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ACL Tear??!!

LordOpie

MOTHER HEN
Oct 17, 2002
21,022
3
Denver
So I just got home from the Ortho. He did a bunch of manual tests (MRI is tomorrow), looks at me and bluntly said, "You tore your ACL." I should sue him like the Fat Lady. I kid.

Fortunately, he said that I could be cycling again a week after the sugery (if I have it). This will ruin my snow season tho -- no skiing or snowshoeing :( Was really hoping to take someone snowshoeing. Maybe we can at higher altitudes at the end of the season. Sorry, rambling.

Ok, so the big question to those who have a torn ACL but did NOT have surgery, just therapy to strengthen everything else. Are you happy you took that route?


Here's why I ask that question with a bit of history...
If I tore it, I know exactly when it happened... May 2003. Friends and I were bouldering in Arches NP near Moab, Utah. I came to a four foot drop off, jumped and landed in a deep pit of soft sand. A huge crunch of my knee and I went down. I popped four ibuprofens cuz I knew it was bad.

While I'm restricted to non-technical hiking, I can. I can still jog, but I have to focus on foot placement and leg extension. It's 'only' caused me trouble on my bike three times. Since I am functional, I'm hesitant to have surgery. But maybe I should?

I know I'm being premature since the MRI is tomorrow, but this doctor has A LOT of experience from his own ACL tear, to diagnosing patients, and having performed the surgery many times.

Plus, I wanted to vent :D


UPDATE (9/6/05): Got the results back and did tear the ACL along with the meniscus.
 

Brian HCM#1

MMMMMMMMM BEER!!!!!!!!!!
Sep 7, 2001
32,119
378
Bay Area, California
I had mine done 6 years ago and it was worth it. No matter how much you strengthen it without surgery you'll be very limited with your activities, due to the fact you have no stability in the knee.
 

MMcG

Ride till you puke!
Dec 10, 2002
15,457
12
Burlington, Connecticut
I had a partial tear of my ACL and lateral Meniscus of my left knee, 6 weeks of PT and at home exercises and I've got a green light from my Doc (got it on Monday) to do whatever I damned well please. No need for surgery. But then again my tears are just partial and not full blown tears of the ACL and lateral meniscus, so my case may be very different than yours.

the Doc definitely didn't feel the need for surgery in my case, but had I not worked my ass off in PT and at home, it may have been a different story and I may have needed to go under the knife.

I think the bike riding I did definitely helped a lot though! :thumb:
 

jaydee

Monkey
Jul 5, 2001
794
0
Victoria BC
If it's completely gone or really unstable, get the surgery. The ACL is what causes your femur to glide and roll properly on your tibia. Once the proper biomechanics of the knee are severely compromised, you have almost a guarantee of eventually ripping up your menisci and developing early arthritis. But it doesn't hurt to give it your best shot with a serious strengthening and proprioception program. A good (expensive) brace helps, but it's not like the real thing. Find yourself a good sports physio and get his/her opinion. When I was a physiotherapist, I had a lot of patients after ACL repairs, and they almost all had great results, except for the odd one who didn't bother to follow instructions.
 

Greyhound

Trail Rat
Jul 8, 2002
5,065
365
Alamance County, NC
Brian HCM#1 said:
I had mine done 6 years ago and it was worth it. No matter how much you strengthen it without surgery you'll be very limited with your activities, due to the fact you have no stability in the knee.
Ahhhh......yes. I'm a fully functional cyclist, snowboarder, golfer, volleyball player, checkers grand-master and foosball wizard.

And I have a completely torn ACL. Have had so for many years.

But walking is clumsy sometimes.


.....I tore mine out in college, and just never had the time to get it fixed. Why not? Well....at the time, the surgery and the rehab weren't as sophisticated as is now-a-days. The working world called and I had to answer--no time to be laid up. Maybe later.

Either way.....if you don't get the surgery, your forward and rearward stability will be affected. No more sudden stops, my man. That's where the instablity occurs. The ligaments you have on either side of the knee will maintain lateral stability, so you can still shuck and jive on your flag football team....but I wouldn't try out for the Broncos, or anything. Well.......come to think of it, they could use the help these days--wouldn't hurt to try. ;)

So...what I'm saying, is. You're still a functioning human being without the surgery. I ride all kinds of silly and have never had a problem whatsoever---with the knee, that is. Balance, however...is a completely unrelated issue that has nothing to do with the knee. Get the surgery done, though. I plan on doing it as well. Just gotta pencil that in one day. I know it will give me problems down the line.....hell, it does already. But, everybody has pains, and who knows if mine is related to this or whatever. The other knee hurts sometimes, too. :think: What's that all about?

