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HomeAnswersOrthopedician and Traumatologyacromioclavicular ligamentGrade 3 dislocation of ACL. Is surgery compulsory?

Is surgery necessary for grade 3 dislocation of ACL?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Anuj Gupta

Medically reviewed by

iCliniq medical review team

Published At October 18, 2018
Reviewed AtAugust 9, 2023

Patient's Query

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?

Answered by Dr. Anuj Gupta

Hi,

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.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Anuj Gupta
Dr. Anuj Gupta

Spine Surgery

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