MCL Tear Injury Treatment Recovery
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Knee & Shoulder Surgeon
About Dr. S.K. Gupta
M.S. (Ortho.) Mumbai,
M.R.C.S., F.I.A.S. (Japan),
F.A.P.O.A. (Singapore),
- Arthroscopy,
- Joint Reconstruction,
- Sport Injury Surgery.
Dr. S.K. Gupta: Contribution In MCL
- Dr SK Gupta’s Surgical technique published in International Journal -Reconstruction of Superficial Medial Collateral Ligament: Modified Danish Technique with Dual Adjustable Loop Suspensory Fixation Arthroscopy Techniques 2023-12 Journal article DOI: 1016/j.eats.2023.07.039
- Worked with Dr Masashi Kimura, Gunma sports medicine research centre, Japan, with exposure in arthroscopy and sports injury
- International Faculty at Singapore advance knee symposium Dec 2023 talk on MCL and ramp lesion
- Faculty Chandigarh Arthroscopy course April 2023 performed live PCL reconstruction and talk on MCL
Faculty and surgery demonstration for Advance knee and shoulder arthroscopy workshop at SRMC Chennai Aug 2014.
Read More -
All About MCL
The MCL is one of the most important ligaments on the inner side of the knee, offering essential support and stability while controlling knee movement. MCL injuries are usually caused by a direct impact to the knee, often occurring in athletes or individuals engaging in high-impact sports. Such injuries may cause pain, swelling, and instability in the knee.
Treatment of MCL injuries is different from the extent of tear. Minor ones are usually handled conservatively through the P.O.L.I.C.E. method, where rest, application of ice, compression, and elevation are recommended. More extensive tears may necessitate surgical intervention.
MCL reconstruction surgery is recommended for complete tears or when conservative treatments fail to alleviate symptoms. The procedure repairs or reconstructs the damaged ligament to restore knee strength and stability, thus allowing for full recovery.
This treatment is particularly helpful for athletes and people who need perfect knee functionality for high-performance activities. According to Dr. Gupta, MCL reconstruction not only alleviates pain but also prevents further knee damage, enabling patients to return to sports and physically demanding tasks with confidence.
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Dr. S.K. Gupta is a renowned surgical orthopedic doctor practising in India.
MCL Tear Treatment
Another very important ligament that is inside the knee and keeps the joint stable and prevents over movement is the medial collateral ligament. A tear in the MCL can cause severe pain and swelling in the knee along with instability of the knee; hence it sometimes does not allow a person to walk or perform any other physical activity.
For severe MCL tears, surgery is needed to repair or reconstruct the damaged ligament to stabilize the knee again. Surgical intervention is usually indicated for complete MCL tears or when other treatments fail and the knee becomes unstable and painful.
Conservations are mainly tried for partial tears of MCL. Such treatments can be offered as rest and exercises. The use of a knee bracing orthotic can aid such healing, thus saving such surgeries. But still, the symptoms become severe in many cases so surgical intervention will occur.
The primary goals of surgery are to repair the ligament, which means relief from pain and improvement in the stability of the knee, and a return to an active lifestyle without discomfort.
The standard surgical method of an MCL tear is performed with minimally invasive techniques involving arthroscopy. The procedure involves very small incisions, through which a camera is placed to clearly view the knee joint. This gives the surgeon a clear path to deal with the damaged ligament and to give an accurate assessment of how much to repair. Generally, this procedure takes about an hours, and most patients are taken home on the next day.
This normally calls for a period of going on braces and using crutches after surgery since the knee would have to heal with reduced stress placed upon it. Full recovery may take up to several weeks, wherein time, physical therapy is essential to regain strength, flexibility, and stability in the knee.
Surgery is usually indicated for patients with complete tears of the MCL or for those who do not improve with conservative treatments, remaining in pain and knee instability. Surgery aims to abolish pain, stabilize the knee, and allow people, including athletes, to return to their previous activities.
