Q. Is surgery necessary for grade 3 dislocation of ACL?

Answered by Dr. Anuj Gupta and medically reviewed by iCliniq medical review team.
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Hello doctor,

My husband dislocated his ACL. I would like to get his X-rays evaluated for a second opinion. He was diagnosed with grade III dislocation. Is surgery necessary based on the X-rays attached? What are the risks if he does not operate? How does non-operative treatment compare? How long does he have to make a decision on surgery based on the X-rays? The doctors mentioned that if he does surgery, he would need to have two procedures. Could you advise what are the names of the procedures to repair his shoulder? It was also noted that there is haziness in the lower lung. Is immediate treatment needed for this? How severe is this?

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Dr. Anuj Gupta

Orthopedics And Traumatology


Welcome to icliniq.com.

This is clearly acromioclavicular joint injury (attachment removed to protect patient identity). There are two ligaments which basically keep our ACL joint in position. In type 3 injuries, both ligaments are torn. Now, according to literature, treatment of type 1,2 injuries is non-operative and type 4,5,6 is operative. But the treatment of type 3 is controversial. It is basically surgeons choice. I usually try for six weeks conservative and if my conservative treatment fails then I go for operative.

Operative treatment depends on the time of injury. If it is acute, then we can apply a hook plate. In old injuries, we can do mini-open endobutton fixation. I am sorry, I cannot guide you for the type of surgery because you have not mentioned the day of injury. Nothing is to be done for chest if it is not symptomatic. I think it is just an incidental finding.

Also Read Answers From:
Acromioclavicular Ligament Ligament Injury

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Can I do pull ups again in my life after acromioclavicular joint separation?
Query: Hello doctor, I just had my acromioclavicular joint separation (grade 2 or 3), AC ligament torn. I am ready to accept the recovery time. My question is can I do pull ups again in my life? Or any permanent disability may occur?  Read Full »
Dr. Jay Indravadan Patel

Answer: Hello, Welcome to icliniq.com. Sure the X-ray looks kind of AC joint separation due to the ligament injury. With the image, the injury looks between grade II or III. I will advise you to take the call for the MRI shoulder to focus on the AC joint. This will help us understand the extent of the lig...  Read Full »


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