/ Torn Anterior Cruciate Ligament

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stevo 30 - on 19 Nov 2012
Hi guys, went into surgery Friday for an Anthroscopy with a suspected torn meniscus turns out its a torn anterior cruciate ligament so got to go back nxt thurs to b explained to what's gonna happen nxt so I'm sure there will be people in ere that's done the same thing and was wondering how you got on? Without surgery could you still do all the things you did before? If you had the surgery how long was the rehab? Thanks for any input cheers. Steve.
Shearwater - on 19 Nov 2012
Might be worth taking a look on some ski forums; an exploded ACL isn't an uncommon ski injury, so there should be plenty of old/current threads on the issue.
Chay - on 19 Nov 2012
In reply to stevo 30: Hi There,

I ruptured my ACL a few years ago, got it reconstructed with a segment of my patella tendon. I then re-ruptured it last year and i haven't had it reconstructed again.

If you have good muscle structure around the knee, it's possible-like i do-to keep climbing, though it aches a lot and can sometimes collapse and be unstable. It all depends on the individual and the structure of your knee, though what i would say is if you opt for the surgery, be aware that doing the things we do, it's quite likely the reconstruction will go again/the graft will stretch.

For the best chance of going without surgery, get swimming/cycling a lot and get a wobble board. Strengthen the main muscles and the tiny muscles that hold the stability of your knee and you could be ok.

Like I say, it differs- Listen to your body, but don't rush into a surgery that leaves you out for a long time and may not entirely fix the problem long term.

Best of luck!
GB
Barry Kerwin - on 19 Nov 2012
In reply to stevo 30: listen to the medics, I ruptured mine whilst playing football and continued playing for 10 years afterward (admittedly not at a very high standard) didn't bother with the docs, strong leg muscles at the time didn't necessitate an op, it wasn't giving way etc. The result was eventually a reconstruction after I had put a rather large hole in the condyle of the femur through usage. stick with the medical advice.
stevo 30 - on 19 Nov 2012
In reply to stevo 30: Thanks guys I think which ever way it goes it doesn't look like the knee will ever be same again will it, not only is it a major part of everything outside work im a carpenter so spend much of my time on my knees or building roofs etc. should find out nxt Thursday extent of damage! Think i mite be struggling to get into the mountains this winter :-(
stevo 30 - on 19 Nov 2012
In reply to Barry Kerwin: Sounds nasty mate hope you can get a good job done on it we take our bodies for granted don't we till the shit hits the fan , then sometimes it's just too late!
Andy Nisbet - on 19 Nov 2012
In reply to stevo 30:

If you decide you want the operation, then say it's necessary for your work, and that way they're more likely to do it, whereas for pleasure they may well say that you'll manage.
stevo 30 - on 19 Nov 2012
In reply to Andy Nisbet: To be honest pal I'm self employed with a baby on the way I just can't see an operation bein an option for me it's a bit of an awkward situation with some serious thinking to be done gonna try not jump to too many conclusions tho will see what happens Thursday! Cheers.
Andy Nisbet - on 19 Nov 2012
In reply to stevo 30:

I wasn't recommending it; I've no idea what the options are. Only telling you that affecting your job is an important factor in getting ops on the NHS. Good luck whatever happens.
edwardwoodward - on 19 Nov 2012
In reply to stevo 30:
My experience:
I tore my ACL when I was in my teens, had meniscus removed a few times for bad twists (memo to self: when the doc says "Don't play football", don't play football!) then it stabilised. By my late 30s I was starting to twist and jar my knee again (muscle loss due to age/slowing down, I think) and I had reconstruction when I was 42. I've had no problems with twists and jarring since, despite having almost no meniscus left, but it took a while to get to where I am now - maybe 98% of stability and flexibility.

I'd say get it done and the younger the better.

