2 1/2 weeks after injury to intervene. If they felt the mcl would heal on it’s own I would suspect they would wait 6 weeks. Thoughts?

    1. It does seem that they felt the MCL was healing well enough that it did not require a repair. Operating at 2 1/2 weeks after an MCL sprain can bring up the issue of stiffness since the MCL injury itself can hurt (significantly) for weeks to months. The MCL pain might hold back the ACL rehab ??? We’ll see.
      Thanks for stopping by…
      Howard Luks

  2. Thank you, Dr. Luks for the very informative details pertaining to acl/mcl tears. I have finally found the answer that I was looking for which was whether ligaments can and will shrink if not repaired in severe, complex tears.

    Here is a little background information on my injuries. I have always had lax ligaments especially in my knees. I always sat in the form of “W” and many times when I would fall I descend down “collapsing” to the ground on my derriere with my legs in the formation of a W. I never thought about it and as I look back, it was natural to me. However, last year I slid and hit the floor so traumatically and in that W formation that I heard a huge snap and pop from one knee with excruciating pain. The other knee was a grade 2 complex knee injury.

    To make a long story short, I finally had confirmation from the MRI and went to an orthopedist who said it would heal over time and that he had seen many like it. Basically, he said surgery wasn’t necessary unless it continued to bother me. This was only pertaining to the most severe injured left knee.

    I have never been able to squat or do the normal things I used to do and my knees are always swollen and I can’t sit comfortably anymore. My back has begun to hurt because I have to bend forward without bending my knees and walking is arduous. Lately, though I have felt as though there was shrinkage at the medial collateral ligaments of both knees. This was my hypothesis. I searched the web and could not verify my speculation until I came across your website. I also wondered whether surgery would be possible considering the length of time since the original injuries. Do you think it is too late? I feel a bit despaired over my current physical condition. What are your thoughts?

    Thank you again for your very knowledgeable statements. I am very grateful for I have found the very answer I was looking for regarding “shrinkage”.

    Sincerely,
    Judy

    1. Thanks for the kind comments!
      Without examining you though I can not comment on your particular injury.

  3. Dr. Luks,
    I currently have a combination grade 3 MCL/ACL sprain. I did it on a snowmobile while attempting to “assist” the snowmobile during a turn and stuck my leg out as if I was on a motorcycle or peddle bicycle. Heard/felt the pop of the MCL then the twist of the ACL as my leg was forced underneath me to the rear of the snowmobile. A 6 inch maple assisted me the rest of the way off of the snowmobile breaking my left ribs 9-12 and a subsequent hole in my lung. I am trying to clarify my current direction to brace for six weeks while I rehab the MCL tear and prepare for ACL surgery. I do NOT understand how a completely torn ligament just reattaches itself and grows back to bone, etc. . . Can you please advise and thank you in advance.

    Denis J.A. Mugridge

    1. Hi Denis .. Grade I and II MCL tears heal very well. Grade III tears of the MCL are usually repaired. Otherwise they might not heal well and will remain loose. Your exam is key in the decision making. I have had many patients diagnosed by MRI as Grade 3 but their exam showed that they were a II at best. In the setting of a grade II tear, the answer to your question is yes… the ligament will heal to the bone. A grade III might “heal” as well.. just not in the correct position.

      1. I completely forgot to check for your reply Dr., but I do thank you so very much for your response. My doctor concurred with the MRI and graded it a 3, but stated that there we a tiny bit left attached and that it would be enough for the healing process. I had allograft surgery at the end of May and have been recovering quite well. He also cleaned up my slight Medial Meniscus tear and some arthritic “hairs”. etc. . .the Meniscus is really the only thing that can still give me a little bit of pain at times, along with a little bursitis at the bottom of the knee cap, but otherwise I have recovered well and have rehabbed very well according to my Dr. and P.T.

        Thanks again Dr.

