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  1. #1
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    I Am Done - Torn ACL News This Morning

    Impact crash to my patella and I have a torn ACL..........first opinion=reconstructive surgery! 6-12 months recovery. I could not believe what I was hearing.

    I saw some brainy health advice in this forum before. You all might be able to help.
    Referrals requested for a spectacular ortho surgeon needed for second opinion outside Kaiser please PM me. I already have a second scheduled with Kaiser. Want a third, fourth or fifth. Any Drs. in the house? I know ACLs do not heal but how do I know that it is completely torn. Got an MRI and xrays. Not 100% conclusive other then clinical tests and mobility techniques. From MRI Drs. quote "it is swollen and definitely does not seem right to me". He did not say there is a gap between 2 halves of ligament. WTF. I am going under the knife for that. They put me under and dig around and - oops! this guy aint got nothing torn!

  2. #2
    Brentster
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    That sucks SO bad. I guess "Get well soon" doesn't apply here. Good luck buddy.

  3. #3
    Master of None
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    I guess it's the opposite for me. I've had a torn ACL for 1.5 years and Kaiser dragged their feet and didn't want to fix it. I've torn my MCL from the bone about 20 times now because of it. Ouch.

    Finally back in January they agreed to do the surgery, and next week it should be done!

    Try this test if you can: Sit on the floor and rotate your bad leg at the hip so the inside of the knee is facing the floor. Bend the knee about 15 degrees from straight. Relax the leg (important) and gently push down on your leg just above the knee. With my bad ACL the knee joint will slightly separate and the lower part of my leg will visibly rotate a significant amount.

    If you have a spare $15k, Dr. Sanders is an expert in ACL reconstruction and sports medicine.
    http://www.sandersclinic.net/

  4. #4
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    If the MRI in inconclusive for the tear then the "slices" taken must have missed it. The ligament is not the thick. You have several options.

    1. get another MRI and hopefully they can see the entire ligament or lack there-of. I would recommend waiting until the swelling goes down a bit. Fluid on MRI lights up like a christmas tree.

    2. wait for the surgery and see how stable you knee really is. You can always have the surgery later if your knee is too loose. Unless you fall again and the lack of the ligament causes torsion and further damage. So you have to be careful. But several people walk around with no ACL.

    3. Have a scope first. That way they can see the ligament first hand, no wide open surgery.

    Here is a reassuring thought. They can do ACL replacement arthoscopically now. With the right rehab and an allograft, you can be walking the next day, on the bike in 4 weeks, and off road in 4 months. I know, because I did it. Surgery in December, riding trails in April.

  5. #5
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    mlepito:
    Thanks that is uplifting advice. Swelling is down. Kind of non-stable rubbery feeling. Can the scope be done the day of surgery to make the descison? What is you percentage back.....80, 95?

    presslab:
    Tried the test, hopefully right, maybe a cm. of movement.

  6. #6
    Master of None
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    Do you feel it rotating and coming apart? It will have that sort of 'that shouldn't be happening' feeling.

    I had a preop appt. this morning and I showed the surgeon's assistant how it comes apart. She was impressed with how much it moved.

    There is the Lachman's test too:
    http://en.wikipedia.org/wiki/Lachman_test

  7. #7
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    They would do it at the same time. If they scope and there is no tear, they stop of course. If the tear is there they replace it. Like I said before, if you are worried about the scope, you can get another MRI to get a better look at the ligament.

    I would say I'm 85-90%. It still feels funny and it sometimes feels unstable but when I move on it, it's fine. I ride with no problems. But to be honest I rode with the ligament torn with no problems. It was when I took some time off due to rain that my knee started to really get loose.

  8. #8
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    Spoke to paramedic friend of mine whose friend is an ortho surgeon. He asks him so what you do today and he says "a couple knees and a shoulder before lunch and a couple more after". I guess this is a very common procedure and I shouldn't be worrying so much.............like an everyday thing. It is not like I had a catostrophic knee blow out like football players. Comments like knee reconstruction and 6-12 months is hard to take but thanks all.

  9. #9
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    Just keep in mind, it's not like this is the last year you will ever ride. Taking the proper time off now will insure many years of riding in the future. Keep that in mind when you do your rehab, and it will pay off.

