Thread: ACL allograft surgery report thread

surgery is tomorrow AM. i can't believe it. FINALLY!

all the gimper posts were a huge help to me during the diagnosis/decision/expectation process, so i'll try to report on everything here with the hope that it'll help someone else someday.

my "demographic" info:


tele skier, snowboarder, hopeful future pound dog owner, lover of ice cream.
female, 28, 5'3'', 125
injury is a complete ACL tear, everything else looks good. hurt it playing soccer on july 2, had to wait three annoying months to have surgery because of timing with my wedding and the surgeon's vacation schedule. but now the big day is here! wooooooey!

going with the allograft dead person tendon 'cause that's what the doc is recommending and because i want to minimize injuries to my body.

surgery is tomorrow at 6:30 am. hopefully the doc is a morning person.

went for a pre-op appointment yesterday and got my brace fitted along with a healthy supply of celebrex, percoset, oxycotin, and phenelan (anti-puke pills). i've only had two perscriptions in all my 28 years- and they were both prescribed in 1985- so seeing the four amber bottles chilling on my bathroom sink is creepy. but i'm sure they'll become cherished friends when the screws start screaming on thursday. took a celebrex yesterday, another today, and i'm suppossed to take two more tomorrow morning before heading to the surgery center. i can't remember why, but it seemed like a good reason. something about reducing the amount of drugs they need to shoot into me tomorrow.

Yesterday my doctor said "Our job is the easy part...we just go in there and fix it. Your job is the hard part. The rehab," he said, shaking his head, "it's a grind, it's tough".

Which i understand intellectually, but still sort of feel like I'm in denial...and I'm not sure i'm mentally prepared. I've never been injured (or even sick) before, and although I know ACL surgery is SO minor compared to what other folks are dealing with, I'm still scared. But I know I'll be okay in the long run.

anyway, that's the process so far. I'll post again as soon as I can! later skaters!

Good luck! Rehab sucks, but just take it one day at a time. It probably won't be as bad as you think.

You said the magic word, "allograft". Cue Dr. Mark/Mork and the resulting heated discussion......

(I have an allograft too.)

You'll be fine. After two weeks things will improve a lot. PT was actually fun for me I really enjoyed it. At 6 months you can get back to the footie, slowly. Good luck!!

Originally Posted by amyzilla

You said the magic word, "allograft". Cue Dr. Mark/Mork and the resulting heated discussion......

We could argue about that all week, and then some.

But to be honest, it's best to go with what the doc suggests. After all, he's the one who is hackin' your knee and drilling holes in the bones and all. And if he's not really in tuned with using a certain type of graft, well you might be hosed.

Good luck ikkin, and when you can hit the PT hard. It's over 6 months from my OP and that leg is still a lot weaker than the good leg.

Yup, good luck girl!

I'm about 14 wks out from an autograft myself. "Supposed" to be cleared to ski at 4 mos, but the leg doesn't really feel solid enuf yet and I'm glad it's still in the low 80's to be honest. This is the surprising part to me - how long it takes to regain strength.

I was also a complete acl with no associated collateral damage. I did the auto cause my dr said there would be reduced time to be ski-ready.

Plenty of diaries to read on here but I put away the crutches and brace 2 days after the surgery. Only advice I can give based on my experience (I won't go into the details) is take it real easy and be careful even if you can walk, especially on stairs. As far as I could tell, my screws never "screamed". Almost all of the surgery-associated discomfort was relatively minor (OTC painkiller stuff in reality) and seemed to be associated with the graft harvest, as advertised. So my impression is that allograft should be a (relative) piece of cake. Hope it's so! Try to relax and enjoy the adventure.

I'm nearly 5 months post op and feeling pretty normal. I did the allograft thing and the surgery part was pretty easy. Used very little pain medication. I would rather feel uncomfortable than crazy, which is what pain meds do to me. I worked on getting my ROM back as quickly as I could and then concentrated on the leg strength part. About six weeks after the surgery I doubted things would ever get back to normal but things really began to improve after about eight weeks. Then huge difference after third month. Back to running, hiking, biking now. Did PT three times a week for three months with almost daily gym visits. Still hitting the gym almost daily 'cause sweating is so much fun.

Originally Posted by ikkin

Which i understand intellectually, but still sort of feel like I'm in denial...and I'm not sure i'm mentally prepared.

I know what you mean. I went through all the stages when I found out the bad news 5 days before I was supposed to leave on a 6 week adventure vacation in the southwest.

* Denial (this isn't happening to me!)
* Anger (why is this happening to me?)
* Bargaining (I promise...)
* Depression (I don't care anymore)
* Acceptance (I'm ready for whatever comes)

I mangled the MCL in a big way plus the total ACL which means last 4.5 weeks have been slow. The really depressing part is I get to go though all the yuck again in in 21 days. Double Crutch, Single, heel slides, Brace, 90 degree bend (Sweet), Bike Trainer, full extension, Clutching on my car.