  4. Well, a tear of acl and complete tear of the medial lateral collateral ligament with torn meniscus and baker’s cyst in left knee is this so common? Surely, you, Dr. Luks, must have some idea that this is a “complex tear”. confirmed by radiologic reports? I was merely asking for your opinion since this is what your medical blog is about., merely that and nothing else. I’d rather face the truth about my physical circumstance at this point and know if there is hope; but, it seems I’ve wasted my time and yours.

    Sincerely,
    Judy

  5. I am an active 57 year old who fell off a ladder while pressure washing my house. MRI confirmed a torn ACL,a torn lateral and medial meniscus. I need to decide about how much surgery I want Not sure if I should do the ACL repair or just the meniscus..

  6. i had mcl+acl surgury about 2 weeks ago. currently my knee cant bend more than 45 degree. is it normal to gain flexion so slow? how many days estimated to gain 90 degree flexion?

    please advise

  7. I was wondering about the probability of a healthy 21 yr old rehabbing from and returning to college football after acl, mcl, meniscus tears with a fractured (hairline) femur.

    1. If all goes well then you have a 75% – 80% chance when all your rehab and training are fully completed. Don’t rush back

  8. Im a 17 year old girl and I had an ACL inury about a week ago today. Its swollen still but I can bend it and straighten it out and bend it with only minimal pain. I try walking on it but it hurts when I fully extend my leg standing. I have been freaking out over this injury, but im convinced it isnt a tear but only a sprain or something. My doctor thinks its necessary to get an MRI but I really dont want to get one if I dont need one. Any advice?

    1. An exam should really be able to tell you what’s going on … but at your age if there is any question an MRI can shed some further light on the issue so you know what’s wrong and what your options are.

  9. My friend tore her ACL, MCL, and meniscus and fractured her tibia and fibula on November 25 and is going in for surgery today at 8:30 do you think she will be able to recover and continue with gymnastics after she heals or not because they waited a long time after the incident? she also has been walking on it since it happened but sometimes uses her crutches at school i dont know if that would impact it or not but what are your thoughts?

    1. If you look at the statistics … 80% or more high level athletes return to sports competition after ACL surgery. The MCL certainly complicates things… but if all goes well she has a reasonable chance of returning.

  10. Hello Doctor, my name is Nate. I recently had MCL surgery (9/23/15) due to being involved in a motorcycle accident. I am set for ACL surgery on 2/12/16, however, I am not able to bend my knee completely, as well as still feel pain when trying to bend it. Therefore, is it wise to have the ACL surgery, even though, I am still feeling pain, and can not bend my knee 100%?

  11. Hi, my name is Sharron. On the 1st of the yr I tripped and fell and it twisted my knee and in the process I felt and heard some snapping and it really hurt. Went to the er did xrays nothing broken. But was referred to an orthopedic doc he set up and MRI just got the results back 01/21/2016 and it’s the mcl and acl that are both torn. They aren’t 100% sure if it’s a partial for the acl have a doc appointment on the 17th of Feb with the surgeon to see what is best to do. But it just seems like so long to wait since they said the mcl will definitely need surgery. Just wondering your thoughts on the lengthy wait for everything. Thank you.

    1. As I said in the article… on Grade III injuries are considered surgical candidates. Most MCL injuries are not Grade III and most do not require surgery. Good Luck to you.

  12. Dr. Luks,
    Last week I fell during bouldering, I landed on my feet, but I heard a few popping sound and twisting in my knee. I was in immediate pain. The xray didn’t show anything broken, I’m having my MRI appointment in a few days. I’m in a lot of pain, it’s still swollen, can’t bend my knee at all, can’t put any weight on my leg because it feels like my knee cap constantly wants to pop out.
    Do you think I might have torn something or is it just a really bad sprain?
    Thanks in advance!