And don't ski.
stevo 30 - on 20 Nov 2012
In reply to stevo 30: Thanks everyone for your comments can always rely on you guys when you need to know something, thanks again.
StuDoig - on 20 Nov 2012
In reply to stevo 30:
I ruptured my ACL about 5 years ago and did a fair bit of reading up prior to making the call. From the advice I was given, and my reading, I decided the op was the best option. I ruptured the ACL in January and had the op at the start of March after a fair bit of physio and exercises to strengthen the supporting leg muscles. I was hill walking aging in June, climbing by August and in the Alps the following year with no problems.

As I recall, I was told that about 30% of people will notice no difference in not having the ligament in place (inc. sporty / active folk) though obviously that means 70% do!

One thing that was absolutely key was good physio. I went private (Surgeon advised a particularly good sports physio locally) and having a good, positive, fairly agressive, physio used to dealing with sports injuries and getting folk back playing sport made a huge difference. I've had friends who had a similar injury but who's physios were more intent on rehab for everyday life (i.e nothing more difficult than a walk to the shops of climbing a flight of stairs) and they suffered more. Really research surgeons and physios if you can as they can make a huge difference (might be no choice in surgeon though unless you are going private).

5 years on I have no knee problems, still climb in summer and winter, still visit the alps etc so can't say that long term the injury, or resultant surgery has caused any problems.

Cheers,

Stuart
Kurt Physio - on 20 Nov 2012
In reply to StuDoig:
If your knee is unstable (giving way) I would go for the surgery, particularly if you do dynamic sport.

In most cases people return to full fitness (6 months of rehab.

I have not seen many re ruptures and the ones that I have seen are due to load that would probably have ruptured a normal ACL.

Kurt.
mikekeswick - on 20 Nov 2012
In reply to stevo 30: I snapped mine a good few years ago now and I lived with it snapped for around 2 years which was a mistake....you would think it was ok, forget about it and then turn/twist/stop funnily and it would give way - even with strong leg muscles...some people say that they can live without an acl ok but not in my case it was awful not being able to do things and always thinking 'what if my knee gives way here....'.
Anyway I had mine reconstructed with a section of my hamstring and have never looked back. I had a brilliant physio and how well you recover long term is massively affected by how hard you are willing to work on the re-hab. I gave it everything and touch wood my knee is perfect now. I can do everything I used to with zero in-stability/pain etc...
Also find a good, well recommended surgeon and ask your doc to be referred to them instead of the 'random' that you will be given if you don't specify.
If you are going to be kneeling a lot then make sure you get it reconstructed with the hamstring and not the patella tendon method.
My advice would be to 100% get the op done. All this 'you might be able to manage' without it is fine if all you want to do is sit at a desk....but seriously if you want a full and active life then there is no choice in my opion. Get it done!! The re-hab will pass quickly, just apply yourself to it fully.
Good luck and I feel your pain....
stevo 30 - on 20 Nov 2012
In reply to stevo 30: Thanks guys some really useful info just wondering with the op how long it would be before I could get bk to work? At the moment I'm not sure how bad tare is all I can say is as soon as I did it the leg just totally buckled in the worst pain I've ever felt and I couldnt put any weight on it without it giving way was like a jelly knee! At min hospital gave me some exercises to do and the lack of range I have is scary at the min I know this should increase but the pain it causes doin them is horrid! Also from what I've read making do with an unstable leg in long run can cause a hell of a lot of damage to rest of knee! I really simpathise with you guys that have done it and thanks for taking the time to share your stories, thanks.
TheDrunkenBakers - on 20 Nov 2012
In reply to mikekeswick:
> (In reply to stevo 30) I snapped mine a good few years ago now and I lived with it snapped for around 2 years which was a mistake....you would think it was ok, forget about it and then turn/twist/stop funnily and it would give way - even with strong leg muscles...some people say that they can live without an acl ok but not in my case it was awful not being able to do things and always thinking 'what if my knee gives way here....'.
> Anyway I had mine reconstructed with a section of my hamstring and have never looked back. I had a brilliant physio and how well you recover long term is massively affected by how hard you are willing to work on the re-hab. I gave it everything and touch wood my knee is perfect now. I can do everything I used to with zero in-stability/pain etc...
> Also find a good, well recommended surgeon and ask your doc to be referred to them instead of the 'random' that you will be given if you don't specify.
> If you are going to be kneeling a lot then make sure you get it reconstructed with the hamstring and not the patella tendon method.
> My advice would be to 100% get the op done. All this 'you might be able to manage' without it is fine if all you want to do is sit at a desk....but seriously if you want a full and active life then there is no choice in my opion. Get it done!! The re-hab will pass quickly, just apply yourself to it fully.
> Good luck and I feel your pain....