First Goal, classic x-country on March 1st. Anyone want to baby sit me?

Originally Posted by hemas

We could argue about that all week, and then some.

But to be honest, it's best to go with what the doc suggests. After all, he's the one who is hackin' your knee and drilling holes in the bones and all. And if he's not really in tuned with using a certain type of graft, well you might be hosed.

Agreed, and it depends on the case. I don't think there's a blanket option that works best for everyone.

Hope the surgery went well. I did mine along with some meniscus damage which required being in an immobilizer for the first month. My experience has been positive. Rehab was really easy. Never painful or disappointing(which my rebuilt shoulder frequently was). The hardest part is sticking with it, mainly because it feels like nothing is wrong with it. It has felt weak at times but really not more than my good one. I'm excited for this season and have been hitting the gym a lot. I think I'll begin it stronger than I have in recent years.

How did it go and when are you planning to go back to work/drive?

-esc

hi all! THANKS for all the responses! i meant to post a report earlier but our internet went on the fritz, so this has been my first opportunity. so here goes!

so the surgery went really well. showed up at the surgical center at 6:30am, was taken to a prep room and given some sexy surgical wear- a nice backless gown complete with old bloodstains (ick!), some fabulous mid-calf sock things, and a poofy blue surgery hat. donned it all and then sat in bed 'till the anesthesiologist showed up to start my IV. going under was the scariest part for me, but they gave me some vicatin and i was MUCH more relaxed after popping those babies. i think they also added some relax-the-patient juice to the IV...i don't remember but i definitley wasn't as scared. i guess the surgeon came in and talked to me, don't remember it. i guess i was hamming it up with the nurses and calling the anesthesiologist "handsome", don't remember it. don't remember anything really. vaguely remember them putting a mask over my face and telling me to breathe deeply in the surgery room...but that's about all i remember after the vicatin.

i do remember shaking when i woke up after surgery, which ended pretty quickly...i guess it's a common side-effect. i woke up with my brace on and the nurses were really nice...i had apparently been making them laugh pretty hysterically before i went under. they grabbed my husband and we chilled for a bit in the recovery room while i woke up. headed home after an hour or so, getting back around 1:00pm. i proceeded to sleep the rest of the day, night, and next day.

the next few days were replete with oxycotin and percoset, so i never really felt any pain. i slept a lot and refilled the cryo cuff as often as i could. my doctor also told me to point and flex my toe and try to clench my quad muscle, so i did at least 4 sets of 20 of each of those exersizes each day. the percoset didn't make me sick, but it did make me itch. like. crazy. everywhere. i felt like a junkie...it drove me crazy! they made me sleepy, too.

went off the insane painkillers after a couple days and had a follow up appointment on friday (surgery was wednesday) and the doc said it looked "marvelous". i've got four scope holes and a small incision where they slid the graft into my leg (gross). they removed the stiches from all of them. doc said i had a clean ACL tear and a small strectch mark on my meniscus, but nothing else to worry about. "the rest of the knee looked great," he said. "you should be skiing in six months". yipee!! (which actually sounds a bit aggro to me, but we'll see how it feels)

since then i've just been hanging out, eating ice cream and vegging. and watching TV and reading. i was able to put full weight on the leg the day of surgery, and i've been hobbling around the house sans brace and crutches fairly easily as well.

had my first PT session today and i'm apparently a bit ahead of the game. extension is 2, flexion is 98, which my PT guy says is pretty good. he gave me a lovely list of thrilling exersizes like "heel slides" and "leg raises", so i plan to heel slide and leg raise myself to death. he also set my brace to 60 degrees and told me to stop using my crutches.

so, anyway, all is well! i'll keep posting milestones and progress as i reach them, but for those about to go under the knife: don't worry, it's not as scary as it seems, and you'll do fine. hang in there.

love and speedy recoveries to all!
ikkin

oh yeah, escii, not sure about going back to work. i'm blessed to have a super flexible job and a very understanding boss. maybe next week, which would be 1.5 weeks after surgery. but maybe the week after that, not sure. i think i'll start driving tomorrow, which wil be exactly one week post-op. the knee feels fine, but i feel a little light-headed, not sure why. i'll be driving as soon as the lightheadedness goes away!

I returned to work five days after surgery. Drove after four days - left knee, automatic. Actually, sitting in my car was the most comfortable since the car seat adjusts a million different ways so driving was great. I sit in a cubicle in front of a computer so that was easy, too. Plus, office chair has wheels so I didn't mess with the EVIL crutches once I got to work. Additionally, for the ladies out there, going to the office bathroom was easier in the handicapped stall than going at home. Bigger space, higher toilet and bars to pull up, lower down with. Hope that wasn't too much inform ation.

meant to post earlier- and actually wrote a long post last week- but my internet died and ate it right as i clicked "post reply".

