ACL injuries

[Blues34]

a couple of months ago i had my meniscus removed since the surgery i have been able to play sports again, recently i contacted a 2nd orthopedic surgeon to see what his assessment of my knee is.

My first surgeon said that i have a grade 1 tear to my ACL and would not require surgery, the 2nd surgeon says that the surgery on my menicus surgery was fine but my ACL is unstable and is more then a grade 1 tear, and it will cause me instablity. After this diagnosis the ACL injury has started to play on my mind, when i was told my ACL is fine i played sports normal, now that i have been told it isnt im starting to feel instablilty (this may be a mental thing).

I was curious if my ACL has a grade on tear are there exercises i can do and a brace i can wear to make sure it heals correctly or is surgery the only option.

thanks

[SPK]

I'm in a similar situation. I tore the cartilage on my Lateral Meniscus playing Rugby League and suffered Bone Contusion and Subcortical Fractures on my Femur. All symptoms associated with a ruptured ACL.

However, MRI scans revealed that my ACL did not rupture and has in fact, been partially torn.

According to the MRI report I have a 'High Grade Partial thickness Tear or a Full thickness tear in the Midsubstance of the ACL'.

Whilst undergoing an Arthroscopy to repair the cartilage, the ACL was examined and tested and it was found indeed to have been partially torn. However, subsequent testing showed that while the Ligament is torn, the knee seems to be quite stable.

At present it does not seem to be bothering me at all, however the surgeon has advised me that despite the results, it was still showing signs of abnormal stability.

It has also collapsed on me at least twice.

I am in two minds about what to do exactly. Do I let it go for a while and see how it all goes, or do I go pre-emptive and have it reconstructed.

I am active in Rugby League and under 21 so I have very healthy odds of making a complete and full recovery, but I don't wish to have unecessary surgery.

I simply want to take the most proactive path to recovery.

[injuryupdate]

In these situations (partial ACL tear) a wait and see approach is worthwhile. A high percentage unfortunately will become unstable and will therefore eventually need reconstruction, but playing sport and seeing whether the knee holds up is the best way to test if the examiners disagree with the scans or each other.

I think giving way episodes where the knee subsequently swells up are an indication for reconstruction (or retirement from the sport as the patient chooses).

[SPK]

In these situations (partial ACL tear) a wait and see approach is worthwhile. A high percentage unfortunately will become unstable and will therefore eventually need reconstruction, but playing sport and seeing whether the knee holds up is the best way to test if the examiners disagree with the scans or each other.

I think giving way episodes where the knee subsequently swells up are an indication for reconstruction (or retirement from the sport as the patient chooses).

After the Collapses there has been no swelling, and after the initial injury was sustained there was no dramatic swelling.

My own thought of thinking was that maybe it's time to hang up the boots, but I would be devastated if I was to hang up the boots and then have to have a reco anyway.

My Orthopedic Surgeon did an excellent job with the Arthroscopy and I have complete and utter faith in his ability and as I say the knee has been fine the last 2 weeks since the Op, but is it still worth seeking an second opinion? Particularly since it is still so soon after the Op and I am still doing Rehab.

[Unregistered]

After the Collapses there has been no swelling, and after the initial injury was sustained there was no dramatic swelling.

My own thought of thinking was that maybe it's time to hang up the boots, but I would be devastated if I was to hang up the boots and then have to have a reco anyway.

My Orthopedic Surgeon did an excellent job with the Arthroscopy and I have complete and utter faith in his ability and as I say the knee has been fine the last 2 weeks since the Op, but is it still worth seeking an second opinion? Particularly since it is still so soon after the Op and I am still doing Rehab.


after my knee collapses there isnt any swelling at all, just a slight pain in the back of my knee. The confusing part of this entire situation is each surgeon is telling me something different, those tell me i'd be fine, others tell me i need it operated in as my muscles are holding my knee together and others say it will cause me further injury in future. After my op i came back and played league. im considering having it operated on and getting it out of the way but i dont think i can go through thr rehab

[SPK]

after my knee collapses there isnt any swelling at all, just a slight pain in the back of my knee. The confusing part of this entire situation is each surgeon is telling me something different, those tell me i'd be fine, others tell me i need it operated in as my muscles are holding my knee together and others say it will cause me further injury in future. After my op i came back and played league. im considering having it operated on and getting it out of the way but i dont think i can go through thr rehab

Yeah that's part of my confusion as well. Conflicting views.

The Orthapedic Surgeon I saw, seemed pretty confident that it would need a reco, especially if I wanted to go back to footy.

When I went back post-op, I didn't see him, I saw the Intern/Registar and he said it all seemed to be ok and that if there were any problems that were non-cartillage related come back and we'd deal with them seperately.

And while I'm thinking of it, what exactly is a mid-substance tear? I think I asked the Surgeon and my Sports Physician a few times but they either didn't answer the question fully, or went into so much depth and used so much medical jargon that my eyes glazed over.

