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sachin_patel 06-28-2013 12:20 PM

ACL tear - without surgery
 
Hi Guys,

Sorry for long description. Here goes my story.

I had a knee injury about 3 months ago. I went to doctor and he said my ligament feels loose so lets do MRI. MRI Results showed partial tear in knee but he said It looks like you have complete tear. (Because you have bone bruises and usually that happens with complete tear). I haven't torn my meniscus.

I went to another doctor for second opinion. He also said you have complete tear looking at MRI.

All this time my knee doesn't feel unstable. So far it gave way only once on the day I was injured.

The first doctor prescribed Physical Therapy as I was skeptical about operation.

After a month i had followup appointment yesterday and he said, my knee feels pretty stable to him. no need for surgery.. call us back if you have instability.. continue exercise and use a brace.


I am now worried if this is bad decision for long term... has anyone done something like this?

Thanks in advance.

waves2ya 06-28-2013 06:21 PM

Look out for when you are not ready/musculature not activated; stepping off a curb; going down steps cold; a bad spot.

All depends on your athletic life/goals. If you don't fix and knee becomes unstable at wrong spot and you tear your meniscus...

Then there's not much you'll be able to do (technically).

RogueFLIP 06-28-2013 08:48 PM

ACL surgery is an ELECTIVE surgery.

There's no way to know if by not getting the surgery, that down the road you'll develop arthritis because your knee has been traumatized which has possibly planted the seed of OA. Plus because a main stabilizer of the knee is gone, your body will have to compensate with other parts to order to maintain the stability of the knee, which may add to compression forces which could possibly contribute to the development of OA.

But that's not to say that by getting the ACL reconstructed that down the road you WON'T get any OA, again your knee has been traumatized, now twice - once for the initial injury and another for the surgery. Again, that in of itself may have planted the seed for OA.

Don't give into the fear of other people telling you oh you might hurt something by stepping off the curb or stairs bc you don't have an ACL....like you can't do with a knee that has an ACL?

You're not feeling any instability with your knee at this moment which is good. Bc if you were, then the surgery wouldn't even be questioned.

The question you have to ask yourself is can I tolerate being out a good 6 months minimum from all sports activities because that's the time frame for the rehab. 6 months MINIMUM. And that's just the time frame. I'm not going to get into how much work it is in this post.

NLBwell 06-28-2013 09:05 PM

See if you can throw a football.

I tore my ACL (and partial tear of LCL) playing basketball. After a couple of days I went to the doctor. He did all the standard manipulations to see if the ACL was loose, and it did not appear to be (this was before MRI's were common, and my legs were exceptionally strong back then). I skied and played tennis on it just fine, though it felt a little strange. However, one day I threw a football to my son. I fell over. I tried again. I fell over again. Something about planting the front leg and then twisting over it when throwing a football just could not be done with the torn ACL.

sachin_patel 06-29-2013 07:01 AM

Quote:

Originally Posted by RogueFLIP (Post 7547016)
ACL surgery is an ELECTIVE surgery.

There's no way to know if by not getting the surgery, that down the road you'll develop arthritis because your knee has been traumatized which has possibly planted the seed of OA. Plus because a main stabilizer of the knee is gone, your body will have to compensate with other parts to order to maintain the stability of the knee, which may add to compression forces which could possibly contribute to the development of OA.

But that's not to say that by getting the ACL reconstructed that down the road you WON'T get any OA, again your knee has been traumatized, now twice - once for the initial injury and another for the surgery. Again, that in of itself may have planted the seed for OA.

Don't give into the fear of other people telling you oh you might hurt something by stepping off the curb or stairs bc you don't have an ACL....like you can't do with a knee that has an ACL?

You're not feeling any instability with your knee at this moment which is good. Bc if you were, then the surgery wouldn't even be questioned.

