Medical questions & health advice by board certified doctors
"How feasible is ACL surgery for someone with Spina bifida?"
I have SB myelomeningocele, & my right knee turns in quite a lot when I walk. I was diagnosed with osteoarthritis at 16. I fell recently & completely tore my ACL. After 2.5 (I have to wait another 1.5 to see the surgeon) I still can't walk without crutches & there is mild pain by the end of the day. My doctors who referred me to the surgeon worry that because of my SB, I will not be a good candidate for surgery. However, without it, I will have to use crutches or a wheelchair for the rest of my life--& I'm only 23. The difficulties of using chairs & crutches in my area in addition to injuries associated with using these things long term (*more* joint damage) seem just as bad. I've always been able to walk with nothing but AFO's and for the sake of the rest of my health, I'd like to keep it that way. Does my SB really make me a bad candidate for ACL reconstruction?
There is nothing about spinal bifida in and of itself that would absolutely prevent you from having a surgery on your knee. In fact, people with chronic musculoskeletal problems from spinal bifida, cerebral palsy, and other life-long neurological conditions are often among the patients who benefit most, in turns of quality of life and improvement in function, from orthopedic surgical procedures. Therefore, what I would suggest is that you go ahead and meet with the orthopedic surgeon who has been recommended to you by your primary doctors. That surgeon will be able to perform an overall evaluation of your situation and of your specific injury and make recommendations about whether or not surgery is a good option for you. Sometimes, ACL injuries settle down with time and do not require surgery, depending on how severe the tear is and how unstable the knee is afterwards. I think from your question that you say it has been only 2-3 weeks since your injury; if that is the case, there is still plenty of time to allow the inflammation to go down and healing to occur. Therefore, the orthopedic doctor may recommend rest and physical therapy for a while instead of surgery.
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