OT: i just tore my ACL, what to do

Submitted by BlueCE on February 16th, 2013 at 3:40 PM
Hey guys, I was skiing today and it looks like I tore my ACL. Doctors said it was my choice Re: surgery. Recommendations? I am 35 and fairly active. Thanks

Comments

a non emu

February 16th, 2013 at 5:15 PM ^

But seriously, I have ACLs done on both knees. Did patella graft on one, and hamstring with the other. Looking back I would have done patella on the other knee too. My hamstring has never been the same since the surgery. 

And get surgery. I went two years without surgery on my left knee after tearing my ACL (long story), and really messed it up. Ended up badly tearing my meniscus as well and having to lose a chunk off it. I am fully resigned to arthritis by 40. I just hope they have some awesome replacement knee by then and I can finally be part-transformer :)

But post-surgery has been fine. There are still random aches and pains and the knee never got back to feeling completely normal, but I play sports, can run around, and have no problems with instability or anything else. The rehab is long, and it sucks, but really really push yourself. The key to full recovery and getting your strength back is being diligent about your rehab.

OHbornUMfan

February 16th, 2013 at 5:33 PM ^

And do the best job rehabbing that you humanly can.  I got one repaired in high school and the other one repaired in college in '02.  I did a much better job rehabbing the second, and I can still tell the difference with ease today.

richardinthedirt

February 16th, 2013 at 5:50 PM ^

I tore my ACL and virtually every other ligament in my knee two years ago skiing, so I feel your pain. I had surgery and I am still not 100%. Whatever choice you make, rehab like crazy but don't over do it. I wish you a speedy recovery.

readyourguard

February 16th, 2013 at 6:12 PM ^

I tore mine at 41 (6 years ago).I haven't had it repaired but have been able to run, snowboard, do squats, and surf since then. I suck at all of those activities, but I'm able to do them without an ACL.

Spontaneous Co…

February 16th, 2013 at 6:30 PM ^

I tore mine at age 31. I had no cartilage damage, went with the hamstring graft and had a great experience. 24 hours after surgery bent my knee flat to 90 degrees. On a bike the next day, jogging lightly in a straight line 6 weeks later.

It did take 18 months for my hamstring to recover but it never hurt, it was just weaker. And you can't start rehabbing your hamstring until after the 6 weeks so since I was done with rehab by then I never really did anything to strengthen it.

Knee itself feels as good as new and doctor said its 3 x stronger than my native ACL. Good luck!

redhousewolverine

February 16th, 2013 at 6:34 PM ^

I had a friend who partially tore it senior year of college. He was given the same advice: wait for the swelling to go down, see a specialist, and then get an mri. He tried playing basketball a couple weeks later and injured it again. Opted for surgery but after be made a trip to India. When he was hiking there it was a bitch cause of the elevation changes and going downhill and all. He ended up having to sit a bunch of his planned activities out. Reaffirmed his desire to have the surgery. Really depends on what the doc says and how active you want to be. Rehab was tough but he had a netflix so that helps.

asstastic

February 16th, 2013 at 6:42 PM ^

I've torn my ACL twice and went to two different doctors. The first doctor used my hamstring and it didn't take in my knee. The second one used my patellar tendon and had a completely different method of therapy. I was back to competitively playing high school golf and shooting low 40's, a month and a half after surgery. The second doctor is Dr. Shelbourne out of Indy and used to be the team surgeon for the colts and I think does the surgeries for Purdue and other teams as well. I'd highly recommend him

umeuph97

February 16th, 2013 at 6:50 PM ^

Do the surgery, follow the doctor's instructions.  If they tell you not to walk on it, then don't.  Do the PT, do your exercises at home. 

Shower the morning before surgery, because you may not be able to for a few weeks after.  (that really sucked...)

As soon as you can after surgery, get Vitamin E gel caps.  Pop (as in break open) one a day and smear it all over your incision.  My doc couldn't believe how fast my incision healed and how good it looked.  Oh, and if you don't want a scar (minimize it anyway), keep the incision out of the sun as long as you can. 

