ACL reconstructive surgery - yes or no?

[LeftmostAardvark]

The specialist that has been assigned to me by an insurer after a car accident last year just let me know that I've probably ruptured my ACL wilth damage to the cartilage and medial meniscus. It is highly likely that I'll need reconstructive surgery. This poses a fair problem for me as I'm primary carer for two young kids and starting an intensive 12 month retraining programme in September, so taking 4-6 weeks off my feet in the next couple of years is pretty much impossible.

Has anyone had it? Has anyone opted to manage the condition without surgery? Thoughts welcome as I try and work out the best way forward.

[The_Doc]

It all depends on age, baseline stability of your knee and what you want to do with the knee viz a viz sports.

Plenty of people manage without no ACL in the joint, and conversely most people will not be able to return to full function on the sporting pitch/field/court with no ACL.

I cannot give you a report on how the rehab feels or goes, but most people recover quicker than they were expecting, even if it isn't to full activities in the first three or so months.

I simply build them

There are survivors on this forum though....

[LeftmostAardvark]

Thanks Doc. I have trouble with stairs and can't run, but can manage most other stuff day-to-day. I'm 37 and reasonably active, but about to change career to one where I'll be on my feet for most of the day (secondary teaching). I feel like I could live with the knee as is! but it would be uncomfortable and limiting. OTOH, taking surgery over the summer would mean my wife would have to as good as give up work - she can't take the time out and expect to go back to her job, and then in September I'm back to Uni for a year, with another 12 months at least to establish myself in career mark II.

What if I left it two years, would there be any point in the surgery then, or may I just as we'll leave it until I pop my clogs?

[FamilyDub]

I had a hamstring graft-type ACL reconstruction & double meniscus repair at the end of Septemer last year after living with no ACL for five years after a football incident at age 26, now aged 31.

I too just 'lived with it' and the thing is, the less you do, the more muscles will weaken, the more you'll hyperextend/twist and hurt your knee, the more you'll do less... You see where I'm going with this cycle

Although, it must be said (even as someone who hated jogging), after eight weeks recovery, the feeling of running as fast as possible was fantastic!

There are pros and cons of doing it/not doing it, so best thing to do is ask questions of your GP and Consultant Orthopaedic Surgeon...

...Or failing that, strangers on the internet!

[The_Doc]

LeftmostAardvark said:

Thanks Doc. I have trouble with stairs and can't run, but can manage most other stuff day-to-day. I'm 37 and reasonably active, but about to change career to one where I'll be on my feet for most of the day (secondary teaching). I feel like I could live with the knee as is! but it would be uncomfortable and limiting. OTOH, taking surgery over the summer would mean my wife would have to as good as give up work - she can't take the time out and expect to go back to her job, and then in September I'm back to Uni for a year, with another 12 months at least to establish myself in career mark II.

What if I left it two years, would there be any point in the surgery then, or may I just as we'll leave it until I pop my clogs?

You need to talk over your individual case with a knee surgeon from here on in, I'm afraid. Can't diagnose/treat over the wires.

My best wishes

[LeftmostAardvark]

Thank you both - it has confirmed my suspicion that it is dependent or so many factors as to be 'no one answer'.

[FamilyDub]

You can ask here or PM me if you've questions.

[Terminator X]

I was in hospital for a few days and had to walk with crutches for 3 weeks albeit was fine to walk under my own steam after that. Didn't get back to football for 12 months though + it was never really the same as I had to have keyhole surgery every few years to clear out all the crap building up in the knee joint. I gave it up after a few years and stopped. Still run on it fine though (5k and 10k x country) even though 20 years have passed since I had the surgery.

TX.

PS pre-surgery I used to collapse a lot when the knee gave way, even just walking along minding my own business!

[RCBRG]

I had an ACL reconstruction, and have absolutely no regrets whatsoever. My knee is 100% good as new! absolutely fine running! cycling, skiing, surfing/kitesurfing etc. before surgery it would give way without warning, leaving me very nervous of it. I would absolutely recommend the surgery

Just wish the surgery on my dislocating shoulder was anywhere near as good!

[assadahmed]

I'm two months post op now. Sustained the injury four years ago. You will certainly need someone to care for you for around 3 to 4 weeks before you are able to move around on crutches without the leg hurting too much.

