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Child Orthopedics
Spine - Cervical
Spine - Lumbar
Spine - Thoracic

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Help! I tore my ACL mountain biking last week. I'm supposed to have surgery but I'm also getting married in six weeks. I don't want to walk down the aisle on crutches or wearing a brace. Can I put the surgery off until after the honeymoon? Will waiting two months make a big difference?

Anterior cruciate ligament (ACL) injuries are often accompanied by damage to other soft tissue structures of the knee. Patients are advised to have surgery sooner than later, especially when there are combined injuries, but also to prevent additional injuries. Surgeons are advised to carefully evaluate the joint for any additional ligament or cartilage tears before doing surgery for the ACL. Sometimes patients like yourself opt out of surgery for any number of reasons. They decide to wait before having the operation. It's natural to wonder what effect that might have on your injury and recovery. Surgeons know that without the stabilizing force of the ACL, patients can end up with meniscal tears that weren't present at the time of the ACL injury. And it's possible that in patients with combined ACL and meniscal tears, the meniscal tears get worse over time. That's one reason why surgery is advised sooner than later. How long can you delay? Well, the ideal time for surgery isn't really known yet. According to one recent study investigating this very question, waiting more than six months was too long. MRI studies clearly showed degeneration of the meniscus and joint because of the delay. Waiting two months is under the six month deadline, but any amount of waiting increases your risk of reinjury and further trauma to the joint and surrounding soft tissue structures. Your surgeon will be the best one to advise you. After looking over your imaging studies and perhaps with the benefit of an arthroscopic exam, you will have enough information to guide you. Your activity level may be curtailed if you decide to wait -- just to prevent further injuries on that unstable knee. Your surgeon may have you see a physical therapist during the interim. A nonoperative approach with a rehab program to restore strength, motion, and coordination may be all that's needed.


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