ACL Surgery for me [Archive] - The Paceline Forum

mwos

01-20-2006, 10:13 PM

Serpico

01-20-2006, 10:20 PM

Keep your spirits up, it could've been much worse (not that that makes it any easier, but you know what I mean). :o

Keep us updated, everyone here is concerned.

Hope you heal soon--you sound like an extremely active person, but please take it slow for awhile (get some good books, watch some films, etc, stuff like that).

-Jason

93legendti

01-20-2006, 10:35 PM

Today I got the results of the MRI on my right knee. The bad news is my MCL definitely has a level 2 tear, the ACL is torn and the bone is bruised. The good news is the menicus is intact so no problems there.

So, I will be in pt for 6 weeks to rehab the MCL then will have ACL surgery. According to the timeline given to me, if all goes well, I'll be riding again around early June.

I am allowed to use my bike on the trainer.

My friends are now watching the lift lines very closely, making sure there are no "closed" ropes across them before they enter.

Kathi

I am so sorry to hear that. Get a few more opinions. (Unless your knee is clearly unstable.) I partially tore my right ACL (and meniscus) in 1990. 1 doctor wanted to cut, 1 doctor said no surgery. The third doctor said he wasn't sure the ACL required surgery, but since my knee was locked that we should do a scope, see why it was locked and check the ACL. I went that route. He cleaned out the meniscus, found a bone chip in the joint (which caused the lock) and found my ACL still had very good stability. I didn't get the ACL repair and skied for 7 more years (with a brace) until another accident gave me good reason to quit. I was biking within 6 weeks.

It has been almost 16 years and my knee is still stable.

(BTW, at the time, the doctor who wanted to cut said that only 33% of ACL injuries need to be surgically repaired immediately.)

justinf

01-20-2006, 10:56 PM

I was one of those 33%. I broke the bony acl attachment in my right knee two years ago. Unfortunately, at the time I had to wait 2.5 weeks hobbling around on crutches and percocets due to hospital scheduling. No fun, but plenty of time to check out my options, from second (and third) opinions to quack energy healing and everything inbetween. Not that energy healing is by definition a bad thing, but my experience, well that's another story entirely. . .

Good news is, even if your second opinion (that you should get) verifies that you need the arthroscopic surgery, it's an injury that will heal. My knee has never been 100% again but it's close and cycling does it good. Good luck to you.

gasman

01-20-2006, 11:17 PM

Kathi-
Sorry to hear you need surgery. In 2006 MRI's are very good at diagnosing ACL tears, they rarely misdiagnosed. If your orthopod is very experienced at caring for knee injuries and repairing them then he or she shouldn't have problem with you getting a second opinion. Surgery isn't the only option but it is the route I would take to get the most stable knee in the long run. The surgery can be done arthroscopically and the rehab is not bad. The 2 guys I know who did not have surgery wish they had done the surgery.
Good luck.
Hope you heal well.

mwos

01-21-2006, 12:02 AM

The ortho showed me the MRI and the ACL is definitely torn.

In the past the menicus was not considered that important and was removed but now the attitude is different, they try to save the menicus any time it can be saved. Since my menicus was undamaged the real goal is to protect it from damage in the future. Skiing without ACL reconstruction will put the menicus at risk and I don't want to do that.

I have a friend who didn't have surgery and skied with a brace. He raced with it for years. He gave up and had surgery because he got tired of his knee "popping out" when he walked.

If I do the surgery in March, then I should be ok to ski again in Dec.

The ortho is young but he is really into sports medicine. He's also looking out for my interests in that he recognizes how important my sports are to me and is recommending the best protocol for my recovery.

Besides, many of my friends have had ACL surgery and they don't seem to have slowed down because of it.

Even if I don't do surgery I'm out until mid April or early May with the MCL tear.

Serpico, its so hard to occupy my time with books and videos. I'm going to save that for after surgery, in the meantime I'm going to paint some rooms in the house.

Kathi

vaxn8r

01-21-2006, 01:53 AM

93legendti

01-21-2006, 08:54 AM

I don't know that much ortho but I think in 1990 there wasn't as much a gap between those who had ACL repair vs those who didn't. Maybe someone can clear that up but I think the balance is now tipped in favor of doing repair, even for "non-athletes". Probably just talking outta you know where though...

I would not let a young surgeon operate without checking with older ones first. In general young surgeons may be more inclined to cut -- as the surgeon who inserted the rod for my ORIF to fix my right femur fracture in 1980 told me, the young ones haven't necessarily seen all the negative side effects of surgery. After the operation I couldn't bend my leg. (Not to mention the 2 friends I have whose ACL repairs failed, ugh!)

