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rws
07-13-2004, 10:12 AM
Has anyone here had a serious injury to their ACL and been able to return to competition? With reconstructive surgery or not?

Last week I tore my ACL while playing a match. I'm a middle-aged player (48) but very competitive and love playing singles. I've now been to my family doctor, had an MRI and now consulted with an orthopedic surgeon who has explained the options of arthoscopic surgery to clean up the damaged tissues vs the major reconstructive surgery process. I don't know all the nuances or medical terms but am now considering the having the reconstruction.

Anyone out there been through this? Can you shed any light on the situation or what it will be like?

Thanks,
RWS

bigserving
07-14-2004, 11:34 AM
Knee surgery is a huge event. Do it as a very last resort. I would seek six and seventh opinions. Read books on the subject. Explore options.

I you have the resources, seek out an opinion from a athletic experienced orthopedic surgeon. If you have a pro sports team in your area, try to see their team doctors. Even Universities have experienced athletic surgeons who can really give you the best diagnosis about your particular injury.

A friend of mine and I had knee soreness at about the same time. He celebrated his opinion that he needed surgery. He has had four surgeries in the past eight years and is worse off now than ever.

I went to physical therapy at a sports-injury facility. My doctor has written three books about sports-knee / injuries-surgery. He is a surgery at last resort kind of doc. I still have a sore knee that has torn cartilage that I rest and rehab a couple of time per year (from overuse).

Do your homework. You cannot get too much information. Surgery is a big step that may effect you the rest of your life.

Good Luck.

BillH
07-14-2004, 01:21 PM
I'm 51 and I tore my acl 12 years ago in a Tai Kwon Do match. When I began playing tennis again approx 5 years ago, my orthopedist recommended that I continue to use a custom knee brace and thought I would be ok. Last year, my knee began "giving" more frequently until it was almost a weekly occurence. My Orthopedist then recommended an ACL reconstruction using a hamstring graft. I gave it alot of thought because I didn't want to go 6 months without playing tennis. I was used to playing 5 times per week. I had the surgery on August 27, 2003. I never had any real pain and the 6 month rehab went pretty fast. I started playing tennis in mid-January and I am back playing 5 times a week. I have one more month of wearing the knee brace and then I can lose it forever. I feel great - the knee feels good and I'm playing better than ever. The up-side is that I can see how my mobility will continue to improve and so will my game. Feel free to contact me if you have more questions - I know exactly how you feel at this point - find a good surgeon and have the surgery - you won't regret it.

rws
07-15-2004, 04:50 AM
Bigserving. Was your problem specifically your ACL? It seems to be different from other "knee problems". However, I do intend to get other opinions and have started reading whatever I can find on the subject. The doctor said the MRI showed that I had a "complete" tear in my ACL and he has tried to inform me of my options. He is definately not pushing for surgery - in fact, I can't get him to commit one way or another.
BillH, thanks for your experience with ACL problems. After your initial injury did you have a lot of swelling? My leg has been swollen for 1 1/2 weeks now from my thigh down to my foot. It does go down if I elivate the leg for a few hours but then the swelling just returns when I put the leg down. Was this similar to what you found? After surgery, how long were you out of work? How soon were you able to start the rehab? Did you use physical therapists or were you do most of it on your own?

Thanks,
RWS

BillH
07-15-2004, 07:35 AM
rws - Yes, my knee was swollen for some time after the initial injury. I took one week off from work after the surgery and found that that was sufficient. I started rehab at a clinic on the Monday after my surgery on Thursday and went 5 times per week for 3 weeks, then three times per week for another 5 weeks. I then started rehab on my own at a local gym until the 6 month mark. After 6 months, I started back at tennis by hitting on the ball machine with little lateral movement for a couple weeks, then started going to drills at my club. By the end of 7 months, I was pretty much back to my regular tennis routine, but did not "go all out" for another month or so. It is mainly a mental thing - after all you go through with the injury, it takes a while for your brain to trust that your knee is really all there. I play now without any regard for my knee. As I mentioned, I have to wear the knee brace for one more month (how long you wear the brace varies from doctor to doctor). However, when I quit wearing it next month, I have no fears at this point about the knee. I plan to go all out and play without fear. If it happens again, I know I can get the surgery and be back playing again within 6 months.

There are two primary graft procedures - hamstring and patella. Do your research on which you prefer and get a orthopedist who does primarily that procedure. There is good and bad with either procedure - its up to you. If you have a completely torn acl, you will never have full stability and function without the surgery - trust me, I've been there. Find a surgeon who has confidence in the procedure and recognizes that tennis is important to you and you need the mobility. Good luck - feel free to ask more questions if you want, like I said, I know exactly the doubt you're feeling now.

menelaos
07-15-2004, 12:56 PM
RWS, I'm someone who had a partially torn -almost total tear- on the ACL for 12 years and believe me it's no fun playing with it. No matter how much I tried to avoid side moves there would be an instant moment where I would feel the instability on the knee.
Once I corrected last year my life changed. I worked hard to get back on track. I know it will never become as it once was. But I'm happy with the decision that I made.
Now for you age is a factor. The younger you do it, the better it is.
And I'm sure the older someone the less free time he has to rehab.
You have to be committed because atrophy sets in immediately after the surgery. You'll be on crutches for a couple of weeks and then you'll be wearing a brace to walk until you muscles become strong enought to hold your walking.
A lot of work but a lot of benfits too.