Best bit of advice give.

I used to work in reconstructive surgery and spent many hours in surgery with orthopaedic surgeons.

Let me tell you one thing for starters, not all surgeons are equal. Some are OK for standard hip and knee replacements but many are quite frankly in the wrong job, only becoming surgeons because they had the brains to do so and that they get adoration, money (private work) and kudos, not necessarily because they are passionate about the craft or the patient. This means that there is a lot of, quite frankly, appalling practice and shoddy workmanship.

Then again, there are maany highly enthusiastic, professional one who have specialist interests and some are very interested in ACL/PCL work and would consider this their specialist subject. I worked around Nottinghamshire and Lincolnshire and there are probably two surgeons out of goodness know how many whom I would want to have my ACL done.


nniff - on 20 Nov 2012
In reply to stevo 30:

We're beginning to form an orderly queue here. I'm now due an arthroscopy in a week or so to scrape the bits out of my knee. Lots of words like 'degeneration', 'Ganglion', 'cartillage loss', 'surface fissuring'. All in all a really rather depressing report. Happy ********* birthday :o(


So much for me hoping for 'keep it until it gets better'
stevo 30 - on 20 Nov 2012
In reply to nniff: Best of luck with that pal hope it goes well! I know how ya feel it's hard to be optimistic i just feel pissed off that something that happened so so easy could have a major impact on the rest our lives, I do feel selfish in a way tho cos there is a lot of people out there with really serious problems but generally us outdoorsy people can be a bit selfish but when getting out into the mountains etc means so much to us ur gonna be slightly pissed arnt ya!
Kurt Physio - on 20 Nov 2012
In reply to stevo 30:
Depends on your job. Usually you are not allowed to drive for 6 weeks and are to avoid twisting on the operated leg for 15 weeks.

No contact sports for 6 months and sometimes longer for football and rugby depending on the consultant.

Hope that helps

Kurt
nniff - on 20 Nov 2012
In reply to stevo 30:

Thanks for your kind words. I was distinctly 'off' this morning but I'm getting over myself now. On the bright side, it will be better, albeit with rather less of it. On the down side, no ice in Jan. Maybe Feb. I'm blocking out (or trying to) any thought that it will be worse.

Still, I had it done 15 years ago (same knee) and maybe I'll get another 15 years out of it before it needs more attention.

I'd say get your knee done - I know one mountain guide who has had artificial knee ligaments for years (he was soloing when the bit of ice he was on detached. He woke up to found himself looking at the sole of his boot which was nestled next to his hip).
stevo 30 - on 20 Nov 2012
In reply to Kurt Physio: Cheers kurt quite a lengthy program then think I better concentrate on winning that lottery then so I can av the time off building sites are not gonna be a very friendly place are they!
stevo 30 - on 20 Nov 2012
In reply to nniff: Cor that made me wince abit pal hope the guide were ok after all that!!
AndyIce - on 20 Nov 2012
In reply to stevo 30: I had both ACL and PCL done 25 years ago with synthetic replacements as the technology wasn't up the the tissue grafts you can get today. The surgery was much more invasive than it is now and left me with something that would win hands down at a knobbly knee competition!