I'm all for waiting to see how it goes, but I don't want it to be in vain. I'd rather just get the surgery and get it all over and done with now so I can start the rehab ASAP, rather then every time I run out on the field playing too self cautiously and trying to protect it. I guess I want reassurance that I can safely step off my knee, or change direction without being worried that it'll give way on me.

[Ella]

Hey there

I think maybe having a go at the sport and seeing how you go might be the way to go.... although I have to add that lack of swelling doesnt mean that you havent got a problem. I completely ruptured my ACL, but had absolutely no swelling what so ever.... it actually meant that my knee injury was misdiagnosed by 3 drs and a physio because they expected swelling with an ACL rupture. It wasnt until I saw some sports Drs in Melbourne some 4-5 months after injury that it was correctly diagnosed and dealt with... I had the reconstruction nearly 4 months ago. So I guess what Im saying is find a good OS and be guided by what they tell you.

Alla

[SPK]

My Knee has been hurting like hell this past week (3 weeks after a scope), particularly when I've had the knee on a a sideways angle. i.e. turning to go into a room or go up some stairs.

Is it possible this pain is ACL related? I have a partial tear in the ACL and I'm a little concerned that I might be straining it and doing more damage to it.

[Unregistered]

Hey there

I think maybe having a go at the sport and seeing how you go might be the way to go.... although I have to add that lack of swelling doesnt mean that you havent got a problem. I completely ruptured my ACL, but had absolutely no swelling what so ever.... it actually meant that my knee injury was misdiagnosed by 3 drs and a physio because they expected swelling with an ACL rupture. It wasnt until I saw some sports Drs in Melbourne some 4-5 months after injury that it was correctly diagnosed and dealt with... I had the reconstruction nearly 4 months ago. So I guess what Im saying is find a good OS and be guided by what they tell you.

Alla

Alla or is it Ella

Are you completely happy with the surgery you got and if so could you forward his/her contact details to roe48@2ozemail.com.au

I live in Beechworth and need the ACL reconstruction I can go public but I think I'm prepared to pay the private.

Regards Joris

[Alla]

Hi there

Sorry for the delay... didnt realise there was a reply. Email me at allanicholson@yahoo.com.au and I'll forward the details of the process that I went through and give you the phone numbers.......

I am really happy with the work that I had done.... Im still not running but it is a long process that takes time. I have the tinyest scar from the surgery..... looks nothing like I expected, and is really neat. I've had very little pain, and few problems. I highly recommend the Drs and Surgeon that I had..... The surgeon I had is a legend, he was very professional, explained everything to me, and has been fantastic in the follow up.

Hey we are close geographically.... Im near Shepparton..... I went private for my surgery..... much quicker and less expensive..... and I'd recommend getting the reco sooner rather then later otherwise there will be muscle wasteage to deal with.... It took 5 months for me to find a Dr that could diagnose the problem I had, and once I found him I'd had the surgery in less then a month..... problem was 5 months meant I had loads of muscle wasteage even though I'd been trying to keep it built up (I favoured way too much...but didnt realise!)

Alla

[Alla]

Hi there,

I just realised that you did give an email address..... I couldnt access it from this computer.... I'll try again from another and get back to you...

Cheers
Alla

[Alla]

Hey Joris,
The link doesnt seem to work... you might have to PM me....
Alla

[deegee]

yeah with a partial tear, a wait and see approach would be the best way to go providing there is stability on clinical testing... I had a partial tear playing soccer, surgeon number one said reconstruction while surgeon number 2 said a conservative approach would be best in a non-professional athlete due to the fact that my mri showed the architecture or something of the acl was still quite in tact and that i had no swelling and a negative pivot shift test. so 6 months later after doing quads/hamstring strengthening i returned to soccer for 8 months before unfortunately having my knee give way on me in a standard "plant and change direction" motion. had the reconstruction a little over 2 years ago and still playing. *knock wood*
so all i can suggest is, that providing you have some stability there, a wait and see approach would be best. but if ur having ur knee continually give way on you, either retire from sport or have the reco, coz u dont wanna wear away the meniscus and give urself problems later in life.

[SPK]

Thanks for the advice DG. My injury sounds pretty similar to yours. Minor swelling and negative on the Lachmans and one surgeon saying I should get it reconstructed. I haven't consulted a second one yet though.

I'm going to wait and see and focus on getting full flexion back to my knee from the scope. I need to build up that damned VMO to stop the PF pain so I can get a decent idea on how everything is working.

The knee seems to be fairly stable. I've had a few episodes where it seems to almost wobble/buckle but it never fully goes. It's usually pretty minor too. I'm not sure if this is related to the weakened Quad and Knee or the ACL itself but I am planning to get a referral to a Knee specialist soon anyway, just to make sure and see what he thinks.

At this stage I'm not even sure if I'll be playing Football again so I have no real way to test it out. Regardless of whether or not I go back to footy or indeed sports in general, if it needs a reco I will have it done.