• Dr. Vikram Mhaskar was good, friendly, polite. Yes my problem and diagnosis was explained in detail. Dr. Vikram Mhaskar was good in nature and explained the problems nicely. He motivated me too much and was anytime available on phone. It was a good experience with doctor.

    Akshya Bhayana
    Visited For ACL Reconstruction

  • He was very good. He was available on phone anytime and provided all the information. The surgery went well and he kept me updated regularly.

    Ayaana Sriram

  • Arthroscopic Ligament Surgery

    What are ligaments?

    The knee has four rope like structures (ligaments) that keep the thigh and leg bone together and prevent them from slipping.

    Medial collateral ligament (MCL): This originates on the thigh bone and inserts on the leg bone in the inside if the knee. Its function is to prevent the knee from moving excessively sidewards.

    Lateral collateral ligament (LCL): This originates from the thigh bone and inserts on the leg bone. Its function is to prevent sideward movement of the knee.

    Anterior cruciate ligament (ACL): It originates from the thigh bone and inserts in the leg bone preventing excessive movement in a front to back plane and in rotation.

    Posterior cruciate ligament (PCL): whose function is to prevent backward movement of the knee.

    How do the ligaments break?

    The four ropes that keep the knee together are prone for injury, most commonly via sporting activities and two wheeler accidents.

    How do I know they have broken?

    The patients typically presents with a pop after the injury that lead to inability to immediately weight bear on the limb. This may be followed by a swelling in the knee that lasts a few days to a week.This can be confirmed by doing an MRI.

    What are the types of ligament surgery?

    ACL: This may be repaired or reconstructed. Repair involves joining the end of the ligament back to its attachment. Reconstruction involves making a new ligament using spare tendons of the patients own body. Both techniques are done via keyhole surgery.

    ACL Repair : this is the latest advancement in ACL treatment that has been pioneered by us. At times when the ligament comes off at one end and is preserved more or less 80-90 percent. It is possible to fix it back at the location with specialised devices. This is greatly advantageous as it preserves the native anatomy.

    ACL Reconstruction: this is done when the ACL is torn with most of its structure disrupted. In this situation it is not possible to preserve the native ligament completely and needs to be reconstructed using spare ligaments in the body (most commonly the hamstring tendons).

    PCL: The PCL again may be repaired re reconstructed. When it comes off one end with a piece of bone, the piece can be fixed back. However, if it is torn in the middle it needs to be reconstructed using spare tendons (hamstring tendons).

    MCL: The MCL is repaired via mini open surgery, where the ends are either repaired if done early, or reconstructed when done later.

    Posterolateral corner: the structures most commonly injured here are the popliteus and LCL. They are reconstructed using spare tendons.

    Do all ligament tears need surgery?

    Not all ligament injuries need surgery. There are two types of patients copers and non copers. Copers have an inherent capacity to compensate for a tear. They also may belong to a less active lifestyle where the particular ligaments role is not that significant and may never require surgery.

    The ACL more often than not does not heal up and requires arthroscopic surgery in non copers.

    The PCL has a propensity to heal and in low grade tears may have a trial of conservative treatment using a brace with a posterior support.

    When is the ligament surgery mandatory?

    Ligament surgery is required when the patient wants to lead a very active lifestyle that includes recreational sport. Also, if there are concomitant injuries to the meniscus and other ligaments of the knee.

    Is there a right time to do the surgery?

    Yes if not associated with a meniscus injury one should wait till the movement is at least over 90 degrees in the knee. However if there is a meniscus tear its better to operate earlier to get the meniscus repaired and do the ligament surgery. The rehabilitation is more aggressive than to avoid stiffness.

    How long does it take to recover?

    This depends on the ligament/ligaments torn as well as whether they were associated with a meniscus repair.

    A brace may be needed to be worn for upto 6 weeks in meniscal repairs, PCL reconstructions and multi-ligament surgeries. However, the patient becomes free of crutches in 3 weeks time. Return to sport is usually after 6 months.

    What implants are used?

    We use the best implants available in the market. No local implants are used and only international devices are used.

    Typically a suspensory device is used at the thigh bone (Femur) and a Bioscrew (plastic) is used on the leg bone (Tibia) to fix the new ligament.

    Repair/reconstruction of the MCL and LCL are done using suture anchors(plastic screws with two threads) and bioscrews.

    How are we different?

    Dr. Mhaskar preserves the native ligament wherever possible. Having worked with elite sports teams and being an exclusive knee specialist he realizes the importance of preserving what you have. He is a pioneer in ACL repair and almost always repairs the meniscus.He has published extensively on factors that improve success rates of ACL reconstruction in prestigious journals like “The Knee”.

    How much does it cost?

    This depends on the number of ligaments torn and whether any concomitant tear of the meniscus has been repaired. Most insurances, panels are acceptable. This will be discussed with you by Dr. Mhaskars team.

    How successful are these operations?

    Ligaments surgeries most commonly being done in a minimally invasive fashion (arthroscopy) are very successful and have a quick recovery. The success rates are in excess of 95%.