  10. #10
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    I'm one month out of surgery. ACL with my own hamstring as graft material. I'm walking with no brace and riding the trainer two or three times a day. Its getting better and the swelling is going down. I'm working hard on extension and flexion. REHAB REHAB REHAB like its your job only work harder on REHAB than you do on your job!!!
    CruisenSurly

  11. #11
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    thetreadway:
    Got it! Did they give you a choice to graft a piece of your patellar tendon...big strap along the outside of your knee across the knee cap. What about a cadaver ligament? My doctor said they got issues with infections and dead tissue when it is taken from a cavdaver.

  12. #12
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    I tore my medial, lateral and ACL in one accident. I am also a member of GHC which is affiliated with Kaiser. I went in and had arthroscopic surgery. When I came out the physician told me I had a torn ACL. I took a week off the bike and then started biking again. The surgeon for GHC said anytime I wanted to I could have ACL surgery. I opted not to have surgery. It hasnt slowed my biking down at all. I cant run up stairs like most people and I really cant run but I havent really thought about surgery. Anyway I thought I would throw this out that there is a "no surgery" option that I am sure a lot of people opt for.

  13. #13
    Krista
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    I tore my ACL in half 4-5 years ago playing soccer (I heard/felt the "Pop", very loose knee after it "healed", no ligament showed up on the MRI...) I did wait till the swelling went down to have a MRI, then was told by Dr #1 and #2 I absolutely had to have surgery, Dr #3 said I should buy a custom ACL brace instead and wear it when I played sports like soccer, basketball or skied (any twisting/pivoting sport). I started cycling and am now racing pro in the NMBS series.

    The knee has really tightened up due to the strength of my leg muscles and I almost never notice any issues, none when on the bike. I was told if I quit cycling at this level my muscles may not protect the knee as well and I might have to consider surgery in the future. Recently I visited another Ortho Dr for something else, he checked my knee and said I did the right thing in avoiding surgery.
    (If I wanted to play soccer instead of riding my bike, I would have the surgery.)

    Hope this helps a bit, good luck!
    Krista

  14. #14
    Barely awake in Marin
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    My GF tore her ACL and as a result she broke her leg in the Sierra Nevada. All her weight came onto one leg that slipped on a rock, and her knee just let go...and this was not the ACL tear, that happened 4 years ago (another lovely Kaiser misdiagnosis/ignorance)...but it still led to a blown vacation (day 1 of 9), two rangers, nine firefighters, 1 hour of stretcher-carrying through the woods, a helicopter airlift...ugh.

    Recovery for her is going great; 6 months later she's hiking up 30% slopes with trekking poles, jogging with her brace, and biking without knee support. But she's also hyper-obsessed with doing her therapy exercises every day. She's a trooper! (FWIW, she got an allograft, rather than a hamstring graft, from some dead guy's ligament. Zombie cyborg, that's so hot! )

    Our experience was that it was pretty easy, all told. Pain in the butt, tons of logistics, long road to recovery, and time consuming (for the PT). But she's got tons more confidence, and the surgery itself was a slam dunk.

  15. #15
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    Leave it to MTBers to be helpful. Thank you. K_park has provided some inspiration here. I can XC on it all day, its when I thrown on the full face, elbows and knees that I am concerned. At this point it is loose and rubbery. At the gym I can't do the calf lifts with one plate (the one where the weights are at your ankles but the weight is lifted with your shoulders).

    Got fitted for a custom leg brace today and received some references for an ortho outside Kaiser Sosey.

    Check this out, the Kaiser ortho setup the second opinion with someone he got published with and studied with under the same Dr. at UCI Med. Center.

  16. #16
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    What the hell is this Kaiser that everyone refers too?

    As u may see in the forums thread, I had my ACL operation 3 weeks ago yesterday. Hamstring graft.
    The bottom line is if you want to get your knee back close to what it was, AND you don't want to have further damage done to ya knee every time you jolt it or twist it or fall off ya bike, then the knee re-con is the sensible way to go.

    As my $pecialist said "Don't have the Op is ok, but you'll have to modify your lifestyle, or you run the risk of completely trashing your knee or going thru a lot of pain each twist"
    I wanted to get back out there and not be in fear of that next bump would cause the pain and swelling all over again.

