I hurt my knee while skiing. How serious is it and will I need surgery?

Q. Last weekend I fell while skiing. My left knee twisted and my bindings did not release. I felt a pop in my knee. The ski patrol brought me down the mountain on a sled.

At the hospital, I had X-rays and got an MRI. The diagnosis was a torn ACL. I was given crutches and a brace and I was told to see an orthopedic surgeon upon my return to Miami. I was wondering how serious an ACL tear is and do I need surgery?

A. There are four main ligaments that stabilize your knee. The MCL and LCL are on the inside and outside parts of your knee and are important for sideto-side stability. Since the MCL and LCL have a good blood supply, they usually can heal non surgically with bracing and rehab.

The ACL and PCL ligaments cross deep inside your knee and are important for pivoting activities.

If injured, the ACL and PCL usually cannot heal as there is a very limited blood supply to these ligaments. When an ACL injury happens, it is common to have damage to the knee cartilage and other ligaments. Thus, an MRI scan is helpful in diagnosis.

Initially, most ACL injuries are treated with physical therapy to decrease knee swelling and regain motion and strength. The degree of instability, associated damage of other knee structures, your age, and your activity level helps to determine your need for ACL surgery. I recommend you see an orthopedic surgeon with sports medicine experience to determine the best options for your knee injury.

Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send your questions to HarlanS@baptisthealth.net