  13. I am confused and worried. Not sure what to do. I have had a ski accident and have confirmed via MRI that I have raptured cal and high degree tear of mcl. The physio told me to start the range of rehab exercises and two weeks in I was feeling better. I saw a surgeon after 2 weeks and he told me to go back to brace and crutches and not to push with my exercises in order to give my mcl a chance to heal. Th physio is now saying don’t do much. For the last two days I haven’t done much with my leg and had a brace on most of the time, but I am feeling now my leg is getting worse and my knee is getting stiff again. I am not due to see th surgeon for another 4 weeks. Should I just take it easy or should I try to move my leg up and back. Thy said do the quads exercises but that is it. Will it all get worse? I am also. Infused in terms of the timings. In the ski resort th doctors there wanted to operate on the same day, but the surgeon here is saying it can be done up to 12 months after th surgery? Please help clarify what should I do?.

  14. Hi Dr Luks.my question is I had an MCL sprain playing soccer I went to the Ortho got X-ray everything looks good he put me on a knee brace and crutches for 2 weeks.i can walk but with a lot of pain I can’t bend my knee because of the pain and I feel under my leg a muscle very hard I don’t know if I should wait to see if it gets better with time or if should get an mri to see what’s really going on

    1. HI David…
      MCL tears hurt .. usually a lot. A severe MCL injury can sideline you for 2-3 months. If you’re concerned then check back with your surgeon to be sure.

  15. Dear Dr. Lurks,
    On February 11th of this year I tripped over the dog and hit my knee so hard that it dislocated and I heard an awful popping sound as soon as it dislocated and I had significant swelling and bruising within the first ten minutes and I couldn’t move and even in the brace I can’t bear weight on my leg because of awful pain on the outside of my knee middle of my knee and in the back of my knee. I still have significant swelling. I can keep my leg straight but can’t bend it. Do you think I may have torn my ACL and possibly other ligaments as my PCP suspects? I see Orthopedics this Friday. Thank you for your time.

  16. Hello Dr. Luks,

    I love your website its helped me so much! I has ACL surgery on march 3rd 2016 after waiting 7 months for my mcl tear to heal as well and i was doing PT for 6 months post initial injury in September 2015. Im about 6 weeks post op and my mcl KILLS like it hurts when i walk i feel it stretching almost. I know there is an incision there like where they took the graft from but should it hurt this much? I thought it would be healed by now! it wasnt a serious mcl injury or else my surgeon would have done something. Do you think its an issue??

    Thank you Doctor

    1. Thanks for the kind praise.
      unfortunately without examining you I really can not tell why that area would be bothering you.

      1. Oh i see, its okay I’m seeing the surgeon on the 25th, I’m just scared that i retore it and thats why all the stress is on the mcl. Thank you for the reply!

  17. Hello Mr Luks,
    I have torn both my MCL and ACL, partly injured my LCL while skiing on May 7th 2016. I had my MCL repaired with a 2.35 cm screw fixing on the Tibia on May 16th 2016 . And at the meantime I am recovering from the MCL operation, the doc said the LCL is healing itself. It is now the seventh week PO and my knee is able to bend 120 degree. Although I am still wearing brace with the assistance of crutches, I feel my knee is not stable while walking, especially I land the leg with a degree of bending if not completely straighten. Is it normally or bcos of the torn ACL that there is not enough support to the knee?

    Is it a general process of repairing MCL first then ACL if both of them are torn and why?

    Another question is that I will hopefully have my ACL reconstruction 5~6 months later. Is it still a good time to do so or should be sooner?

    Many thanks!

    1. Managing a multiple ligament injured knee is difficult. Some of us fix everything at once, some will fix the MCL then come back and reconstruct the ACL later. 5 months is a long time to wait… if done as a two stage procedure then we can usually proceed with step two when the MCL heals (2-3 months) and your motion is near normal. The LCL component can be worrisome… LCL or postero-lateral corner injuries do not tend to heal if anything is torn. That can produce a very unstable knee. Without examining you I do not know what the issue is with your knee. You may consider a second opinion… but you need to find a doc who is fluent and comfortable with multi-ligament injuries- not many are.

