Unusual ACL Story, any advice?

[dmd]

This is my first post here, and I would sure appreciate your take on this. Please be patient, it's a long story.

Took a fall last Christmas eve and sprained my knee. I was able to ski back to the chair to get home, and I was walking (limping) on it the same day. It was stiff, with some pain and swelling but no bruising. First Aid looked at it and said I had sprained my MCL. It didn't seem too bad and did not have it examined further.

It was recovering steadily over the next four weeks, but then I had several days where there was very sharp pain at the inside of the knee. I figured I had just inflamed the soft tissue, but I finally decided to have an orthopaedic specialist look at it. The guy has a great reputation in sports medicine in this area.

He said the MRI showed I had torn the ACL clean off the bone, and I have a complete tear of the meniscus. Surgury would be required.

Then I told the doctor this story: About 20 years ago, I had badly sprained the same knee. I heard a pop when it happened. It was much worse than what I am dealing with now. The MRI did not show anything torn, but the surgeon concluded I had completely torn the ACL. He diagnosed it by some subtle movement of the joint as he twisted and pushed on the leg. I remember him demonstrating it to his intern, "There, did you see that?" as he moved my leg. The surgeon said I could have it repaired, but I seemed to be recovering nicely. Apparently not everyone needs the ACL, and this was the case with me. I eventually recovered without surgury, and I have been skiing with no problems for nearly 20 years since that first accident.

Back to the present. The doctor says this is remarkable and that I am defying the odds. He said to start rehab on the knee and wants to see me again in one month. What eventually happens depends on how much I improve over the next four weeks.

The doctor didn't say anything else about the meniscus. Is this a problem? I have noticed my knee pops on random occasion when I'm walking, but there is no catching or pain when it pops.

I think I know the rehab exercises I need to do, but does anyone have any specific recommendations?

Any advice or insights from anyone who has been there?

Thanks!

[erosenberg]

i have torn my meniscus on two occasions, never an ACL. if there is no pain and no limitations to movement, without a doubt i would argue towards self rehabilitation. go with surgery only if it's your last option. steer clear of the knife at all costs!

[dingdong]

Living with torn acl over a period of time leads to the damage to other internal structures of the knee, meniscus being the first of them. Meniscus protects you articular cartilage, so over a period of time a meniscus deficient knee might have some articular cartilage issues. Bottomline, get a second opinion, and get your acl and meniscus fixed. Meniscus might need to be trimmed, or if you are lucky the doc would be able to fix yours without trimming. Do your homework, internet is a great resource, and spend sometime to find out about your condition. But, if you were just going to make your decision based on other people's opinion, IMHO, you need to fix your acl, unless ofcourse, you are just planning taking a walk in the park as your only recreational activity, and even then your knee might be getting damaged everytime it pops.

[dmd]

Bringing this back to the top. One opinion says avoid surgery if possible, another says have the meniscus and acl fixed. I would like to hear some other thoughts.

I know the meniscus needs repair. The classic symptoms of a torn meniscus have started to appear (locking and sharp pain that suddenly appears and disappears), and I intend to take care of it.

It has been seven weeks since the injury, and I am doing well on strength and flexibility. There are no signs of instability in my knee at this time. As I said, I tore the ACL about 20 years ago. It has not bothered me or caused any limitations ever since I recovered from the first accident. It doesn't seem to be bothering me now.

Is there any reason to have the ACL repaired when he works on the meniscus? What sort of questions should I ask the surgeon? I have a big decision to make within two weeks, and I want to make a good decision.

[splat]

I tore my acl and meniscus last May 31st. Had surgery June 11. Retore meniscus in October. Having meniscus repair or menisectomy done this Friday. Won't know which til the doc looks at it and makes the call.

Based on the pains and symptoms, I'm pretty certain I've torn one or both in the past and waited for them to heal (like years). I did it airing into moguls and just beating the shit out of them in moguls. I got to the point I could ski, but barely walk. Stairs and slopes were damn near impossible. Riding bike was really good for them, but I skied in braces for another 10 years for added stability in my knees. Then I got prolotherapy and threw my braces away five years ago. Guess I should got more......