Surgery is normally the last course of action once other non-operative treatments such as bracing, physical therapy, and medications are tried. Consultation with an experienced orthopedic specialist will determine if surgery is necessary as they will carry out a thorough evaluation and make recommendations on the best treatment.
Why Consult Dr. S.K. Gupta for MCL Surgery
Dr. Sheetal Kumar Gupta is an arthroscopy and sports injury specialist heading the arthroscopy and joint reconstruction unit at Galaxy hospital, Bhopal. He has been a consultant for sports medicine, Sports Authority of India & State Sports Academy and is serving National level teams of various disciplines like Hockey, Judo, Kabbadi, Water Sports, Wushu Taikwando etc.
He has done his fellowship in Arthroscopy and Sports medicine from Japan and was trained at various international surgical centres. With an experience of more than 21 years, he has performed over 12000 knee and shoulder surgeries including complex ligament surgeries and surgeries of around more than 8000 National/International level players of various disciplines. He is National and International level faculty for various seminars, conferences and workshops.
Notable Achievements:
- Trained at Japan, Germany, UK, Singapore, Malaysia and Thailand.
- Visiting sports medicine specialist Sports Authority of India (SAI).
- Ex Sports injury specialist to Indian senior Women National Hockey team.
- Ex-Dope control officer, National Anti-doping Agency (NADA).
- National faculty for advance knee and shoulder arthroscopy workshop and conferences.
- Performed more than 8000 arthroscopies independently including knee, shoulder, ankle and hip arthroscopies.
- Successfully operated over 2000 players who are back in sports and have won national and international medals after their surgeries.
- Successfully treated more than 10000 sports players of various disciplines.
- Internationally trained and more than 18 years of experience.
- Has treated National and International level players of Hockey like Sardar Singh, Shivendra, Sandeep Singh, Dilip Tirkey, Sameer Dad ; Olympic champion Ankit Sharma, Commonwealth Karate champion Supriya Jatav, world champions of Judo like Sanathoi, Kalpana Devi, Navjot to name a few and boxing legends like M.C. Mary Kom & Sarita devi.
Types Of Treatments Offered By Galaxy Hospital
Dr. S.K. Gupta specializes in problems of shoulder, hip and knee. These are the following types of treatments that the doctor provides.
Knee Surgery
Shoulder Surgery
- Shoulder Dislocation
- Rotator Cuff Repair
- Shoulder Impingement Surgery
- Shoulder Arthroscopy
- Shoulder Replacement
- AC Joint Reconstruction
- Biceps Tenodesis or Tenotomy
- Frozen Shoulder Release
- SLAP Repair
- Subacromial Decompression
- Capsular Release
- Bankart Repair
- Latarjet Procedure
- Reverse Total Shoulder Replacement
- Labral Repair
- Labrum Repair
What Happens When You Have an MCL Tear?
An MCL (Medial Collateral Ligament) tear occurs when the ligament on the inner side of the knee is partially or completely injured. This type of injury can lead to a range of symptoms, including: (vid new- how do I know that I have MCL tear?)
- A popping sound or sensation at the time of injury
- Swelling around the inner side of the knee
- Pain on the inside of the knee
- Tenderness when touched
- Difficulty continuing activity due to pain
- Reduced range of motion in the knee
- Discomfort while walking or bending the knee
- Knee instability or a feeling that the knee might give way
An MCL tear can significantly impact your ability to perform everyday activities and may require medical evaluation to ensure proper treatment and recovery.
What is an MCL Reconstruction?
It is a surgical intervention meant to repair a ruptured or torn Medial Collateral Ligament (MCL) that is an essential stabilizing element on the inner knee side for movement. (vid new- MCL surgery, considerations?)
In MCL reconstruction, a graft is used in place of the injured ligament. This graft is typically obtained from the patient’s own body, referred to as an autograft.
The graft, once harvested, is positioned on the site where the MCL is damaged. Both ends of the graft, are inserted into pre-drilled sockets in the knee bones, thereby positioning it to integrate well with the tissue around it and to heal properly.
This enables the patient to return to his normal activities and exercises. Reconstruction of MCL is particularly useful in patients who have grade III tears of the knee or whose responses to nonsurgical measures are not significant.