Menelaos

couch
07-15-2004, 07:21 PM
rws,

I tore my ACL about 6 1/2 years ago. It was in the middle of my usta season and I tried as hard as I could to play with a custom-fitted brace and just could not do it. I was going to cause more damage by doing that so I decided to have surgery. I was 28 at the time and in great shape so my doctor recommended the patella tendon graft. He recommended this graft because it is supposed to be the most stable and longest lasting graft. The downside is that the patella tendon graft is the hardest to rehab.

Most guys I know who are in their 30's and older have opted for the cadaver or hamstring graft. From what I understand, and remember, these procedures are done more "arthroscopically" and are easier to rehab because the surgery is not as "invasive". The downside is that the graft is not as strong and may not last as long.

As I mentioned, I really didn't have a choice on whether or not I was going to have the surgery. One of my strengths is my movement and it was taken away. I can say that after my surgery I feel like I have not lost a step (okay, maybe a quarter of a step. And that's not due to the surgery). In order to make the surgery a success you need to follow your rehab to a "T". I rehabed my knee like crazy because I wanted to get back on the court. One thing to be careful about is not to do too much too soon after surgery. That's where people get into trouble. You actually feel great but the graft still needs time to heal. Just follow your doctors orders and you will do great.

One thing that I continue to do is workout my legs to keep them strong. Having strong muscles in your legs will help stabilize your knee that much more after surgery.

Oh yeah, my knee did not swell at all and I was not really in any pain when I did it. I did mine playing basketball. I wore my brace for a little less than a year and ditched it after that and have not looked back. I'd say the sooner you can ditch the brace the better.

Good luck with whatever option you choose.
E-mail me if you have any questions.

rws
07-16-2004, 07:33 AM
Hey Guys,

Thanks for the responses. It sure is giving me food for thought. I just found out that I can't even have the surgery for a month (scheduling problems at the hospital and such....).

Those of you who had the surgery - was it done in-patient or out-patient?

My doctor says that I will need to stay home for 2 weeks! Wouldn't this be excessive considering I pretty much work behind a desk?

After 2 weeks my leg swells up from my thigh to my ankle every day until it is almost twice the size of my other leg. Did this happen to you? The doctor tried the drain the knee and got a couple of syringe fulls of fluid out but seemed to be puzzled that it wasn't blood.

Any other advice, comments, experiences?

Thanks for all the help.

RWS

couch
07-17-2004, 04:42 PM
rws,

I had the patella tendon graft so I did stay home for two weeks because it is a more invasive surgery and takes longer to heal from. My knee never swelled at all; I suppose all tears are different though. Mine was done out-patient.

If your doc looks puzzled after draining your knee I would definitely get a second opinion. I went to an orthopedic surgeon when I tore mine and he said, "well, looks like we might want to operate down the road." I was like what? If it's torn I want to get it fixed and get back on the court asap. I had some other problems with this doctor in the past. I tore cartilage in my knee and he pretty much didn't believe I was hurt until we did the MRI. I switched from him and went to the University of Louisville's team physician (best thing I ever did)He works with athletes and understands an athletes mentality. My doc was pretty funny; he did a couple of movements with my knee and said, "yep, it's torn. Here are your options for surgery: patella tendon, cadaver, and hamstring graft. Here are the advantages and disadvantages of them." I think someone mentioned in an earlier reply that you should try going to a sports oriented orthopedic surgeon. They really understand what us athletes are going through and will probably help you a lot more with your rehab. My doc had his own rehab facility for the U of L athletes and I think I worked out there for the first few months.

menelaos
07-23-2004, 07:33 AM
RWS, I had moderate swelling after surgery and certainly it was only concentrared in the lower thigh and upper calf areas.
Don't let swelling discourage. It will take some time for it to away.
Remember, before you get on the operating table, that the challenge starts AFTER the surgery. Your hospital stay will be around 10 hours.
Your rehab will last a lifetime!!!! The knee will never become as it once was but it will be pretty close ONLY if you keep exercising it.

Find a good sports doctor and do it!!!

Menelaos

k01as05
06-04-2008, 03:12 PM
Hi! I recently had ACL recontructive surgery about 6 weeks ago with the patella tendon autograft. I am very concerned about developing patellar tendinitis and was wondering what exercises I should stay away from. Different physical therapists have told me different things and I do not know which one to believe!