The question you have to ask yourself is can I tolerate being out a good 6 months minimum from all sports activities because that's the time frame for the rehab. 6 months MINIMUM. And that's just the time frame. I'm not going to get into how much work it is in this post.


yeah.. i don't mind being out for 6 months.. i don't like it but i have to do it for my knee..

sachin_patel 06-29-2013 07:02 AM

Quote:

Originally Posted by waves2ya (Post 7546751)
Look out for when you are not ready/musculature not activated; stepping off a curb; going down steps cold; a bad spot.

All depends on your athletic life/goals. If you don't fix and knee becomes unstable at wrong spot and you tear your meniscus...

Then there's not much you'll be able to do (technically).

That is also something I am afraid of.. I know I won't be careful all the time..

sachin_patel 06-29-2013 07:03 AM

Quote:

Originally Posted by NLBwell (Post 7547045)
See if you can throw a football.

I tore my ACL (and partial tear of LCL) playing basketball. After a couple of days I went to the doctor. He did all the standard manipulations to see if the ACL was loose, and it did not appear to be (this was before MRI's were common, and my legs were exceptionally strong back then). I skied and played tennis on it just fine, though it felt a little strange. However, one day I threw a football to my son. I fell over. I tried again. I fell over again. Something about planting the front leg and then twisting over it when throwing a football just could not be done with the torn ACL.

You mean throw a football with hand or kick it with the good leg?

NLBwell 06-29-2013 10:11 AM

Throwing the football. The front leg plants into the ground and the body rotates over it as you throw. I could toss a baseball around without a problem.

RiceWithThat 06-29-2013 01:37 PM

I'm a 40yo female and tore my ACL in April playing tennis. I also had a tibia contusion form the force of the rupture and a minor lateral meniscus tear.

Did you see an orthopedist or a GP? My MRI was read by three different radiologists, and only one recognized that my ACL was torn (complete). My GP claimed my ACL seemed fine after his exam, but an orthopedist was able to notice the tear on his exam.

I just had the reconstructive surgery two weeks ago. I decided to do it because I want to continue to play tennis, which because of the movements specific to the sport really shouldn't be played without an ACL.

I was pretty worried about the surgery, but I am glad I did it, happily reporting that I have been walking, almost normally, for several days now. I am really amazed at how quickly I am recovering from this procedure.

Sumo 06-29-2013 04:55 PM

I tore my ACL at 21 in my first rugby game my sr year.
It took about 6 months and 5ish doctors to diagnose it. Which means I lived without an ACL for quite some time. I went skiing/snowboarding and tried other sports, but never felt right, which is why I went back to the doc.
I had the surgery, and can't imagine life without having done it.
12yrs later, my "repaired" leg is just as strong as my other leg, and I never think about my knee when doing anything. I have never been limited doing anything because of the knee, this includes tennis, bball, rugby, skiing, soccer, you name it.
I would say if you have any issues at all with the knee to go for surgery. It has advanced so much that it really isn't even a big deal anymore, and 6 months rehab is nothing, if you don't have to think about it going forward.

sachin_patel 06-30-2013 05:15 AM

Quote:

Originally Posted by RiceWithThat (Post 7548796)
I'm a 40yo female and tore my ACL in April playing tennis. I also had a tibia contusion form the force of the rupture and a minor lateral meniscus tear.

Did you see an orthopedist or a GP? My MRI was read by three different radiologists, and only one recognized that my ACL was torn (complete). My GP claimed my ACL seemed fine after his exam, but an orthopedist was able to notice the tear on his exam.

I just had the reconstructive surgery two weeks ago. I decided to do it because I want to continue to play tennis, which because of the movements specific to the sport really shouldn't be played without an ACL.