Not all MCL tears need surgery. The decision to have surgery is based on the severity of the tear, the patient’s activity level, and the success of conservative treatments.
Most MCL injuries can be treated without surgery through non-surgical methods such as rest, ice, compression, elevation (P.O.L.I.C.E.), and physical therapy. These measures help reduce pain, manage swelling, and restore knee strength and mobility.
Surgery might be required in the following cases:
- Severe or Complete Tears: Surgery is often required for fully torn MCLs or when the tear causes significant knee instability.
- Failure of Conservative Treatment: If the injury does not improve despite rest, rehabilitation, and other non-surgical treatments.
- Persistent Instability: If the knee feels unstable or buckles during daily activities, surgery may be needed to restore stability and function.
- Associated Injuries: When the MCL tear occurs along with other knee injuries, such as an ACL tear or meniscus damage, surgical intervention may be necessary to repair all affected structures.
Surgery is typically recommended for individuals with high activity levels or athletes who need to regain full knee functionality and stability for sports or demanding activities.
Does MCL Reconstruction Lead to Knee Replacement?
MCL (Medial Collateral Ligament) reconstruction surgery does not directly lead to the need for knee replacement; however, there are certain situations where individuals may require knee replacement in the future. The primary goal of MCL reconstruction is to repair the damaged ligament and restore knee stability, but various factors can influence the long-term outcomes:
- Long-Term Instability: If the knee remains unstable after MCL reconstruction due to insufficient healing or improper rehabilitation, it can place added stress on the joint. This may cause wear and tear on the cartilage over time, increasing the risk of arthritis or other joint problems that could ultimately lead to knee replacement.
- Arthritis or Cartilage Damage: Pre-existing cartilage damage or other knee injuries (such as damage to the meniscus or other ligaments) combined with an MCL tear can result in joint degeneration. Over time, arthritis may develop, causing pain and limited mobility. If arthritis becomes severe, knee replacement surgery may be necessary.
- Repeated Injuries: Individuals who suffer multiple knee injuries, especially if they are not adequately treated or rehabilitated, can experience cumulative damage to the knee joint. This damage can lead to the need for knee replacement, particularly if significant wear occurs on the joint surfaces.
- Age and Activity Level: Younger, more active individuals who undergo MCL reconstruction typically have a lower risk of needing knee replacement soon after surgery. However, older adults or those who continue engaging in high-impact activities may experience faster joint wear, which could accelerate the need for knee replacement.
In conclusion, while MCL reconstruction surgery itself does not directly result in knee replacement, long-term issues such as instability, arthritis, or joint degeneration can increase the likelihood of needing knee replacement later in life. Proper post-surgical care, rehabilitation, and addressing any existing joint damage are critical in minimizing this risk.
MCL Tear Repair: Home Remedies
Home remedies for managing the symptoms and recovery process of MCL tears; these are usually feasible for mild to moderate injuries. These methods can be useful in the early stages of recovery, especially; however, after consulting a healthcare professional for a proper diagnosis and guidance, particularly if the injury is severe. Some common home remedies for an MCL tear include:
Rest is very important because the injured ligament needs rest to heal. Refrain from engaging in activities that can cause knee stress, including running, jumping, or quick movements. This way, one prevents further injuries and gives their knee time to recover.
Ice Application: Applying ice on the knee may help decrease swelling and help with pain relief. Use an ice pack, wrapped in a cloth, 15-20 minutes at one time, several times in a day, especially during the first 48 hours after injury. It helps with controlling inflammation and will reduce your pain.
Compression: Use of an elastic bandage or compression wrap around the knee helps in stabilizing swelling. Be careful to avoid too-tight wrapping because it can hamper blood flow. Compression of the knee can stabilize the fluid buildup and maintain the balance in the injured part.
Elevation: When practical, elevate the knee above heart level to help reduce swelling. Rest the leg on pillows if sitting or lying down to aid fluid drainage from the injured site.
