I'm scheduled to have surgery on my knee that I've put off way too long. I first injured it two years ago and since re-injured it six weeks ago. That's why I finally dragged myself back to the doctor's. I guess the inside of the knee is fine -- it's the ligaments along the outside edge that are shot. I'm not a competitive athlete but I do like to jog, play tennis, and get in a few pick-up games of basketball over the lunch hour each week. What are my chances for getting back to that level of activity again?

When an injury is not treated in the first few weeks, it can become a chronic problem. Instability and reinjury are common weeks to months to years later -- especially in more active adults. Sometimes a rehab program makes it possible to avoid (or delay) surgery. But when chronic instability becomes your norm, then surgery to repair the damage is needed. Chronic injuries may require more than just a repair of the torn tissue. Left over time, the torn ligaments and/or tendons retract (pull away from the bone) and scar tissue fills in. If that happens, then the procedure is more likely to be one involving reconstructing the tissues using tendon graft material. Depending on which tissues are damaged, the surgery can become quite complex. Healing takes time. The graft has to become incorporated into the bone and be strong enough to withstand forces placed on the soft tissues with running, jumping, twisting, and turning required by activities like jogging, tennis, and basketball. Rehab is a key component to recovery following knee reconstruction. Even top athletes must follow the surgeon's protocol and work their way through range-of-motion and strengthening exercises. With your activity level, you'll likely want to include endurance training and activities to restore proprioception (joint sense of position). All of this will take four to six months. But with a good outcome, you can be back on the court in good form!

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