Anterior Cruciate Ligament

What is your ACL, and what does it do?

Anterior Cruciate Ligament or the ACL is an important ligament inside the knee. It is present in the middle of the knee, and pairs with another ligament called posterior cruciate ligament, or PCL. Both ligaments help in stability of the knee joint, and prevent the knee from sliding on itself, hence preventing the feeling of buckling, giving way, or falling. In the absence of either one, or both the ligaments, the knee is unstable, and the patient will have difficulty walking, but especially with running, pivoting, and cutting.

What does it feel like to have a torn ACL?

Patients who have a torn ACL usually remember an injury in which they may have fallen or got hit on the knee, with or without hearing or feeling of a pop in the knee joint. These patients have sudden onset of pain associated with swelling. They also have limping because of pain. These patients also have instability and may have episodes of buckling or giving way.

Can an ACL tear heal without a surgery?

In case there is a complete ACL tear, the chances of healing without a surgery are remote. That nevertheless does not preclude conservative treatment as patients with low demands can be treated with physical therapy. If the patient has a partial tear of the ACL then, there is chance that the patient may get better just with physical therapy. If the patient does not got a stable knee even after physical therapy, then they may need ACL surgery.

Is ACL surgery serious?

ACL reconstruction, or repair surgery of the knee, is one of the major arthroscopic surgeries of the knee. It involves inspection of the joint, with repair, or reconstruction of the ACL along with treatment of any associated injury like meniscal tear. The surgery itself may take one and a half to two hours to complete. The rehabilitation process after the surgery is tedious, and involves constant supervision with a physical therapist, and a physician.

Is surgery required for a torn ACL?

If the ACL is torn completely, and the patient is in high demand of work, or recreation, then ACL surgery is preferable to give stability to the knee. If the patient is in low demand work, or has multiple comorbidities, then patients may be treated conservatively. Patients who do not undergo ACL surgery have higher chance of getting injury to other parts of the knee, like the meniscus, and the cartilage.

Can you still walk with a torn ACL?

After the ACL is torn, the knee becomes unstable, which is worsened by strenuous activities, like running, or pivoting, and cutting. Patients can still walk with a torn ACL, and may, or may not, require a brace to stabilize the knee.

How long does it take to recover from a partially torn ACL?

Patients with partially torn ACL are instructed to do all of this, and, have a rehabilitation program with a physical therapist. They may take up to eight to twelve weeks to recover. Some patients may take longer periods depending on the ACL torn. Few patients may even fail rehabilitation protocol, and may have to undergo a reconstruction of ACL, later.

Can you still walk with a torn ligament in your knee?

A torn ligament in the knee does causes instability. If only a single ligament is torn, patient is usually able to walk, though he may have some instability, and may need to use a brace, or crutches for support. If the patient has injury to multiple ligaments, or ligaments and meniscus, it may be difficult for the patient to walk without having a feeling of instability, or giving way, and may have episodes of falling.

Can a partial ACL tear heal on its own?

A partial ACL tear, depending on the amount of ligament involved may heal on its own, and patient may recover by use of physical therapy. If the patient has high grade partial ACL tear, then these patients may not recover completely, and depending on the requirement of the patient, may need to undergo surgical reconstruction of the ACL.

Can ACL be repaired?

ACL tears if present early after injury and if MRI show that they are reparable, then a trial for repair can be given to the ACL. The ligament is fixed back to the bone using some sutures and buttons to allow a natural healing process and keep the native ligament in its place. Repair leads to early recovery and owing to the retention of native ACL, gives better proprioception and hence early rehabilitation and recovery.

Is ACL repair better than reconstruction?

ACL repair, if possible, give better result than reconstruction because in ACL repair, the native ligament is kept as such and is fixed back to the bone to allow healing. In case of reconstruction, a ligament substitute is put in place, which not only takes a longer time to heal, but also takes time for ingrowth of nerves and vessels, which may also still be incomplete to give a result similar to an ACL repair.

How long before I can return to sporting activity after an ACL reconstruction?

After an ACL reconstruction, patients must be involved in a rehabilitation program with the physical therapy under direct supervision of the therapist and the treating physician. Patients must be in brace initially, which is gradually weaned off in four to eight weeks. Patient is put in rigorous physical therapy program and is also allowed to strengthen his muscles in the gym after about three months from surgery. Patients must strengthen their quadriceps as well as the hamstrings and must regain full range of motion and power before they can indulge in a sporting event. They are puts into sports rehab program. It could take six to twelve months before a professional sportsman can return to play.

How long does it take to recover from a torn ACL?

A torn ACL, when treated surgically, may take up to 6 to 12 months to recover completely and allow the patient to do unrestricted activities as before the injury. In patients who do not opt to operate may have a long rehabilitation process with suboptimal results, but if the results allow the patient to live a satisfactory life in their activities of daily living as well as work and recreation, then the result is found to be okay.

What are the risks of ACL surgery?