I think the key is physiotherapy. You need to start exercising the knee as early as 3 to 4 days after the op. Obviously at this stage it will be very basic exercises but these are crucial in getting flexibility back in your knee. If you have a strict routine this will help with your recovery and allow you to start doing more intense exercise earlier.

If you do have the op and can afford pay for a private physio two times a week, that will also help to get you back on you feet asap. A decent physio will work wonders by massaging and stretching the knee.

[AlfaPapa]

I was very relieved to find this thread.

After a climbing accident three weeks ago where I ruptured ACL, PCL, Medial ligament and the meniscus, I'm currently in the heaviest full length leg cast waiting for the Medial Ligament reattachment to hold (fingers crossed) and about two months off reconstructive surgery on the cruciate ligaments.

Thank you for sharing your experiences. As an active 31 year old, I have been very concerned about how well I will recover - you've all cheered me up a lot.

[FamilyDub]

AlfaPapa said:

After a climbing accident three weeks ago where I ruptured ACL, PCL, Medial ligament and the meniscus

Through the months of rehab I saw around 40-50 people, only 1 person I saw had ruptured her PCL. Treatment for an ACL repair sounded much easier in comparison...

Good luck.

[AlfaPapa]

Thanks FamilyDub - apparently it is quite unusual. I was bouldering and fell >3m and twisted on the knee as I landed.

My x-rays have been doing the rounds - my knee just looks like a pile of bones dropped randomly. So after being sent home to 'walk on it' from A&E after being diagnosed with a dislocated knee cap, I am more than happy for professionals to see what a *very* dislocated knee looks like.

[joema]

I opted out.

I hyper extended my acl and tore it off the tibia plateau. So not the same but...

That was 3 years ago. I had a lot of physio to get me to where I need to be to do the graft from the hamstring.
They did an arthroscopy and it had reattached itself. Because I'm usually active I have decent stability and strength is through my leg muscles.

It will never be right but the chances of a successful full reconstruction werent high enough to make a significant difference so stuck with what I have

We're all different though. If you really need it done you need it done

Edited by joema on Wednesday 28th May 17:52

[joema]

joema said:

I opted out.

I hyper extended and tore my acl and tore it off the tibia plateau. So not the same but...

That was 3 years ago. I had a lot of physio to get me to where I need to be to do the graft from the hamstring.
They did an arthroscopy and it had reattached itself. Because I'm usually active I have decent stability and strength is through my leg muscles.

It will never be right but the chances of a successful full reconstruction werent high enough to make a significant difference so stuck with what I have

We're all different though. If you really need it done you need it done

Edited by joema on Wednesday 28th May 17:52

[RyanTank]

OP, as your getting all this investigation/treatment due to the car accident, cant you push to get the op ASAP. highlight to them that you are about to re train and need it done before then otherwise you will incur a big loss in earnings to both you and your partner, as a result of the accident. they may then push you through to a BUPA centre to get the op.
Could family help out with your care, meaning your partner shouldn't need to take as much time off?

If I'm honest I'd opt for the surgery, you may even recover quicker than what they estimate.

I will be chasing mine up once all my other ongoing leg issues are solved, as I partially ruptured my ACL 15years ago and being young and stupid, didn't actually take on board their advice to slow down on the amount of football and mountain biking I was doing at that time. a few months after my keyhole surgery on the cartilage my knee popped and hurt like a bugger for a few weeks. I assumed it was just the remaining cartilage going like before and ignored it. Until I was a test case for a physio friend and he did the whole knee stability test. and found I was wobblier than I should be, so suspected a torn ACL.
Have lived with it since, but notice it getting sorer the more I do again, cant even sit with my left knee bent under me or resting the left foot on my right thigh without it playing up after a few minutes.

So even if you chose to live with it for a bit, don't leave it too long before chasing up a fix, as i said if insurance is taking care of it then certainly take their offer of surgery up!
I waited 19months on the NHS for a MRI when I originally blew my knee!
When I needed one on my shoulder after an accident, I had it within 2 weeks of the specialist requesting one!

Terminator X said:

PS pre-surgery I used to collapse a lot when the knee gave way, even just walking along minding my own business!

Did you find it quite funny to see peoples reactions too!?
was always a great excuse for drunkenly falling over too mind! blame it on the bum knee!