    Now its a bummer not riding, surfing, skiing etc for the next 6 months, but this time next year I hope to have forgotten all about it and have a good strong knee again and doing stuff.

    Like Treadway said, Physio, physio. Hurts a bit but the improvement is there every day. Time goes fairly fast and I'm walking reasonably well at this stage with no pain
    Good luck which ever way you go.

  17. #17
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    ripper1 - Kaiser Permanente standard HMO (health managment organization, I think), managed health care and you cannot select any Dr. you want.............KAISER KILLS!

    You feel like saying MOOOO! walking in.

    Yah from what I hear the rehab/PT is more than 50% of a successful op.

  18. #18
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    Wow, don't like that idea where you cannot select your own doctor despite having Private Health cover.
    Fortunately my health fund here in Australia covers my Specialist of choice (the one I was referred to) and most Private Hospitals. The use of the hospital for my Op and the overnite stay cost me $50 instead of about $2000. Mind you, I will still have to pay a fair percentage of the bill for the specialist and aneathesist when they arrive in the mail...soon!!

  19. #19
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    Yes, there is good and bad with Kaiser. My surgery will cost $100 with a specialist from a world known med. center.......UCI, thats University of California Irvine (not sure if you knew what UCI was or not). Pain meds = $50 Wow, responses far and wide-Australia. How much comes out of your pay per week on average going to the government for healthcare?

  20. #20
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    I opted for using my own Hammy as the graft material. It hurts and is maybe a little more work to get your hamstring stretched back out but, the literature says your own hammy is stronger than the cadaver and without all the obvious scary possibilities which are slim but still there. I'm one month out and walking pretty well and getting my flexion and extension back I'm at 126 degrees of flexion and almost full extension. Don't sweat it too much, they do these all the time. Just work hard on your PT and you'll be riding trails in 5 or 6 months....I hope!!!
    CruisenSurly

  21. #21
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    Both my Ortho and Sports MEd Docs say my ACL (partial) tear happened years ago...most likely on a parachute jump or other "on the job" stuff...

    I had an ACL strain this past July, and they did the whole MRi/exam thing again, and the Surgeon told me: "We could operate on it, but my goal would be for it to be as strong as it is now"



  22. #22
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    good story

    My girlfriend completely tore acl, ripped mcl and tore the miniscus thingy on the 27th of April this year (skiing) Surgery was last month and she walks without a brace now. Rides a trainer several times a day, swims, works full time (not at a desk) and REHABS CONSTANTLY. PT says she'll be running in a month.

    Surgery took less than two hours. Was at the hospital for five hours total. She had an MRI but the doc said that they wouldn't know the condition for sure until they get in there. Thats when they found the ripped miniscus. Doc said to use her hamstring for the ACL because it's her's and there'd be less complications during recovery. Also said that the Patella graf takes longer to rehab.

    She had the work done in Eugene Oregon at SLOCUM.

    Do it.

    Caz
    I am a Mountain Biker therefore I am late

  23. #23
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    This info might be too late but. I tore my MCL and ACL and fractured my tibial plateau. I flew to Houston and was fixed up by Dr. Mark Sanders. Never used crutches, no braces. Started walking a few hours after surgery, started stairs, squats and ridin the bike a few days later. Was back riding motox less than 90 days. Check out the injury forum at thumpertalk.com his cell phone number is in his signature. Helluva guy. He takes most insurance and will pay for your travel expenses as well as hotel for you and a significant other. Good luck! His website has some impressive videos. sandersclinic.net

  24. #24
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    My brother tore his ACL on a backpacking trip with me. He rotated his leg wrong under full weight, heard a loud POP, he started hollering. He couldn't bear any extra weight, but he determined he could still walk, and would rather do so, than be airlifted out. So I Aced his knee with a 6" ace, and told him 'Don't take this off til we're home" Guess who carried both packs. He got his knee scoped when he got home. All they did was 'clean it up, take out the pieces'. So he doesn't have an ACL in his left knee. He runs, lifts weights now like nothing ever happened. Maybe he doesn't know he's not supposed to be able to do that?

  25. #25
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    If he does physical stuff He'll eventually do untold damage to his knee to the point where he will have constant swelling and pain and his knee will crap itself. Best to have the reconstruction. It's not that bad, I'm 5 weeks out of the Op and getting better every day

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