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Thread: ACL Gone

  1. #1
    Road Warrior
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    Bonking ... not feelin' well ACL Gone

    Tore the ACL off my right knee 2 mo's ago. As I am 48 years young the doctors don't recmend having it fixed Just getting back to riding. Any advice/ suggestions would be greatly appericated.

  2. #2
    mmm bacon
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    What damage did you do to the knee, it's rarely just an ACL there is usually damage to the meniscus either the left right or both. Is the doc suggesting PT to specifically strengthen the leg. I am 32 I had ACL surgery Feb 5th. I'm just about 6 weeks out and can walk, straighten my leg to 180 degrees and can bend my knee to 110 degrees. I waited three months to have the operation and rode every day which the doctor and surgeon said I could do. As the months went on my leg got wicked sloppy, to the point that I felt uncomfortable walking without my brace. When they finally did operate I had large tears in both the medial and lateral meiscus and the back of the patella as well as the ACL reconstruction and to boot I had a lateral release which is what contributed to my "sloppy" knee feeling. Lateral release is due to the kneecap not tracking properly. I would suggest a second opinion, specifically an MRI so they can see exactly what is wrong, depending on your financial and insurance situation of course. If you are adamantly against surgery look into the CTi2 brace, I just got mine, better than anything else out there. Hope you feel better. Sorry about the long post JK

  3. #3
    aka Dick Dangle
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    what the hell

    I would find another doctor now, I say.If you are active and I'm sure you are you need a Knee that is stable and without the acl most of the time it will be unstable.

  4. #4
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    As a PT, I've worked with many patients who are "older", and have had ACL reconstructions. I don't think it is at all unreasonable to get it fixed if you plan on remaining active. You'll find a surgeon willing to help out, don't let your age be a factor in what treatment you seek.
    "It's our struggles that define us..."

  5. #5
    sixsixtysix
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    Did you completely rupture your ACL or just tear it? A tear may or may not require surgery, depending on if the Dr. feels it may get worse with time. Mild tears most often will not be surgically repaired, but controlled through PT and strenthening of the hamstring and quadracep. If you completely ruptured your ACL, then you tore it straight through and then you are ACL deficient and are 100% gaurenteed to need surgery to reconstruct the ACL, either by harvesting a part of the tendon in your hamstring, or by a cadaver ligament graft.

    I am ACL deficient, but at only 30yrs old. Tore mine for the 3rd time last October, along with a slew of other things that went wrong. (See my post "Destroyed Knee Again") With the way things are looking, I will not be getting a new ACL for at least a year, if at all. They can't harvest anymore from my hamstring and my Dr. will not use cadaver grafts for fear of infection/rejection. That being said, there are some things you absolutely need to do to take care of whats still good in your knee if you are ACL deficient.

    1. Get a brace. Not a Walgreens neoprene sleeve brace, we are talking a Level 4 Combined Instability brace which is designed for people with severe knee ligament instabilities. A bunch of companies make them, Donjoy, Breg, CTi etc. I just ordered a Donjoy Extreme Armor CI brace, which is designed for MX riders and Skiers who have destroyed their knees. It also has a knee/shin pad attachment for a little extra protection. Talk to your Dr. about getting one, if he feel's its un-necessary then you need him to re explain why he doesnt feel you need one.

    2. Start taking Glucosamine Chondroitin religiously. You can find it at any pharmacy and it will help to protect the vacular cartledge in your knee. The vascular portion of the meniscus can with time heal itself, because it has blood flow, the avascular section of the meniscus can not. You want to protect your meniscus at ALL COSTS. If you are like I was before the last incident and don't use a brace, the chances of completely destroying your meniscus is very high if you twist your knee accidentally because of the ligament instability. That is exactly what happend to me, and I ended up basically shearing all the meniscus on both the lateral and medial side clean off the bone. It had to be all removed in surgery, leaving my knee completely bone on bone now.

    3. Strengthen your hamstrings as much as possible, they will help keep your knees in place in case of a accident and will generally help them be more stable.

    4. Be smart about it. Let your knee tell you what it's up to doing, if it hurts, don't force yourself through the pain, it will only make things worse.

    Good Luck

  6. #6
    conjoinicorned
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    They can't harvest anymore from my hamstring and my Dr. will not use cadaver grafts for fear of infection/rejection.
    goodness man, get a new doctor....NOW!!!

    my 2nd ACL repair was a cadaver graft, and i had significantly better success than with the first one (which was a hamstring).
    what would rainbow unicorn do?

