The anterior cruciate ligament (ACL) is one of the most frequently injured ligaments in the human body. The typical mechanism of the injury is a non-contact twisting movement, usually due to abrupt deceleration and change of direction. Side-stepping (cutting), pivoting and landing from a jump are examples of events that may cause an ACL tear.
ACL tears can be partial or complete. A complete tear of the ACL has minimal ability to heal and often requires surgical reconstruction, as most patients suffer from functional problems, like giving way and instability, and significant pain. To a lesser extent, partial tears also produce pain and instability. There is serious debate within the medical and workers’ compensation communities about the need for surgical intervention for partial tears.
ACL reconstruction involves replacing the torn ligament, usually with the middle third patellar tendon or hamstring tendon graft. Although most people benefit from ACL reconstruction in functional terms, approximately 10% of patients require a second operation, mainly because of the loss of motion, further meniscal injury and graft failure. ACL reconstructions are not very successful in the long-run in people with chronic meniscal and chondral deficiency.
As ACL injuries typically occur in the context of physical activity, it is a common injury among manual laborers, individuals whose job duties include signficant amounts of climbing, lifting, squatting, and carrying.
Due to instability and pain associated with complete tears, manual laborers with any hope of returning to the work force will almost always require surgery and comprehensive post-surgical rehabilitation. Even then, a successful return to long-term gainful employment is not assured. Repetitive trauma associated with hours of manual labor on a daily basis can lead to pain and hasten the need for additional surgery.
Even attempting to return to manual labor on a partial ACL tear can prove problematic. Repetitive trauma will cause pain and, in many instances, lead to greater tearing, even to a complete tear.
Florida’s workers’ compensation system is not especially kind to individuals whose injuries prevent them from performing their regular job duties. Even under the best of circumstances (e.g., a competent and fair doctor; a fair employer), the most a recovering worker can expect are a limited amount of lost wage benefits and employer/carrier-controlled medical benefits. Except in rare instances (i.e., Permanent Total Disability), once maximum medical improvement (see Florida Statute Section 440.02(1) for the definition of MMI) has been reached, monetary benefits will end no matter the long-term consequences of the injury on the injured worker’s ability to perform his/her regular job duties.
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Jeffrey P. Gale, P.A. is a South Florida based law firm committed to the judicial system and to representing and obtaining justice for individuals – the poor, the injured, the forgotten, the voiceless, the defenseless and the damned, and to protecting the rights of such people from corporate and government oppression. We do not represent government, corporations or large business interests.