Insurance insight: Carpet to help keep knee surgery covered?


BACKGROUND: The anterior cruciate ligament, also called the ACL, is located in the middle of the knee and it stops the shin bone (tibia) from sliding in front of the thigh bone (femur). In an ACL injury, there is either a complete or partial tear to the ACL or the ligament has been overstretched; this can happen if someone is hit very hard on the side of the knee, overextends the knee joint, or changes direction quickly while running, turning, or landing from a jump. ACL injuries are often considered sports injuries because ACL tears are linked to sports like basketball, soccer, football, and skiing. (Source: www.nlm.nih.gov) 


SIGNS: Some symptoms that may signal an ACL injury include:

  • Knee swelling within 6 hours of the injury
  • Pain in the injured area, especially when putting weight on it.
  • A popping sound at the time of the injury. (Source: www.nlm.nih.gov)


TREATMENT: ACL injuries can be very painful and can prevent people from carrying out their usual activities, especially if they are an athlete. The two main treatment options for this type of injury are rehabilitation therapy or knee surgery. Rehabilitation therapy may involve using a knee brace, exercises to help the knee's range of motion, and muscle strengthening and stability exercises. Sometimes the rehabilitation therapy alone is enough, but depending on the damage to the knee and the individual person's needs, surgery may be necessary. Two common procedures for ACL injuries are arthrocentesis, where a needle is inserted to remove excess fluid from the knee joint which will lower swelling, and surgical reconstruction, where a piece of tendon from another part of the leg is put in place of the ACL. (Source: www.mayoclinic.com)


INSURANCE COVERAGE: Many times treatment for sports injuries are not covered by insurance or are only partially covered, leaving large bills for the patient to pay. Proving the necessity of correcting the injury with surgery or some other form of treatment is key in getting insurance to cover some of the costs. Some universities have even begun to offer insurance coverage for their athletes because of the issues with excessive costs and continued injury. (Source: www.nytimes.com)



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* For More Information, Contact:


                Karin Gaffney Christensen, Public Relations and Communications

                University of Rochester Medical Center


(585) 275-1311