  18. Hi, My name is Brittany.
    I have tore my ACL on the right twice in the past 2yrs both playing soccer.
    I heard the same popping and I have the same pain when I fell during lacrosse.
    Im not sure if it is the ACL for the 3rd time or not.
    I am only 16 years old. So i dont think it should be anything with bad bones.
    What do you think it is?
    Is it possible to re-tare for a third time?
    Thanks so much!

  19. I am a 62 year old woman and tore both my ACLand MCL….i am not a out there physical person….I am a Special Ed teacher and really just want to know if I can navigate the hallways of my high school without my knee brace? I don’t play football…..I just dont want to do the surgurery …..help!

    1. Often times the MCL will heal well enough. Many people, especially as we get older do not require a brace or ACL surgery. You will know after you complete your rehab. If the knee feels unstable then options include bracing, more PT or surgery.

  20. What do you all think…..do I have to do that surgery…ACL and MCL….and, I was’t playing football….I was replacing a lightbulb and fell back…..lord!

  21. I completely tore my ACL and MCL playing soccer. I had surgery in August of 2015, and am now one year and two months out. I have returned to playing soccer, but not as competitively as I used to. I went to PT for a full year but, since I understand what I needed to be doing and PT was expensive, I do it on my own now (after a year) and have been doing great! I have a question though–I am having a hard time explaining to others why my knee isn’t the same as it was before I injured myself. I don’t know how to explain why running is easier than doing box jumps for me and how to explain how playing soccer is completely different than running for the knee. I know it has to do with the ligaments torn, but could someone please kindly educate me on why exactly the two are so different. The same muscles aren’t being used when you play soccer VS when you go on a distance run, at a comfortable pace…correct? Are running sprints the same as going on an easy paced endurance run? My knee says they aren’t the same after the pain I feel when I over do it on sprinting. I do have a screw in my knee, so that could be the case! Please someone help me out a little because I hate not knowing how to explain myself. All I can tell others is that my knee and quad aren’t the same knee and quad that it was before surgery. But, I can work back to that…it’s just not as easy.

  22. What are your thought on having a Osteotomy for our son’s GENU VALGUM to help reduce the amount of ACL/Menisiscus injuries he has had in the past 4 yrs? He is a Sr. Football player (Linebacker) in Highschool,
    and might wanna play in College.

    1. very challenging decision making. Many variables need to be considered. There are occasions when an osteotomy might be appropriate… BUT — you should seek many opinions before considering surgery. Distal femoral osteotomies are also more tricky than tibial osteotomies for Varus, so be sure that you have seen someone who is very comfortable performing them.

      Good luck

  23. Hi Doctor Luks,

    I am a senior football player at Dartmouth College and I recently dislocated my knee and tore my ACL, MCL, and partially tore my LCL and PCL. I just had surgery on my MCL 10/20/2016. When do you anticipate I will be able to have my ACL surgery and when do you think i will be able to begin rehab/walking on my repaired MCL?

    I have received mixed answers but it has become apparent to me that I will be able to begin rehab at the 3-4 week mark and then have my ACL surgery in 2-3 months. Is this correct or do you have a different answer?

    1. Alex,
      There are a number of variables involved here. Your physical exam is more important than your MRI in determining your “instability pattern”. The pattern of your instability then defines what should be fixed and in what order. If surgical management of the MCL is undertaken first- then you need to let it heal before proceeding with an ACL, etc reconstruction. The timetable you mentioned is reasonable. Not many docs are experienced in managing multi-lig knee injuries… so you will receive many different opinions when you ask around. And each case (mulit-ligament knee injury) needs to be managed differently depending on the exam findings.
      Good Luck
      HJL

Leave a Reply

Your email address will not be published. Required fields are marked *