Patient: Description of condition (onset, main symptoms, hospital visited, etc.): MRI was taken and said that the ACL is torn. Thank you! Patient: I feel helpless now, I don’t know how to be better, some say surgery, some say it can be conservative. Hospitalist: Don’t rush yet, please tell me the main symptoms and the course of the injury you are having. If an MRI has been taken, please send your films and we will decide together whether surgery is needed. Patient: Hi Dean, I have read a lot on the internet as well. I am puzzled that the rupture is a must for surgery, and this is not debated by everyone. It is the issue of tearing that is a headache as people have different opinions. Tear my personal understanding seems to be not a break, right, tear is not a conservative look at it? Is it possible for a tear to grow together? If the tear was missed at the time, how long will it take to get checked to be sure? Should I take another MRI or a physical examination to determine if it is a rupture? These days of injury have been like years. I think we can understand that we are more worried about future problems, and we are afraid to give our family members a burden. Hospital experts: Rupture and tear are just words used in medical imaging, and are not deciding factors for surgery. Our decision to operate or not depends on 1) the patient’s symptoms of knee instability, 2) the patient’s age, and 3) the degree of laxity of the body. Even if the surgery is performed, ACL arthroscopic reconstruction surgery is a relatively mature technique, and there are risks that exist in all surgeries, so there is no need to worry too much. Since you are so worried, can we talk in person when you have time to see me in my clinic? Patient: Thank you, Dean. My family is opposed to the surgery and I have not convinced them yet. The family thinks that if you don’t want to have surgery, why do you want to have surgery? They still don’t agree with me even after I told them what I said. There is no effect of postponing this surgery for a month or two, right? I need time to communicate with my family. It’s so rare to have such a good doctor at the hospital. Hospital specialist: Thank you for your trust. The surgery should be fine 1-2 months late, during which you should pay more attention to your joint function, especially to the presence of laxity (playing soft leg) and pain. Good luck for recovery! Patient: Thank you, Dean, and I wish you good health and good work. Patient: I would also like to ask Dean, if you have reconstructive surgery, post-operative rehabilitation is heard to be very important, does the patient recover on his own, or do you or other staff members specifically guide him? How long does it usually take to resume normal work? Hospital specialist: We have a professional rehabilitation doctor in charge of post-surgery rehabilitation, and you can resume general office work about 4 weeks after surgery. Patient: Dean, does the hospital do single- or double-bundle reconstruction? I’m communicating with my family during this time, thank you again Dean. Hospital Specialist: We decide to do single bundle or double bundle according to the patient’s condition. The basis of choice is relatively simple. If one bundle is broken, one bundle is reconstructed, and if both bundles are broken, both bundles are reconstructed. Patient: Dean, I’m sorry, I would like to ask some more questions. Do you mean that there are two bundles of anterior crossover, one for one segment and two for two segments? Does your hospital always do double-bundle reconstruction? Is it better to have a double-bundle reconstruction or a single-bundle reconstruction? I saw that many patients have single-bundle reconstruction, but not many have double-bundle reconstruction. I have checked the information and said that each has its own advantages. Therefore, I have a question. I may know a little more, but I can’t help but worry. The future recovery into what kind, can still live a normal life, can not exercise, etc. are very worried. Even some patients evaluate the disability, it is really unacceptable. Hospital experts: you’re welcome. Every patient will be thoroughly informed about the surgery they will undergo and fully accept it psychologically and technically in order to better cooperate with the treatment. However, you should know that double-bundle reconstruction is a more technically demanding procedure and not all surgeons have the skills to perform it, so more patients undergo single-bundle reconstruction. I would very much like to check you out in person in the clinic and have a better communication. Patient: Dean do you usually do a double bundle procedure? Do you have to take a lot of autologous tendons on your own body? Is it very traumatic? Do your patients recover better with double bundles or single bundles? I saw the thank you letter from the patient to the director on the internet, and he was able to play sports in five months. What percentage of the original can be recovered in general? Through the communication, the attitude of the family has also eased, and the long-term injury is slowly being understood and accepted. Thank you, Dean, for your continued support. You are a great doctor and a blessing to our patients. Hospital Specialist: Since every patient’s situation is not exactly the same, it is not possible to say whether it is usually a double-bundle or a single-bundle procedure; it should be a single-bundle procedure if the patient is suitable for a single-bundle and a double-bundle procedure if he is suitable for a double-bundle. Generally speaking, double-bundle reconstruction is more invasive and more expensive than single-bundle surgery because it requires double tendons, double tunnels and double fixation. The double tendon does not mean that the tendon is taken twice, but the tendon (semitendinosus and femoralis) is obtained in the same way as the single bundle, and the tendon is cut from the middle and overlapped to form two shorter bundles of tendons. Since the tendon is shorter, the fixation method on the tibial side is different from the fixation method of the single bundle extrusion nail, but is changed to peg screw fixation, and the effect is similar to that of the extrusion nail. Patient: Dean’s patient explanation made me understand better, thank you Dean. Take more care of your health while working. Thank you again, Dean.