The issues for me was the addtional trauma from a 2nd operation and even more if I went with the patella tendon repair route. As the doctors explained to me, the issue was not tear or no tear but knee joint stability-- according to the 3 drs. I saw (and a 4th afterwards for a brace): if your knee was stable the ACL did not need to be fixed. 16 years later, I can say they were right. Do your research and find a surgeon you trust and good luck. I picked mine because he readily admitted he did not know what was wrong with my knee, but since the joint was locked I neede a scope and he coud use that scope to explore. Every other dr. was SURE they knew what was wrong. I realized then that medicine was not purely science--maybe science practiced by "artists".

Good luck!

kestrel

01-21-2006, 09:44 AM

I injured my ACL years ago, but a little over 2 years ago I broke it completely. I got a great Doc, he only does knees and shoulders, a sports guy that handles a college soccer team, and helps out with the pro football team up in Charlotte (With a name something like maybe Panthers. Probably won't go far in the post season...... NOT, go Panthers!). He X-rayed and MRI'ed it, then told me to let the injury heal, then resume riding for at least a month or two and let him know once I'd regained by bike fitness to the pre-injury level. I stayed off the bike for two weeks, then began riding again, once I felt comfortable on the bike, I called him and setup an appt. We decided at my advanced age (58) we didn't want to mess with using my own hamstring, so he did a tibialis donor cadaver replacement. I was on my feet with crutches that day, and putting weight on it the next day. I stopped using the crutches in 3 or 4 days, and was cycling on a stationary bike at therapy by the next week. The first time I tried the bike, I couldn't get my right leg to circle over the top, so I rocked it for about 4 or 5 minutes. The therapist said to force it over while backpedaling. For some reason it was easier to backpedal than to go forward. The next day I began forcing it over the top and I haven't looked back since. The doctor said once I could pedal the bike, I could quit therapy, so I never went back. The physicians assistant gave me a group of progressive excersizes and I stuck to them faithfully. I rode outdoors 20 miles easy by the end of the third week. I started riding everyday at that point, either outdoors or on a trainer. I didn't try to get back on rollers for about two months, by then it was getting warm enough to be outdoors most of the time anyway.
It's been 24 months since the surgery, and I still feel it every now and then, but nothing that stops me from riding. Heck the good knee usually hurts more. If I go inactive for more than two or three days, the knee tightens up and it takes a few minutes of stretching to get it back to full range of motion.
All in all I'd say it was the best thing I could have done. I can run, play some soccer with my boys, and ride all I want pretty much pain free.

The doc did say if I was content running a bit and riding my bike he didn't think I should consider replacement surgery, he said it would function just fine in straight line movements.

72gmc

01-21-2006, 11:44 AM

I popped my ACL while skiing in March of 1993. Just gave way beneath me; the doctor said it was almost torn through already and the meniscus wasn't providing stability. Years of soccer brutalized my knees.

I had it repaired that same month and was skiing, tentatively, in December or January following. Haven't looked back. You sound like you'll experience the same or better results; just channel your frustration into doing your PT properly and don't overdo it (easy to say, hard to obey). Good luck.

Ginger

01-21-2006, 04:54 PM

Sorry to hear that your knee went that way.

I severed my ACL, tore my MCL, and my lateral meniscus back in October of 2004. The ACL jammed up in the front of the knee so it remained bent while the MCL healed in a brace for three months. Surgery was in January and the doc used my quad tendon for a replacement. I'm pretty happy with the results.

I have since decided that if you could replace your ACL without using your own tissue, recovery may be quicker and less painful...because if you use your own tissue, you have to heal whatever donor site they use. However studies show that it takes about the same time to recover no matter what tissue you use, it's just a matter of comfort. The body treats your tissue just like it does the forgein tissue so it really doesn't matter inside the knee.

It takes the ACL one to two years after surgery to revascularize regardless of whether you use your own tissue or not. So while you may be skiing in December, you'll be doing so with an ACL that isn't quite up to snuff, and realistically you'll probably be using your brace.

11 months after my surgery I slipped on the ice outside of work. The ACL is a touch looser than it was before the fall, and I may have torn more of my lateral meniscus...we're doing the "wait and see if it's too painful to live with" test.

Good luck with your knee. Get a second opinion and really consider all of your options.

vaxn8r

01-21-2006, 10:01 PM

I realized then that medicine was not purely science--maybe science practiced by "artists".

Good luck!
You can say that again, though it's not always as bad or as looney as one might think. Often there really are 2 or even 3 different treatment options and they might all boast excellent results, especially if one is more accomplished in a certain procedure over another. I'd always take "more experienced" over "type of procedure" any day. The caveat is many docs can be narrow-minded and quite persuasive that their personal procedure is by far better that someone else's or even better than no treatment at all, as in your case.

As for medicine as science, depends on what you mean. I see people refer to this study or that study proving their point. This often leads to knee jerk changes in therapies. The reality is any study may be biased or rigged to prove whatever they were trying to prove. Legitimate work comes when others, who have no financial, or other, stake in a particular outcome, are able to confirm your results. Ideally speaking of course.