The risks of ACL reconstruction arthroscopically include Medical (Anesthetic) complications like but not limited to: Allergic reactions, excessive blood loss, heart attack, stroke, kidney failure, pneumonia, bladder infections. Complications from nerve blocks such as infection or nerve damage. Complications due to surgery itself include infection, DVT, excessive swelling & bruising, joint stiffness, tingling and numbness, graft failure, damage to nerves or vessels, hardware problems, donor site problems, residual pain, reflex sympathetic dystrophy etc. Some of these conditions may require hospitalization, aspiration, injections or even surgery.

How long do you have to keep your leg elevated after ACL surgery?

Patients are encouraged to keep their knee elevated most times for a few weeks after ACL surgery. This is to decrease the swelling as well as the pain in the knee. Once the patient’s pain has decreased and the swelling is no longer there, the patient can decrease the time of leg elevation. If the pain and swelling recur, then the patients are instructed to use ice as well as elevation and compression to decease the pain and swelling.

How long does it take to be able to walk again after ACL surgery?

Patients can walk within a day after the ACL surgery with a brace. They are also asked to use crutches for support. Patient will be using a brace for four to six weeks. They may use auxiliary crutches for support, if needed.

How long do you have to be on crutches after ACL surgery?

Patients, after ACL surgery, have a brace on the knee, and may use auxiliary crutches for comfort. They may discard the crutches once they are able to ambulate without discomfort.
Is ACL surgery serious?

ACL reconstruction, or repair surgery of the knee, is one of the major arthroscopic surgeries of the knee. It involves inspection of the joint, with repair, or reconstruction of the ACL along with treatment of any associated injury like meniscal tear. The surgery itself may take one and a half to two hours to complete. The rehabilitation process after the surgery is tedious, and involves constant supervision with a physical therapist, and a physician.

How long do you go to physical therapy after ACL surgery?

Patients usually must go for six to nine months of physical therapy after an ACL reconstruction, for it to recover completely, from ACL surgery, depending on the patient’s requirement. If the patient is a sportsman, they may have to go to a sports rehabilitation program so as to recover completely, to a pre injury status.

Can a stretched ACL heal?

A stretched ACL can be treated with a brace and physical therapy and may heal over time enough to provide a patient with a stable knee. If the patient does not heal completely with the brace, and physical therapy, and is still unstable enough to handle activities of daily living, or work, without limitation, then he may need to undergo ACL reconstruction surgery.

When can I take a shower after ACL surgery?

Patients are usually asked to remove their dressing after 72 hours of surgery, and can take a shower after that. Patient can dab the surgical area dry and put band aids over it.

Can an ACL reconstruction/repair fail?

An ACL reconstruction/repair can fail, due to multiple reasons, including wrong surgical technique, injury, fall, or twisting of the knee. ACL surgery may also fail in the presence of infection. In case of ACL repair, surgery may fail to heal the native ligament and a reconstruction may have to be done. These patients may need to undergo a revision of the ACL reconstruction, to get a stable knee.

Do torn ligaments heal themselves?

Torn ligaments of the knee, if in place, and of low grade (partial), can heal by themselves. The lateral collateral, as the medial collateral ligaments are essentially treated conservatively with brace and physical therapy. In case of high grade ligament tear, and if the patient is not getting better with physical therapy and brace, the patient may need a surgical repair, or reconstruction of the ligament, to obtain stability.

How ACL surgery is done?

ACL surgery is most commonly done arthroscopically, in which a camera and a light source are introduced to the knee joint through small incisions. Surgical instruments are inserted through different incision, and the ACL is examined. If the ACL is completely torn, and not repairable, then it is debrided, and cleaned.

The replacement substitute for the ACL is then harvested, either from the hamstring muscles, patellar tendon, or the quadriceps tendon, to replace the ACL. Bone tunnels are then made into lower end of femur, and upper end of tibia to pass the graft, and the graft is fixed using sutures, and either screws or buttons. Any concomitant pathology if found inside the knee is also taken care of.

How long are you out for the torn ACL?

The torn ACL is usually treated non-surgically and may take up to eight to twelve weeks to heal. A patient is usually treated with a brace, and physical therapy. Patient may be out of work, depending on the type of work, from two weeks to eight weeks. If the patient is in high demand job with a lot of manual work, then they may be out for a longer period.

How long does it take to recover from an ACL and meniscus surgery?

The recovery of a combined surgery is a little longer than that of an ACL surgery. There are s slightly higher chances of complications and stiffness owing to increased surgical time and work done inside the knee. The loss of partial meniscus in cases of partial meniscectomy also plays a role in long term recovery of the knee. In cases of meniscus repair, the rehabilitation is slowed due the time needed for the healing of the meniscus.

Can ligaments grow back together?

If the ligament is in it’s place, especially near the, it’s, bony end, then they may heal with the help of bracing and physical therapy. If the ligaments are torn in mid substance then it is difficult for them to heal, because the healing between the two ends of ligaments is not optimal. The ligaments usually do not grow back, but they heal with a fibrous tissue between them.