But.....if you get the surgery, you'll have two more points of attachment than what your momma and daddy gave you(notice how I dodged the oft offending Judeo-Christian reference to "what God gave ya"?..........you gotta do that these days, right? so as not to offend anyone on the Internet ;) ) so the knee will now be super-duper extra strong.....like Steve Austin. Better, faster, stronger. Wait a sec, I need to check my bionics. Either way, knowing all this, I've often thought about just going ahead and bustin' up the other knee so I can have both done----and come out twice as elastic as I used to be. If I cut down on the Oatmeal Cream Cookies, maybe I could then take a run at Lance's record.....you know, with my bionic knees.


....Or maybe try out for kicker for the Broncos. :thumb:
 

Potroast88

YouTube Boy
Jan 18, 2004
2,834
4
Bomb City
I have been walking around with both of my ACLs ruptured for several years. Fortunately, I have excellent health insurance which paid for 2 expensive knee braces. My Doc basically told me that unless I plan on playing sports that involve a lot of cutting type motion (football, basketball, etc.) and since I am in my late 30's that it is really kind of hit or miss as far as surgery goes.
I have had arthroscopic surgery on my left knee to clean up my cartilage and am planning on having the same procedure on my right knee this winter. I already have some arthritis in both knees, but ACL surgery won't help that.
I am pretty sure that I will eventually be looking at knee replacement surgery for one, if not both knees.
 

hooples3

Fuggetaboutit!
Mar 14, 2005
5,245
0
Brooklyn
a close friend of mine had it done.. he at the time was heavily into biking and basketball he was on limited activities for 2 months afterwards..then he startedworking it out to strenthen the muscles. in 4 months he was back to 95 %. he says sometimes after strenuous efforts it is sore the next day.
if you do it.. make sure you go to physical therapy!!!!! it works
 

dogwonder

Nitro
May 3, 2005
1,849
0
Walking the Earth
chillindrdude said:
if you've got insurance and are young (which i assume you are), its a no brainer, get the surgery.
I second that...I've blown both my knees (courtesy of lax) and had surgery on both. Yes it sucks to be out of commission for so long but if you ever want to ski or mtb comfortably again, you need to do it. I have friends that didn't do it...that would be fine for quite a while, then just out of the blue, the knee gives and down you go.

BTW...I'm assuming it is a complete tear. If not, an unrepaired partial ACL can be as strong as a reconstructed full ACL. In that case, in your shoes, I'd skip the knife.
 

LordOpie

MOTHER HEN
Oct 17, 2002
21,022
3
Denver
thanks everyone for the advice. I think if the Doctor recommends surgery that I'll have it. I can't worry about a few months of reduced activity since it should hopefully help me the rest of my life.

But I'm still worried they'll make it worse. I know, the odds of that are low, but I'll talk to my doc about my concerns.


And yeah, I'd like to think 36 is young enough and I've got insurance.


Greyhound said:
...if you get the surgery, you'll have two more points of attachment... so the knee will now be super-duper extra strong...
Seriously? That would be awesome!
 

Brian HCM#1

MMMMMMMMM BEER!!!!!!!!!!
Sep 7, 2001
32,119
378
Bay Area, California
I was doing DH about 6-7 months after surgery, the post surgery was painful, they used my patella, also my meniscus was fried and that was shaved down. If I wasn't that active I may have passed on it, but my wife was pregnant with our first child when it happened and I wanted to make sure I'd be able to do all the fun father/son things without limitations. I still don't push my knee to it's limits @ 39 I'm to old to want to go through the surgery & rehab again.
 

Craw

Monkey
Mar 17, 2002
715
-1
I just had the surgery on February 7th. Well, I guess it's not terribly recent...I tore my ACL 3 years ago. During that time I was pretty much ok. I had a brace for most sports, but there were times where I blew out my knee. Those years were pretty hard on my knee, so much so that I had sustained more damage to the knee, with the meniscus and such.

I recommend the surgery. The recovery time was so quick. I was on my bed in a CPM machine for two weeks, and up and around on crutches. Physical therapy in the third week, off crutches around really soon after, almost like a week or two after.

I started riding in April, and as of now the knee feels great. It still gets sore, and I always make sure to wear my knee brace anytime I'm doing anything remotely active. I still stay away from basketball or tennis, not that I played them anyway, but for the sports I do participate in, biking, climbing etc. the knee feels good.

I also make sure to wear the brace if I'm in the ocean or surfing / flailing around. Just in case.
 

Craw

Monkey
Mar 17, 2002
715
-1
LordOpie said:
CPM machine?
I think it stands for "Continual Passive Motion". Basically it's this thing that you put your knee in and it bends it for you in varying degrees. It helped a lot with the overall flexibility with my knee, and made physical therapy so easy..
 

ito

Mr. Schwinn Effing Armstrong
Oct 3, 2003
1,709
0
Avoiding the nine to five
LordOpie said:
CPM machine?
continious passive motion machine.

Basically like a moving a bicycle pedal all day.

I would go for the surgery. Better to get it done than have your knee falling out of place all the time when you are 50. I do know a few(older) people with no ACL's though, they lead active lives, but have to be very careful when playing sports, usually a knee brace and lots of icing.