Pain Relief: Over-the-counter pain relievers can be given such as ibuprofen or acetaminophen that can help with pain relief and inflammation. Always consult a healthcare provider for dosage and if unsure on medication use.
Physical Therapy : After the swelling and initial pain have dissipated, physical therapy can strengthen the knee through active exercises and encourage mobility, stability, and strengthening of the joint. It further aims at rehabilitation of the function and motion in the knee. The physical therapies may involve stretching maneuvers, quadriceps strengthening, or range-of-motion activities.
These home remedies aid in promoting the healing of an MCL tear, while more severe ones may require proper medical intervention including physical therapy and surgery to make a full restoration and prevent later complications. Only a doctor can be consulted for any injury to choose the best available treatment option on the basis of the severity level of the damage.
Surgery for MCL Tear Treatment
For an MCL (Medial Collateral Ligament) tear, surgery is generally considered when conservative treatments, such as rest, ice, and physical therapy, are not enough to restore knee stability or function. Surgery is typically recommended for severe MCL tears or if knee instability persists despite non-surgical methods. Here’s how surgical treatment for MCL tears works:
Types of Surgery for MCL Tear Treatment:
- MCL Reconstruction: This is the most common surgical procedure for severe MCL tears. If the ligament is completely torn or significantly damaged, the surgeon may reconstruct the ligament using a graft. The graft may be taken from the patient’s own tissue (autograft) The surgeon will attach the graft to the femur and tibia to restore stability to the knee.
- Surgical Repair: If the MCL tear is not as severe, the surgeon may perform a direct repair. In this case, the torn ends of the ligament are reattached to the bone using sutures or fixation devices, allowing the tissue to heal in its original position.
Recovery after MCL Surgery:
- Immobilization: After surgery, the knee is typically placed in a brace or cast to restrict movement and allow the ligament to heal properly. The knee may be immobilized for several weeks, depending on the severity of the tear and the surgery performed.
- Physical Therapy: Rehabilitation is a crucial part of recovery after MCL surgery. A physical therapist will guide you through exercises to improve knee strength, flexibility, and stability. The aim is to restore normal function, range of motion, and prevent future injuries. Early physical therapy may focus on gentle movements and strengthening the muscles around the knee to support the healing ligament.
- Return to Activity: Full recovery after MCL surgery can take several months. The time depends on the injury’s severity, the surgery type, and how well the patient follows the rehabilitation plan. Athletes or active individuals may need 6 to 9 months before returning to high-impact sports, while less active individuals may return to daily activities sooner.
When Surgery Is Recommended:
Surgery is typically recommended for:
- Severe MCL tears where the ligament cannot heal on its own.
- Persistent knee instability despite conservative treatments.
- Simultaneous injuries to other ligaments, such as the ACL, which may require surgery as part of a broader knee repair.
For mild to moderate MCL tears, surgery is usually not needed, and non-surgical treatments such as physical therapy, rest, and bracing are sufficient for recovery. Always consult an orthopedic specialist to determine the best treatment based on the severity of the injury.
Preparatory Steps for MCL Treatment
Post-Operative Protocol for MCL Surgery
Risks and Complications Associated with MCL Surgery
MCL Repair reconstruction surgery is highly successful and carries a low risk of complications.
MCL Surgery Cost in India
The cost of MCL surgery can vary depending on several factors, including:
- Type of Treatment: Surgical treatments tend to be more expensive than non-surgical options.
- Extent of Knee Damage: Severe damage to ligaments or tendons may require more complex and costly treatment.
- Graft Type: The cost varies as per autograft or neo ligament.
- Hospital Choice: Treatment costs can be higher in corporate hospitals compared to dedicated centers for arthroscopy.
- Insurance Coverage: The cost will depend on the patient’s insurance coverage and what it includes for MCL ligament surgery.
- Surgeon’s Expertise: Experienced surgeon’s charges are often higher than novice surgeons.
- Diagnostic Tests: Pre-surgical diagnostic tests such as MRIs, X-rays, or ultrasounds contribute to the total cost.