I was pretty worried about the surgery, but I am glad I did it, happily reporting that I have been walking, almost normally, for several days now. I am really amazed at how quickly I am recovering from this procedure.

thanks for encouraging words.. which acl graft did you use?

sachin_patel 06-30-2013 05:16 AM

Quote:

Originally Posted by Sumo (Post 7549158)
I tore my ACL at 21 in my first rugby game my sr year.
It took about 6 months and 5ish doctors to diagnose it. Which means I lived without an ACL for quite some time. I went skiing/snowboarding and tried other sports, but never felt right, which is why I went back to the doc.
I had the surgery, and can't imagine life without having done it.
12yrs later, my "repaired" leg is just as strong as my other leg, and I never think about my knee when doing anything. I have never been limited doing anything because of the knee, this includes tennis, bball, rugby, skiing, soccer, you name it.
I would say if you have any issues at all with the knee to go for surgery. It has advanced so much that it really isn't even a big deal anymore, and 6 months rehab is nothing, if you don't have to think about it going forward.

Thanks, I am planning to go to another doctor in couple of days.

Which acl graft did you use? both the doctors i visited suggested if i have to go for surgery, cadaver graft works for me..

sachin_patel 06-30-2013 05:17 AM

Quote:

Originally Posted by NLBwell (Post 7548287)
Throwing the football. The front leg plants into the ground and the body rotates over it as you throw. I could toss a baseball around without a problem.

thanks.. I'll give this a try and report back..

Nostradamus 06-30-2013 05:37 AM

What is the best way to prevent ACL tear ?? is there a good stretching excercises ? or that kind of thing doesn't help at all in preventing this injury.

This question is for people never had ACL tear and also for those who had it and have recovered.

RogueFLIP 06-30-2013 08:23 AM

Quote:

Originally Posted by RiceWithThat (Post 7548796)
I'm a 40yo female and tore my ACL in April playing tennis. I also had a tibia contusion form the force of the rupture and a minor lateral meniscus tear.

Did you see an orthopedist or a GP? My MRI was read by three different radiologists, and only one recognized that my ACL was torn (complete). My GP claimed my ACL seemed fine after his exam, but an orthopedist was able to notice the tear on his exam.

I'm not surprised with the confusion. I don't know too many GP's who are familiar with most of the "special tests" that orthopedist's do. Well, familiar, maybe, but experienced, maybe not so much.

But even ortho's can be wrong. Just don't tell them that. :)
Ortho referred me a young kid with a "knee strain". Parent said ortho cleared knee, everything was intact. Ortho contradicted what was on MRI report of ACL tear. Now, I'm not a radiologist, just a lowly physical therapist, I'm not great at reading films, but even I could see the gap where the ACL was missing. And my exam also confirmed the tear. But the ortho was having none of it. "I've been doing this for 30 years, 1000s of patients, surgeries, yadda, yadda....the kid doesn't have a tear".

Always get a 2nd or 3rd opinion if something doesn't feel right.

Quote:

Originally Posted by RiceWithThat (Post 7548796)
I just had the reconstructive surgery two weeks ago. I decided to do it because I want to continue to play tennis, which because of the movements specific to the sport really shouldn't be played without an ACL.

I was pretty worried about the surgery, but I am glad I did it, happily reporting that I have been walking, almost normally, for several days now. I am really amazed at how quickly I am recovering from this procedure.

Getting back to normal activities of daily living shouldn't take that long. Regaining the strength and proprioception awareness of a sport, THAT'S where the time comes into play.

Hope you found a good physical therapist, don't rush the rehab, and I hope you have a speedy recovery. Good luck.

RogueFLIP 06-30-2013 08:35 AM

Quote:

Originally Posted by RiceWithThat (Post 7548796)
I just had the reconstructive surgery two weeks ago. I decided to do it because I want to continue to play tennis, which because of the movements specific to the sport really shouldn't be played without an ACL.

Again, it's an ELECTIVE surgery. I know pleny of people and patients who compete in sports activities without an ACL.

Personal note: uncle (professor at NorthWestern University - so he's an intelligent guy who did his research) with complete tear of ACL....runs, does Brazillian Jiu-Jijitsu.....no problems.

Another physical therapist friend of mine, complete tear of ACL.....owns his own business, so isn't able to take the time off...but that was only part of the reason to forgo the surgery....lots of rehab, but again, runs, other athletic endeavors, going for 2nd degree black belt in karate....no problems....