You're going to build up scar tissue from inactivity, so when there's a terrible ripping noise in PT after the surgery, don't freak. 

Don't rush the PT after the fact or you'll get tendonitis and back to crutches you go. 

Hopefully your tear won't be as bad as mine was, I was on crutches for like a year.  :(  Anyway, there's a summary of my ACL tear experience.  Good luck!

sambora114

February 16th, 2013 at 7:03 PM ^

I had two ACL surgeries; my right knee at UM at age 19 and my left knee in Chicago at age 25. I had the patellar tendon repair on both knees and currently have zero pain and am fully active. That's the way to go if you want to continue being mobile (basketball, skiing, similar cutting sports). Usually you are ready for activity 6 months after surgery, usually you start physical therapy immediately after surgery

Dr. Bruce Miller at the university of Michigan hospital was excellent. Harvard MD and under graduate, he's the head team physician for the hockey team I believe. 

[email protected]

I currently live in Chicago and Dr. Bach operated on my other knee.

https://www.rushortho.com/Bernard_Bach.cfm

Good luck!

MMB 82

February 16th, 2013 at 9:07 PM ^

and didn't know it. I was transported down the mountain, and after a few weeks on crutches, I got better and had it checked by the same ortho who did Bo Jackson's hip. He found my knee to be stable and to continue my rehab- if it worsened I would get an MRI and possibly have it scoped. Within 5-6 months I was almost normal (just some discomfort on deep knee bends) and within 9 months it was completely normal. I ran marathons, played squash, skiied, cycled, etc. without a problem for nearly 17 years. Cycling in particular (I ride centuries) probably stabilized my knee so that I didn't know I had ruptured my ACL.

Two years ago I slipped on some ice and felt something pull in my knee- it hurt like hell, but I walked it off- it didn't swell, and I went skiing the next day without any problem. BUT, I started having these little "incidents" with my knee, and eventually it worsened to the point where I had an MRI and it was "hey, did you know you have an old, total ACL rupture?" It continued to worsen, and I had the reconstruction surgery. I chose a cadaver graft because a) I am over 50 b) I am not a high-level football or basketball player. Cadaver graft has a much faster and less painful recovery.

It was the best thing I ever did- I had to give up running, but I now spend more time cycling. It was also the impetus to drop 30 lbs (better to avoid a total knee sometime in the future).

It really depends on how your knee is, and it's too soon to tell. If it is at all unstable, get the surgery because with an unstable knee you run the risk of further damage to the menicus and collateral ligaments. Cadaver vs autograft is a decision best made between you and your orthopedist. There are arguments either way. If I were Blake Countess I would absolutely have chosen an autograft.

ericmj

February 16th, 2013 at 8:05 PM ^

I didn't read all the posts but' I'm an orthopaedic surgeon who specializes in sports med.  Typically an active 35 yo would get the ACL reconstructed.  Under 40 I still recommend using an autograft.  Cadaver could be an option however there is a higher failure rate under 40.   Unless you are a professional football player, there is essentially no diference in hamstring vs BTB in terms of outcome.  They each have their advantages and disadvantages.  Some surgeons have a preference based on their skills or outcomes.  I personally do whatever the patients wants after they have all the information.  I also send all patients to "prehab" prior to surgery to relieve swelling, gain full range of motion and  strength.  This is essential to a good outcome.  Good luck.  If you are in Ann Arbor, Bruce Miller is excellent.  

vinsacco

February 16th, 2013 at 8:37 PM ^

I agree with the above Dr. I work with the Andrews institute in Pensacola Florida as an Orthopedic Consultant. We work with all types of Athletes.

I would encourage you to repair it at your age.

You are active and have many years ahead of you.

Next to full recovery would be expected.

Dr. Ostrander and Dr. Andrews are top notch. If you're in the panhandle region.

Best of luck to you.

