Partial Re-tear of ACL

[joey54]

Hi Folks,

I'm new here and would really appreciate your advice/opinions.

About two years ago I tore my ACl and had it reconstructed using a tendon from my knee, all had been going fine until about 3 weeks ago I twisted the same knee at football training.

My doctor sent me for an MRI and the results came back yesterday. It says there is a substantial partial tear in my ACL. I've been refferred onto the ortho surgeon who operated on me last time.

What do you think he'll recommend? I'm only in my twenties and have a very active lifestlye so need my knee to be as close to 100% as possible.

Is the fact that they used "substantial" to describe to tear important when considering what the surgeon might do?

Thanks for your time,

Joe

[dede23]

well it cld mean a few things but u need to chat to ur surgeon....but if ur active, and require to have a stable ACL, i wld be guessing a RECON is in line for u. Substantial is a very broad label and it cld mean 30% up to 99% tear so its best to see what he says as to ur next point of treatment. I know patial tears can go without recon but depends how far advanced urs is...... just get ur appointment and then see what his view is. Fingers crossed but dont get too HOPEFUL u will be just rehabing it...... dont think too much either way at this stage- not worth stressing about it cos its done, and its kinda outa ur hands until u consult with him....im going for my 3rd recon in 4yrs so i understand ya mate...... but relax and rest it as much as poss. Let us know how u get on!!

[joey54]

well it cld mean a few things but u need to chat to ur surgeon....but if ur active, and require to have a stable ACL, i wld be guessing a RECON is in line for u. Substantial is a very broad label and it cld mean 30% up to 99% tear so its best to see what he says as to ur next point of treatment. I know patial tears can go without recon but depends how far advanced urs is...... just get ur appointment and then see what his view is. Fingers crossed but dont get too HOPEFUL u will be just rehabing it...... dont think too much either way at this stage- not worth stressing about it cos its done, and its kinda outa ur hands until u consult with him....im going for my 3rd recon in 4yrs so i understand ya mate...... but relax and rest it as much as poss. Let us know how u get on!!

Thanks for the reply. Its great to hear back from people who have experienced my pain too! I'm seeing my OS soon, hoping to get a cancellation. I think myself it will be a reconstruction job but I'm always hoping that maybe he'll just say to me build up the muscles. Sport is my life, I'm just so lost without it at the moment.

I have started things to improve my ROM and they're going really well, it only gets sore the odd time. Has anybody out there just rehabbed and not done the reconstruction after a partial tear? How long did it take you to get back to footy?

I'm sorry for all the questions I just feel completely down about the whole thing, I'm trying to stay positive but its just sooooo hard.

[benlawson]

i think we would only be guessing if we tried to answer your query, however, good luck and i hope you get good news.

A friend of mind had an ACL tear and just did rehab no op and its been 6 months and he is back to full fitness and playing again. Our clubs sport doc said sometimes the acl tears fully/partially but if the tissue surrounding it is in tact, almost like a sleeve around the acl, it can heal over time as the scar tissue builds up so surgery is not necessary, however, he said it was quite rare, only like 10 cases a yr out of a couple hundred

anyway, all the best

[SOSa]

Hi guys, i've just had my second ACL reco last wednesday. Used patela tendon after hamstring graft in Dec 04. Still a bit sore. Came back to footy in 06 after twelve months off and played 6 games before it gave way again. Have waited this long due to kids and work commitments. Surgeon i used was Dr John Patrikios after Andrew Byrne did the first one. I had a block so i could watch the whole op. Amazing. At the beginning of the op he said if the original graft had just "stretched" he could "shrink it" by passing a current through it. Didn't have to worry about it as it was knackered. Hoping to get back into the rehab soon. Didn't have any plans to play again but my 2 1/2 yo has been asking "can you play daddy please", would love to play at least 1 game.

[joey54]

Hi guys, i've just had my second ACL reco last wednesday. Used patela tendon after hamstring graft in Dec 04. Still a bit sore. Came back to footy in 06 after twelve months off and played 6 games before it gave way again. Have waited this long due to kids and work commitments. Surgeon i used was Dr John Patrikios after Andrew Byrne did the first one. I had a block so i could watch the whole op. Amazing. At the beginning of the op he said if the original graft had just "stretched" he could "shrink it" by passing a current through it. Didn't have to worry about it as it was knackered. Hoping to get back into the rehab soon. Didn't have any plans to play again but my 2 1/2 yo has been asking "can you play daddy please", would love to play at least 1 game.

Hi, did you experience any complications due to the fact they had already done a reconstruction job on it? I'm still so upset that its happened!

[road2recovery]

sorry to hear.
if it was me I would be getting advice, and if it was borderline surgery, I would go with surgery.

In my personal experience (I beleive I had a partial tear before the full rupture), a partial tear is a ticking time bomb. Better to go and get it done and save yourself the pain if you do rupture it again. Then again, I would probably stop playing competitive sport if I had to have a second reco, just my 2cents.

P.S - SOSa, you are a madman for watching your own surgery!

[petegogogo]

Well i had exactly the same situation, came back from full reco, everything was fine then coped a knock in footy and re tore half my acl. My surgeon recommended the LARS graft and he said after 6 weeks I should be playing again. Maybe something for you to consider.

[joey54]

Well i had exactly the same situation, came back from full reco, everything was fine then coped a knock in footy and re tore half my acl. My surgeon recommended the LARS graft and he said after 6 weeks I should be playing again. Maybe something for you to consider.

I have heard a lot of mixed reports about the LARS graft. It seems crazy that you could get back playing in 6 weeks compared to 6 months! There must be some reason as to why not every surgeon is doing it?

[dede23]

Joey54- there are increased risk of failure of ACL recons, the more u have BUT, if u ask most ppl who have had mulitple recons on the same knee, they wld just tell u they didnt have too many complications. Im up for my 3RD one on the same knee in a matter of 4yrs (bth failed and one overstretched and the other placed in wrong position)- i had an increased chance of failuire but that was due to my ligaments HYPER mobile. They stretch easily. I think every case is different and the risks and complications go with each person. The more times they have to drill into bones and secure them with endo buttons and all that stuff (they anchor ligament with in the femur and tibia) they run the risk of tunnels they need to make being too big- and require bone grafts to fill them in and then wait 12wks or more for them to HARDEN up enuf to take hold of the new ligament. I had that done in October- and now getting my phase 2 of the recon. Its a frustrating time but bette to have a supportive network of bone in the leg to take the new ligament then risk it loosening and snapping. Hopefully u wont need to go this route of treatment and u can just get it done and start rehabbing.....

Also the LARS isnt widely used in AUst as most surgeons feel its not scientifically a proven technique that holds much success. There have been a cpl of footy players that have had it and sofar they have been ok. HOWEVER- they have physio and drs 24/7 getting them thru the rehab and stuff- most of us dont have this. Its a matter of ringing around to see who uses the LARS- get ready for a $$$ phone bill cos there arent many around.......its been said that u run the risk of further damage if u re rupture the ligament and why go thru that process of rehab and then reinjure it to only go thru the rehab of typical recon down the track...... u have to be a candidate too. Its expensive too. Like $6-7k just for the graft- not sure if priv health cover this..... many wont...... Malcheski was a AFL player who recently used the technique- there wld be an article here somewhere for it.... check it out and get drs name... biggs i think.... hope ur traveling ok!