Following the surgery and rehab I actually did my best climbing and mountaineering ever for many years and it is only now that the arthritis from the original injury is seriously slowing me down - this would have happened anyway and was amplified by the 4 years of 'normal' usage between the injury and getting it sorted. My advice is to get the best infomation you can before you make any decision and don't be rushed by anyone. There are positives and negatives and you are the only one who can judge what they mean for you. In my case they stack up like this;

Positives - stable knee in all life situations, back to all mountaineering without fear of knee collapse at the wrong moment, return to non-contact sports, return to the company of friends do what I wanted to do and not excluded due to fear of consequences for them and me if knee collapsed.
Negatives - limited flexion of knee, inability to kneel very easily both in terms of movement and discomfort from pressure on the knee, sensitivity in the knee when knocked (due to tissue disruption), debilitating arthritis but the chances are this would have happened anyway, loss of strength in the affected leg - it never was the same again!

Overall, I don't regret having it done but it was done by a top man of the time and it was a gamble, also I didn't ask enough questions to fully understand the end result. If kneeling is important to you job press hard for information on what the outcome of the operation will be in terms of flexion and discomfort - these days it may be a lot better than mine!

Good luck with your decision making,

Andy
stevo 30 - on 20 Nov 2012
In reply to AndyIce: Thanks a lot for that Andy I totally agree with everything you say and you obviously know what your talking about all this info you guys are giving is so valuable cos you all have experience that some surgeon who probably doesnt look at life the way we do so it's really important to me what your saying so thanks once again ur all true gents!
Simonpeel - on 20 Nov 2012
In reply to stevo 30: Hi stevo I am currently 6 Months post ACL surgery. I ruptured the ligament and also shatered the laterial meniscus and torn the medial meniscus. with regards to returning back to work I was off For 3 and a half months. ( I had an understanding employer). I maybee could have returned to work slightly earlier if needed to, but the extra time off was a great help to me. I would recomend the op if you want to remain active but eco the advice from other posters with regards to finding a good surgeon and phyiso.
stevo 30 - on 20 Nov 2012
In reply to Simonpeel: Hi Simon wow sounds like you did that good and proper glad you got sorted and you were allowed to rest properly I think that's key isn't it to not rush things and make sure your as good as before taking any risks with it! Good luck for the future pal fingers crossed for good strong knee!
Simonpeel - on 20 Nov 2012
In reply to stevo 30: Cheers steve, Yes I think rest and a good phyiso is key to a good recovery. (easy for me to say, im not self employed). Most of the damage to my knee was caused by not getting the ligament fixed, and trying to carry on as normal. If you get the oppotunity work wise I would say go for it.



arch - on 21 Nov 2012
In reply to stevo 30: Iv'e had an ACL and a PCL in 1997 on my right knee. (Plus a few Cartlidge trims, all from Rugby injuries) The ACL snapped after Six months and i had it have it done again, this time with an artificial tendon as both of my Hamstring tendons had been used. I had the last Two ops at the Droitwich Knee clinic (Along with Robbie Fowler who was in there at the same time) So i got one of the best Surgeons around. If i'd known then what i know now.......I wouldn't have had it done. I could manage alright before i had the last Two ops (The Rugby club payed for the ops so i could "Hopefully" play again, didn't work) If you can strengthen your Quads and Hammies i would give it that ago first. I had Six months off work in total, i can't kneel, the knee wont fully straighten, it's permanently swollen and i'm now on painkillers. If i hadn't of had the op, i'm pretty sure the results would have been the same. But, i didn't need to have it, i could have managed without it.


Best of luck with whatever you decide.

Arch.
John_Hat - on 21 Nov 2012
In reply to StuDoig:
> (In reply to stevo 30)
> >
> One thing that was absolutely key was good physio. having a good, positive, fairly agressive, physio used to dealing with sports injuries and getting folk back playing sport made a huge difference. I've had friends who had a similar injury but who's physios were more intent on rehab for everyday life (i.e nothing more difficult than a walk to the shops of climbing a flight of stairs) and they suffered more. >

+1
stevo 30 - on 21 Nov 2012
In reply to arch: Just goes to show pal doesn't it sounds like your left in a horrible situation and the fact you can't really kneel on it is worrying cos a lot of my work is done on my knees and I'm constantly up and down and doin alot of twisting! I've just got to have the attitude that whatever the outcome I've just got to get on with it the best I can and not moan about it as hard as It will be! Such is life! Thanks for your advice matey appreciate it, take care!!

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