- Anesthesia and Medications: The cost of anesthesia, medications, and necessary surgical equipment is included in the overall price.
- Physiotherapy Sessions: Post-surgery rehabilitation and physiotherapy sessions are an additional cost.
- Follow-Up Appointments: Regular follow-up visits to monitor recovery also add to the overall treatment cost.
Qualities of a Top MCL Surgeon in India
When seeking a surgeon for MCL (Medial Collateral Ligament) treatment, consider the following qualities to ensure optimal care and recovery:
Board Certification and Specialization: The surgeon should be certified and specialized in knee surgeries, particularly in MCL repair or reconstruction.
Experience: Extensive experience in treating MCL injuries and managing complex knee conditions is a vital criterion.
Reputable Practice: Affiliation with a well-known hospital or clinic, reflecting a solid professional reputation and trustworthiness.
Insurance Acceptance: The ability to work with various insurance providers to minimize out-of-pocket expenses for the patient.
Patient Comfort: Ensures a welcoming and supportive environment while addressing patient concerns thoroughly.
Compassion and Bedside Manner: Demonstrates empathy, excellent communication, and a patient-centered approach.
Leadership Skills: Capable of leading a medical team effectively, ensuring seamless coordination during surgery and recovery.
Flexible Treatment Approach: Develops personalized treatment plans tailored to each patient’s unique condition and recovery goals.
Realistic Perspective: Provides honest and clear expectations regarding recovery timelines and potential outcomes.
Commitment to Learning: Stays updated with the latest advancements in MCL treatment techniques and medical technology to offer the best care possible.
Conclusion
A top MCL surgeon not only possesses technical expertise but also prioritizes patient well-being through personalized care and effective communication. Choosing a surgeon with these qualities can significantly enhance the recovery process and overall experience.
How to Choose the Best MCL Surgeon in India
Tips for Choosing the Best MCL Surgeon in India
Selecting the right MCL (Medial Collateral Ligament) surgeon is crucial for a successful treatment and recovery. Here are some tips to help you make an informed decision:
- Seek Referrals: Ask family, friends, or your primary care doctor for recommendations. Compare the options based on their experiences and feedback.
- Check Online Reviews: Read patient testimonials, ratings, and reviews to understand the surgeon’s expertise, care quality, and success rate.
- Verify Credentials: Ensure the surgeon is board-certified in orthopedic surgery and has no history of malpractice or disciplinary actions.
- Evaluate Experience: Opt for a surgeon with extensive experience in MCL surgeries, particularly in handling complex knee injuries.
- Assess Hospital Reputation: Research the hospital or clinic where the surgeon practices. High-quality institutions with excellent facilities can contribute to better outcomes.
- Schedule a Consultation: Meet with the surgeon to discuss your condition, treatment options, and recovery expectations. This helps gauge their communication style and approach to patient care.
- Insurance Coverage: Ensure the surgeon accepts your insurance plan to help minimize out-of-pocket expenses for the procedure and follow-up care.
Conclusion
Taking the time to research and evaluate your options will help you find an experienced, qualified MCL surgeon who aligns with your medical needs and financial considerations.
Why Choose Us for ACL Surgery
Why choose our "surgeon"?
- Our surgeon Dr S.K Gupta is a world renowned knee and shoulder surgeon with extensive experience of MCL and meniscus surgeries.
- He has over 21 years of focused work-experience in knee and shoulder arthroscopy and12000 + successful surgeries.
- He has experience of successful treatment of hundreds of International and national sports persons.
- His highest level of qualifications and mastery in his work, is the reason of making him first choice for MCL Meniscus treatment by patients from across the country.
Why Choose Us?
- The hospital is dedicated Arthroscopy Centre with highest number of MCL and meniscus surgeries.
- This makes every member of the team in your service, highly competent and experienced for MCL and Meniscus surgery pre-op, intra-op, post-op and rehabilitation management.
- The hospital is well known for affordable cost and cashless facility with combination of best surgeon, best equipments, best implants, and specially trained team for knee and shoulder surgery care.
Why does "surgeon's experience" matter?