It's possible to survive without one. And yes playing tennis too.

But if you feel like you want to get it done for peace of mind, by all means, get the surgery.

I'm just trying to paint the picture that you can function very well without one.

RogueFLIP 06-30-2013 08:47 AM

Quote:

Originally Posted by Nostradamus (Post 7549888)
What is the best way to prevent ACL tear ?? is there a good stretching excercises ? or that kind of thing doesn't help at all in preventing this injury.

This question is for people never had ACL tear and also for those who had it and have recovered.

There isn't a specific exercise/stretch/program designed to prevent ACL tears.

You'd be surprised what a generalized strength and conditioning/flexibility program can do to prevent injuries and aid in recovery times for small nagging things.

But in the end, if it's your time, it's your time. :oops:

waves2ya 06-30-2013 03:48 PM

Patel - I should have added I'm a '92 ACL (patella graft) recovery story; some my walk is in this forum...

Also - there are now numerous protocols for ACL 'prehabilitation', many focusing on female athletes. Mike Boyle, Grey Cook - a lot of single leg work and lateral motion drills...

Folks know a lot about the injury now; deceleration key...

Charlie may weigh in.

Sumo 07-01-2013 02:56 PM

Quote:

Originally Posted by RogueFLIP (Post 7550137)
Again, it's an ELECTIVE surgery. I know pleny of people and patients who compete in sports activities without an ACL.

Personal note: uncle (professor at NorthWestern University - so he's an intelligent guy who did his research) with complete tear of ACL....runs, does Brazillian Jiu-Jijitsu.....no problems.

Another physical therapist friend of mine, complete tear of ACL.....owns his own business, so isn't able to take the time off...but that was only part of the reason to forgo the surgery....lots of rehab, but again, runs, other athletic endeavors, going for 2nd degree black belt in karate....no problems....

It's possible to survive without one. And yes playing tennis too.

But if you feel like you want to get it done for peace of mind, by all means, get the surgery.

I'm just trying to paint the picture that you can function very well without one.

This is definitely true, but depends on how your knee is built. I personally couldn't have done much had I not had the surgery. I had it collapse multiple times just walking around.
Quote:

Originally Posted by sachin_patel (Post 7549869)
Thanks, I am planning to go to another doctor in couple of days.

Which acl graft did you use? both the doctors i visited suggested if i have to go for surgery, cadaver graft works for me..

I went patella, but mostly because that was what my surgeon did. My surgery was also in 2001, and orthopedics have advanced a lot since then, so it's very possible it would be done differently if I had it today.
Quote:

Originally Posted by RogueFLIP (Post 7550170)
There isn't a specific exercise/stretch/program designed to prevent ACL tears.

You'd be surprised what a generalized strength and conditioning/flexibility program can do to prevent injuries and aid in recovery times for small nagging things.

But in the end, if it's your time, it's your time. :oops:

I'm convinced mine happened because I was out of shape. Vowed afterwards to never let that be the reason for something like that again.

RogueFLIP 07-07-2013 07:01 PM

Quote:

Originally Posted by Sumo (Post 7554165)
This is definitely true, but depends on how your knee is built. I personally couldn't have done much had I not had the surgery. I had it collapse multiple times just walking around.


I went patella, but mostly because that was what my surgeon did. My surgery was also in 2001, and orthopedics have advanced a lot since then, so it's very possible it would be done differently if I had it today.

Most reconstructions today are done allograft (cadavar patella graft) vs autograft (your own patella tendon). Of course some doctors will give you a choice, some doctors prefer one way versus another. In the end, I don't see too much difference in total recovery time for either way in the clinic.

Quote:

Originally Posted by Sumo (Post 7554165)
I'm convinced mine happened because I was out of shape. Vowed afterwards to never let that be the reason for something like that again.

While I'm sure being out of condition was a factor in your injury, just because you're in some kind of shape cannot guarantee you won't injury yourself (ACL or other injury).


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