Had mine done two years ago (almost exactly). I now have full range of motion and near full strength(I'm stronger than I was, but one leg is noticably smaller than the other). It took a while, but it was worth it. I've taken some nasty sideways hits(exiting a bike from 15 feet up) on my leg and it just bounces right back.

The Ito
 

Greyhound

Trail Rat
Jul 8, 2002
5,065
365
Alamance County, NC
LordOpie said:
thanks everyone for the advice. I think if the Doctor recommends surgery that I'll have it. I can't worry about a few months of reduced activity since it should hopefully help me the rest of my life.

But I'm still worried they'll make it worse. I know, the odds of that are low, but I'll talk to my doc about my concerns.


And yeah, I'd like to think 36 is young enough and I've got insurance.



Seriously? That would be awesome!

Yeah....you just can't go in there and sew it back together in a conventional manner---Anterior ligaments don't work that way. Instead, what they have found, is that tendons--either from the elbow of a cadaver(that's a dead guy, BTW) or from the tendon connecting your patella(kneecap) to the front of your shinbone, will graft themselves to ligaments in a relatively short amount of time. What they do, is attach it to the upper inside of the knee, and then "thread" it through the severed ligament diagonally--forming a sort of "X" shape to the repaired area, and then attach to the bottom inside of the knee.

Some folks don't like the idea of a dead guys elbow tendon in their knee....freaks 'em out, or something. But the downside of having it taken from your knee tendon, is that you now have two injuries to heal from and your patells tendon is now a half-inch more narrow than it was before.
 

DesertYota

Chimp
May 11, 2005
16
0
New Mexico
Ha this seems to be pretty common. I've torn my ACL like 3 times now. First time basketball and partial tear. 2nd time dirtbike and I actually tore the peice of bone up that the acl attaches to. Both I just did physical therapy and was fine. 3rd time really nasty one with a track accident on my motorcycle. That was all the way through the acl I had surgery in february and am doing great now. If you can get the ligament from a dead guy it makes recovery waaay faster. I was walking within a week. after physical therapy my knee feels stronger than it has for years, and I'm definetely looking forward to a ski season with my rebuilt knee and some new K2 Public Enemies. So anyways the surgery is definetely he way to go for a full tear.
 

MMcG

Ride till you puke!
Dec 10, 2002
15,457
12
Burlington, Connecticut
LordOpie said:
UPDATE (9/6/05): Got the results back and did tear the ACL along with the meniscus.
full or partial tears? My tears were partial and I just required Physical therapy.

If complete, you should get the surgery done.
 
get it fixed. i tore mine 8 years ago snowboarding (complete tear nothing left) and that knee actually worked better than the "good" knee i say worked because i just tore my PCL completely. and i have instability and i dont like it. probably gonna get surgery on that too at some point. depends on what doc says. we will see. but i think it needs to happen. i like to be in tact.
 

blt2ride

Turbo Monkey
May 25, 2005
2,333
0
Chatsworth
I would do some research. I don't remember the exact details, but I know Danny Way (the pro skater who jumped the Great Wall of China) had this new surgery for his damaged knee. From what I understand, the recovery time is very short and your knee will be 100%.

Hopefully, a fellow Monkey may have some addition information about the procedure. It may not be for you, and I wish I had some more information, but it's nice to look at all of your potential options.

Good luck!
 

LordOpie

MOTHER HEN
Oct 17, 2002
21,022
3
Denver
Thanks everyone. I'm definitely having surgery. I don't know anything else cuz I haven't spoken to the doctor, just his assistant who read a note to me.

Question is, which surgery, which tendon graft??!

So far, it seems like taking the donor tendon from my hamstring is the best option... as opposed to a cadaver tendon, from my patella, or a synthetic one.

Anyone have insight or links to such info that I might have not found? I want to educate myself beyond what my doctor tells me.
 
i had a patella tendon used in mine. worked great, but i think the recovery may be a little longer. i have heard great things baout cadaver. the best thing is go with what your doc is used to, that means the best success. good luck. you will be happy in the long run. and as everyone says, do your physio, it makes the difference
 

Craw

Monkey
Mar 17, 2002
715
-1
LordOpie said:
Thanks everyone. I'm definitely having surgery. I don't know anything else cuz I haven't spoken to the doctor, just his assistant who read a note to me.

Question is, which surgery, which tendon graft??!

So far, it seems like taking the donor tendon from my hamstring is the best option... as opposed to a cadaver tendon, from my patella, or a synthetic one.

Anyone have insight or links to such info that I might have not found? I want to educate myself beyond what my doctor tells me.
I had the cadaver tendon surgery. For me it was the only choice, because I didn't want to have to recover from two injuries (The acl, then the part of my body they took the replacement acl from), and I thought it would be totally awesome to have a dead guy's body part in my knee.