- The successful result of surgery depends very much on the detailed and focused expertise of surgeon and his team.
- Experience and skills of your surgeon is the most important factor for successful result.
- You must research well about it, as the primary surgery is the most important chance.
Why choose our "operation theatre" and OT team?
- Hi-Tech modular operation theatres, high precision International equipments for arthroscopy, world class OT machinery specific for knee and shoulder surgery
- Protocol based and highly skilled OT team with focussed work in knee and shoulder arthroscopy plays a vital role in surgical success.
- All our operation theatres are well equipped with planum with HEPA filters. High efficiency HEPA filters can remove 99.97 to 99.99% of airborne particles including smallest bacteria to the size of 0.3 microns. This helps to safeguard our patient from infections.
- The hospital has well defined “infection control guidelines” to be followed by all team members. This helps in reducing the infection rate to less than 0.1%.
- “Triple Level checks” for sterility and disinfection of implants and OT support materials is strictly followed.
- “WHO surgical Safety protocol” for Sign-IN, Time-Out, Sign-Out is adhered to In 100% patients.
- “High pressure autoclave with Pre-Vac” and “ETO sterilization” procedures are used.
- Wheeling in, Wheeling out and anaesthesia safety protocols are strictly followed. One Way Traffic protocol is followed.
- Central Medical gases oxygen and nitrous supply And central suction systems are in place.
- Pressure Dampeners are active to maintain OR pressures. Humidity Checks are done to maintain evidence based recommended guidelines.
Why "post-op care" matters?
KPI (Key Performance Indicators) are being regularly caught, audited and analyzed. Team Galaxy takes utmost care and as a result the captured para are between 0 to 0.13%. This practice is one of the central reasons for our very high success rate. The para captured and assessments done are like-
- CAUTI
- PVC IR
- SSIR
- BTRI
- Med EI
- Fall Risk assessment
- Vulnerability Score
- Pain Score
- Pressure Sore vulnerability Assessment
- Patient Satisfaction Index
Post Op care team is regularly following Care Bundles like-
- PVC insertion Care Bundle
- PVR Daily Care Bundle
- Catheter Insertion Care Bundle
- Catheter Daily Care Bundle
- SS care Bundle
- WHO Hand Hygiene Protocol
- Universal Precautions
Patient Safety Protocols being followed are like-
- “7 Level Check” for Side identification
- Pre-Operative Checklist
- BT prep and safety protocol
- Belongings and Material Handover Protocol
- Surgical Site Marking Protocol
- Patient Identification Protocol
- Admission and Discharge Protocol
- Checklist for shifting from OR to Recovery SICU
- Checklist for shifting from SICU to Ward
- The finest details of immediate post-op depends on the expertise of medical, nursing and rehabilitation team.
- Since our hospital serves only for these surgeries, every member is extensively trained, as compared to any other general Orthopaedic Hospital serving many types of surgeries.
Why does our "rehabilitation team results" excel?
- The team follows “Surgical age-based assessments and reassessments” to formulate the customized care.
- Rehab is planned “One-O-One as per the milestones achieved” by the patient till visit date.
- Phases of Rehab are scientifically based on division into Macrocycle, Mesocycle and Microcycles of care, the Pre-Injury level of activity, the Surgical details of patient as per the surgeon; and “not one size fits all” method.
- The “5-Staged Plan of Care” of post op rehabilitation is followed for holistic recovery of patients –
- Protection & Activation
- Recovery of Range
- Strength Development
- Functional Integration Inclusion
- RTS If Sports Person
- Sports-Persons’ prolonged follow up to Return To Sports after RTS Testing is followed.
- Regular skill upgrade training of team is done as per new international guidelines.
- Our Physiotherapy team serves large number of ACL and meniscus surgery post operative patients, with close follow up, for return to normal and return to Sports.
- This huge experience in knee and shoulder surgery rehabilitation is the reason for their best results.
- Our successful results are the reason, why our old patients send other patients for similar results.
Happy to Serve Pt. From Various Cities
- Mumbai
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