  7. #7
    sixsixtysix
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    Quote Originally Posted by ferday
    goodness man, get a new doctor....NOW!!!

    my 2nd ACL repair was a cadaver graft, and i had significantly better success than with the first one (which was a hamstring).
    I'll stick with mine thank you, he was the team physician for the Milwaukee Brewers for 7 seasons and is currently the team physician for the U.S. Olympic Baseball Team along with my family Dr. who was the team doc for the Oakland A's for 5 seasons. My Dr. only does knees and shoulders, and has been recognized as one of the best in the country. For me, his words are gold. He was able to make the best out of a situation where other Dr's wouldn't even touch my knee and actually was able to have me back to a somewhat normal lifestyle routine very quickly.

    His reason for not using cadaver grafts is the risk of viral infection is quite high, so far this year alone there have been 4 reported cases in the U.S of people getting contaminated grafts who have died. Also since I have had 3 ACL reconstructions so far, he is afraid that the tibial plateau may not be strong enough to endure another. These factors combined with the fact that I got a DVT in that leg post op immediately disqualified me from surgery on that leg for 1 yr. After a year he is going to re-evaluate my knee, make sure that all the micro fractures of the tibia are healed and then go from there. They can harvest the tendon from my other leg, but again, is it going to be figuring out the lesser of two evils. My knee has already been labled for a replacement within the next 10yrs, so for now being able to ride, walk and function are good enough for me

  8. #8
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    Well, for better or worse I blew mine at least 15 years ago.

    I do notice it with several distinct actions (stepping down into my boat from the dock is one),

    But otherwise I am fine.

    Good luck, it seems more people now get it done then before.

  9. #9
    Road Warrior
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    New Doc

    thanks for all the replies The first Dr. I saw. Gave me the previous advice after glancing at my MRI. He suggested I see a Dr. speclizing in sports med. if I continued to have problems, I have, and have an appt. already made.
    I have great Ins. but am a self employed over the road truck driver. and more than a few weeks off will put me in the poor house. ACL is completly torn off and I did it playing football in the backyard with the kids.

  10. #10
    mmm bacon
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    just FYI

    it took me 4 to 5 weeks to be able to drive my truck, granted it's only a 5 speed ford ranger look into the CTi2 from Ossur, it absolutely rocks!

  11. #11
    Road Warrior
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    trucks

    actually in some ways driving a tractor trailer is easier than a pickup, and I do have room to streach my legs. My biggest worry is straping and tarping loads on my flatbed trailer, as the risk of twisting a knee is very high.

  12. #12
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    Blew my knee out skiing 4 winters ago when I was 38. Torn PCL, MCL and Meniscus. Before the injury I rode 3-4 times a week for a number of years. I went to a sports doc and he initially recommended surgery and I told him I was not excited by the 6 months of rehab as I have two rambunctious boys. He said a lot of cyclists don't need ACL, MCL or PCL surgery as they have built up their quads, hamstrings and calf muscles to the point where those muscles can compensate for the lost stability in the knee. He put me in rehab to test my stabilty and eventually he stated no surgery was necessary. My leg was stable. He said I can always come back and get the surgery later if the instability became an issue. He said sports that required lateral movement might be an issue. In the four years since I have continued to bike 3-4 times a week. In addition I play hockey regularly and a bit of rugby. The only issue is a bit of stiffness after the rugby. But that goes away with ice and beer.

  13. #13
    Road Warrior
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    Smile Great

    Thats good to hear. Do to my job and riding my leg muscles are in good shape and stability is not an issue except after a few beers. Range of motion has been the main problem, and if family history is any indicator I've still got another 50 years to go. I'm trying to become as informed as possible before I see the next doctor. My grandfather just died at 97. Was active and independent fo 96 of those years. May we all be so lucky.

  14. #14
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    Quote Originally Posted by sixsixtysix

    3. Strengthen your hamstrings as much as possible, they will help keep your knees in place in case of a accident and will generally help them be more stable.

    Good Luck
    Sounds good advise..dumb question perhaps, but is hamstring curls what you do to strengthen your hamstrings? Theres a machine at my gym I might start using if thats the case..

  15. #15
    sixsixtysix
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    Quote Originally Posted by Nostromo
    Sounds good advise..dumb question perhaps, but is hamstring curls what you do to strengthen your hamstrings? Theres a machine at my gym I might start using if thats the case..
    Yeah, hamstring curls and the eliptical machine. My physical therapist told me that in people who have had acl reconstructions should try to keep their hamstring at about 60% of the strength in that leg and the quadracep at about 40%. In people how are ACL deficient that changes to 75% hamstring and 25% quad because the quad being overly strong can actually pull the knee joint out of alignment.

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