[snoweater]

I'm pretty sure that if there is meniscus damage you should have it repaired, it won't get better from what i've heard/read, only worse. the ACL is another thing, i know plenty of people who don't have one, but it does increase chances of tearing other things. If you have the meniscus done, i would do the ACL too.
I had ACL recon 6 years ago and i'm very happy i did. after going through shoulder sugery and rehab recently, the ACL is nothing in comparison. I didn't have any meniscal damage though, so take it for what it's worth.

Whatever you choose, follow your rehab like an insanely obsessive lunatic.

[splat]

i have torn my meniscus on two occasions, never an ACL. if there is no pain and no limitations to movement, without a doubt i would argue towards self rehabilitation. go with surgery only if it's your last option. steer clear of the knife at all costs!

I agree. Did you get meniscus repair or the snip? [/hijack]

[Crampedon]

Here is my knee story- Similar to yours, so maybe yours will turn out happy

I'm 48, cycle a ton, ski 45 days a year, never had a knee injury.

Crashed in December, fell in such a way I was on my back, left ski off right ski on and flat on the snow. Knee made loud pop, was in the aspen under chair 5 on a nice deep vail day. Got up, clicked in and gently turned right. LOUD pop and knee went out, buckled. Guy on chair said he heard it!
Thought I would be taking my first tobbogan ride. Shuffled like a lame-ass through those aspens to the crowd at 5 trying to get in a few laps. Skid down and out, went to pt at steadmans and gal tested it and looked grim, torn acl. Another pt tested asked me what kind of insurance i had ect. Thought my season was pau.

Back home, limping, icing, soaking, two weeks later I get on my bike and it feels pretty good. Ortho doc tests it and says no way it is torn. Road bike for a month, bought a grade IV brace and skid 20 more days on it, felt better and a week of sking! go figure. Now it feels completely normal, make a slight click once in a while. Sprain? Acl? Going to get an MRI after ski season and keep cycling.

Hope yours feels better and heals quik.

[dingdong]

Sorry to hear that you had a knee injury. How did your doc determine that the acl is not torn. Did he perform the lachman test. Also, nowadays every ortho recommends an mri right away for a knee injury, unless ofcourse you have some insurance issues. MRI should pretty much tell you whether the acl is torn or not. IMHO, sub-conciously, you want yourself to believe that everything is fine with the knee, and that skiing till the end of this season wouldn't cause any further damage. It wouldn't matter what your doc says, you just went to the doc to make yourself feel better. You guys have no idea, what can happen to an acl deficient knee only in a couple of years. Talk to someone who has lived through it, and it will give you some perspective. Thanks to the medical advances of arthroscopic surgery, it is not that difficult to rebuild the acl. Yes in medical literature it is well documented that even after rebuilding the acl, it can result in early onset of osteoarthritis, but it will give your active lifestyle back for a considerable number of years.

[eddy]

It was the first day I tried my new Marker Barren binding mounted on my 3 years old Gotama on March 3rd. First run of the day after traverse to Stoke bowl at Alpental back country and skied down. After few turns the terrian gets steep and snow gets heavy. Then I heard the famous POP on my right knee... Stood up try to ski again... but every time I tried turn left it POP and hurt again... total 4 POPs I think... Have to ski and skid with left leg back to parking lot. Went to Orthopedic the next day, he did the Lachmans test then the MRI and it's a complete torn ACL. Doc said my season is over and don't want me even try to skiing with brace as it may cause further damage even I have no swelling just a little discomfort. I feel I can do at least the groomers without problem for the rest of the season which against the doc advice. Is it a stupid thinking? I am 50 yrs old should I just wait to see if it gets better before make decision on surgery and the long rehab? Is any one have release issue on duke or barren bindings? My din was even lowered to 6.5 (150lbs) instead of 8 this time compare with my other skis because the shop said I'am 50 now. Any comments will be appriciate. Thanks

[Rossta]

The first time i tore my acl, i lived with it for several months. it wasn't stable though, and would fall out of place. if yours is stable, i would try to rehab it w/o surgery.

eddy- i have dukes- cranked up from my din chart setting of 8 to 10 in the toepiece and 12 in the heel. crashed hard once, and they released properly.

[Crampedon]

My Doc did a variety of maniputaion tests to see if I had too much motion or if the acl was torn.
He said it felt tight but I should get and mri to be sure. I do have kaiser so I am going to get it mri'd, don't want arthritis or complications...