/ Torn Anterior Cruciate Ligament
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!
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.
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.
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.
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.
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.
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....
> 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.
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'
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
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).
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,
Best of luck with whatever you decide.
> 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. >
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