How do you prevent an ACL tear?

The ACL tear is essentially caused due to injury or fall or contact sports. If a person is involved in high risk activities like contact sports, then they are advised to have strong musculature, especially in the quadriceps and the hamstrings, as this support the knee, hence preventing an ACL tear. If the patient has undergone an ACL reconstruction, or repair, surgery then they are instructed to strengthen their quadriceps as well as hamstrings before they go back into field, to prevent repeat tear of the ACL.

What are the causes of a torn ACL?

An ACL is usually torn due to fall, or injury, especially involving twisting of the knee, or with an indirect force; someone hitting the knee. This usually happens in a contact sport accident, but this may also happen in injuries, like automobile accidents.

Can I do without my hamstrings?

Patients who undergo ACL reconstruction using their hamstring muscles can still walk and function well with their knee with rehabilitation because of other muscles substituting for those hamstring tendons as well as partial or complete regeneration of the tendons.

Should I wear a knee brace to support my knee rather than undergo major surgery for ACL reconstruction?

Surgery for ACL reconstruction is essentially an elective surgery in which the patient must discuss and understand the need for the surgery. If the patient is symptomatic enough to have inability of daily living, work and/or recreation, then it is advisable to undergo ACL reconstruction. Wearing a knee brace cannot substitute for a deficient ACL and patient will still will have restriction with regards to his activity. The knee brace may help in stabilizing the knee for certain movements, but the patients will still not be able to perform a higher level of function with that knee.

How can I tell if I have got a serious ACL injury?

Patients with ACL injury do remember incident in which they may have injured their knee. This is usually associated with, swelling of the knee, pain along with limping. If the patient presents late, they may have symptoms of instability in which they would have knee buckling or weakness because of deficiency of the ACL. A diagnosis of ACL injury is usually made by examination followed by an MRI of the knee.

These questions have been personally answered by:

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.

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I had an extremely friendly and personalized medical consult with Dr Karkare. Dr Karkare was very knowledgeable and very professional. His communication skills was extremely good and explained my medical condition in very simple words. The office visit was very helpful in understanding my medical condition. Thank you Dr Karkare
Padmanabhan Nagaraj
20:49 25 Sep 23
Dr. Karlkare and his staff were excellent. Dr. Karkare explained everything clearly and took his time getting to know my Dad.
Anna Acker
22:46 07 Sep 23
Dr Vedant Vaksha had done emergency surgery in 2020 after a traumatic injury.His office at Complete Orthopedics handled the continued care thereafter.Dr V and his staff had been Professional and friendly throughout the process, taking the time to explain all the questions on how to proceed and what to expect.Whenever I needed to speak with Dr V or the office they were a phone call away, without waiting or calling several numbers like in so many other medical offices.The office was accommodating to scheduling to my needs at all times. Dr Vedant Vaksha earned the following5 out of 5 stars, highly recommended.
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Dr. Vaksha helped me recover from an injury. I am very thankful that he took the time to explain the best treatment for my injury. Also thankful for the wonderful office staff!
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The office is wonderful!… Dr Paresh was very helpful and attentive and made my sister in laws recovery so much better.. Thank you for everything
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17:48 14 Jul 23
The ladies are very welcoming, the service is great, the doctor is very professional and caring and the building is super clean. I really like to come here, the atmosphere is very friendly... Come and you will love it too.
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14:41 30 Jun 23
Dr. Nakul Karkare is awesome! And patriotic! Thank you, Dr. Karkare for displaying the American Flag in your waiting room, honoring and mourning our military personnel, this Memorial Day, who died while serving in the United States Armed Forces.
00:52 30 May 23
Excellent and skilled orthopedic practice specializing in joint replacements. Dr Karkare was trained at the Hospital for Special Surgery and has excellent results, as do his associates!! Would gladly refer family members to the practice!!
00:24 30 May 23
I had such a wonderful experience with Complete Orthopedics in Stony Brook. Not only did Dr. Kuo fix my broken wrist with such kindness and care, but the office staff, including Billing, Reception and the X-Ray Technician, was always so helpful, going out of their way to ensure that each patient felt welcome, answering any questions with a smile, and ensuring any issues with insurance/billing were handled with the utmost professionalism. I highly recommend their practice!
Victoria DeMatteo
19:49 10 May 23
I'm very happy St. Catherine's sent me to this office for treatment after I broke my collar bone! Unfortunately the break was too severe to repair on its own and I had to have it rebuilt a week after the injury. Dr. Vaksha did a great job fixing it. I'm three months out, and I have full use of the arm and shoulder. The whole office staff is very professional, accommodating, and welcoming. I hope to not need orthopedic services again, but Dr. Vaksha will be my number one choice if I or anyone in family suffers such am injury.
Tina Rivera
20:42 08 May 23
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
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15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
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19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18