CAwolverine

February 16th, 2013 at 8:39 PM ^

I tore my ACL (same knee) twice. Both times I went with the allograft repair. The first time after 2 1/2 years the allograft failed while I was playing casual coed beach volleyball. I was beyond shocked and in disbelief as I did nothing that should have torn it. I jumped up to hit the ball, came down square and felt something "wrong" with my knee. I didn't twist it, land funny or torque my knee in any way. Up until it tore again, it felt great.

The results of the second allograft have been very disappointing. I don't want a third surgery so I am dealing with it.

Not sure if you recall, the ex Purdue coach pulled a scholarship offer from a kid very close to signing day a couple of years ago after they discovered he had the ACL repaired with an allograft. They said studies and their experience indicated allografts had a much higher failure rate.

After living through this I would definitely agree and NEVER recommend any go with the allograft.

Hope this helps and your recovery goes well.

justingoblue

February 16th, 2013 at 10:33 PM ^

I just had a torn meniscus repaired by a great sports med guy specializing in knees. Couldn't be happier with Lawrence Lieber of M&M Orthapedics (and played hockey with one of his partner's sons, which is the referral I went by).

King Douche Ornery

February 17th, 2013 at 6:17 AM ^

The fact this is probably a made-up story (the skiing part; you probably hurt your knee falling down the stairs while carrying a six pack of PBR and your TV dinner), and the usual MgoCircleJerk made-up shit, this is rally one of the funniest threads on this board in years.

BlueCE

February 17th, 2013 at 11:37 AM ^

Ha, it is an absolutely true story, enough people on MGo know me personally so that I would not make it up. Right now sitting in the apartment while the rest of the group went out skiing and trying to get a better sit on the flight back. It was a pretty funny thread but honestly I also got a lot of info/things to ask the doctor about.

MileHighWolverine

February 17th, 2013 at 10:38 AM ^

Did mine many years ago skiing as well. My doc had me do a few months of rehab before the surgery to strengthen the muscles around the knee and let the swelling subside, then they cut me open and it was back to square one. I opted for hamstring graft which the doc really preferred over both the patella tendon repair and cadaver graft. His reasoning was cadaver was the least amount of rehab but most likely to have problems (your body could reject it, it could loosen over time and tear, etc.), and the patella option could leave you with problems bending the knee or putting pressure on the knee (squatting or being on your knees playing with kids) as you get older. That was a big concern for me as i was about to start a family when it happened. Downside to hamstring is you have to rehab 2 parts of your leg as taking the graft really messes up your hamstring and obviously your knee is wrecked so rehab is longer and harder but I'm 100% now so can't complain. Took 2 years for me to get there, though. Keep that in mind.

You are in for a rough 6 months but you'll likely be 95-100% once all said and done if you are committed to the rehab. Good luck and Godspeed.

Dantana

February 17th, 2013 at 12:31 PM ^

Valentine's Day was 8 months post-op for me. Tore my ACL and meniscus last February playing basketball. Initially didnt think much of it and about 6 weeks later after the swelling resided I was back playing basketball until I landed with all my weight on it and it gave out again. MRI revealed the damage and I opted for surgery.

My doctor recommended the patella graft so that's the route we took. Im only 29 and still pretty active so it was the best choice. Biggest advice I can give is to stay diligent on the rehab. I only went to PT twice a week, but each visit they gave me exercises to do at home and I kept to a strict 3-times daily routine of rehab at home. After two months I was nearly back to 100% full range of motion and just had to work on strenthening my leg muscles. I didnt do any 'prehab' (doctor never mentioned it so maybe he didnt think it was necessary) but looking back I wish I would have now. The amount of muscle lost through atrophy is incredible.

So far no issues. Started playing bball again about a month ago. Just taking it slow and half-ass guarding guys in pick up ball but it feels good to be back out there. Few downsides to the patella option are the numbness you get on the outer part of the knee due to the nerves being cut when they slice you open to take the patella tendon. Also, it's hard to put pressure/kneel on that knee. Just feels really weird and it probably something I will have to get used to over time. Doctor said it may go away, it may not.

The first few weeks will be the hardest, after that you will start to notice daily improvements and see your rehab paying off. Good luck!