overall, things are going really well. had 128 degrees of flexion and 0 extension at PT last week, which was 1 week post-op. PT guy says that's way ahead of schedule, so i was pumped. things were still pretty puffy last week, but they're calming down now (12 days post-op) and i'm starting to see a glimmer of my knee cap again. surgical tape is still bomber on the scope holes/incisions and isn't really showing signs of falling off. have another PT session tomorrow and i'll give an updated progress report then.

my main incision (where they slid the donor tendon into my knee) was super sore last week, but it seems to be getting better in the last couple days. i haven't been icing nearly as much lately...mostly due to laziness. also off the ibprofen now. been doing heel slides and boring leg raises/sqauts approx. once per day. i'm pretty bored with those and can't WAIT to get my heartrate up and sweat again! i'm hoping i can start on the bike soon.

so things feel pretty good except it's reaaaaally tough to go up and down stairs- it seems to put a ton of pressure on my patella tendon, and the front of my knee hurts like hell, especially on the downs. not sure why.

speaking of stairs, i scared myself a bit yesterday going up some porch steps and through a door. my left (repaired) leg was up through the door when the screen door swung too quickly and grabbed my trailing right leg. the left knee tweaked backwards a bit and i felt a pull and some pain inside the knee...i know this is a really vulnerable time for the graft so i'm hoping (HOPING!) i didn't damage/stretch anything. i haven't had any patella tendon pain since that little event so i'm scared that i wrecked the graft... but i'm trying not to overreact. i'll have mr. PT guy check it tomorrow. fingers crossed.

might go back to work this week, or i might milk it and stay away...it'll come down to how bored i get and how guilty i feel.

okay, ttfn!

okay, three weeks out and i'm still feeling okay. the knee doesn't feel much different than it did last week, it's still stiff- it feels like someone filled the space beneath my skin with a bunch of cotton balls- but my flexion is 136, extension is -2, so i'm close to full ROM after just three weeks, which my PT guy seems amped about.

steri-strips (the tape over my incisions) haven't shown any signs of coming off...not sure what i should do about that. doctor said to leave them alone and that they'd fall off on their own, but they seem to want to stay with me for awhile. i'm thinking about naming them at this point. also thinking about naming my new dead guy graft...i think it needs some love to help it heal.

anyway! my quad has shriveled to patheticness, but i'm working on step-up and ball squats against the wall...not to mention quad sets and leg raises.

been walking around a lot, which might be related to the stiffness...gonna try to take it easier now that i'm back at my lovely desk job.

it feels like its never gonna be better, but reading reports from you guys has helped me be patient and given me tons of hope, soo....

that's all for now.

Drugs are good. I hit 9 out of 10 on the pain scale 15 min after hiking up up my three flights of stairs. 2 oxycode and 20min later life is dreamy. Besides that everything as been normal.

The doc was surprised I did'nt have more damage once he got in there with the scope. MCL healing is like a champ and miniscus were fine.

checking in again. doing pretty well. the worst thing now is just realizing that i'm definitley not skiing this season, which is starting to sink in. but that's just mental. and i'm hoping for some april spring skiing. and maybe i can get it strong enough to ski in march? i dunno. anyway. in terms of my actual knee...

it definitley doesn't feel like a normal knee, but it feels better (less swollen, etc) and i'm walking around pretty bomber now. every once in awhile i'll forget to pay attention to the darn thing when i'm moving it, which to me means it's feeling better, 'cause i'm not hyperpsycho vigilant about moving it slowly and carefully anymore.

still doing wall squats, raises, quad sets, hammy bridges, calf raises, stretches, etc. leg is starting to feel a tad stronger, but it's still amazingly skinny. i took my soccer legs totally for granted! trying to ride the bike as much as i can. i can last about 30 mins with the resistance pretty low.

rehab has definitley shifted from spa treatment to torture treatment, at least as far as the massage thing goes. but that's okay...i know its good for me. PT guy wailed on my quad muscle (it's amazing how tight it is for how little muscle is left) and scar tissue last time, and OOOOOO LORDY it hurt. and sometimes tickled. so its like this pain-tickle torture regimine. i laugh and lurch all over the PT table, its pretty funny. poor PT guy.

patellar tendon still bugs me on the stairs, but its slowly improving, so i'm relaxing.

anyone have any recently repaired acl acceptable winter activites to suggest? i'm thinking snowshoeing?

hey all, just a quick update. not much more to report beyond the six week mark, but i am walking easier.

switched PT people and getting much better experience from my new one. she's more patient, less busy, she listens, she skis, she understands, she challenges me. so advice to those struggling with PT people- don't be afraid to change! find someone that works for you!

did the elliptical machine for the first time today, nice to have a non-bike experience. still working on extension...flexion is pretty good...i can almost get my heel to my butt. and rubbing the heck out of my scars. my original PT person overlooked alot of the early patellar mobilization/scar massage activities, so i'm trying to make up for that now.

spent nine hours on my feet yesterday working at EMS and nothing bad happened. knee feels really good today and it isn't more swollen than normal, which is totally encouraging. i'm psyched to get on snowshoes and may xc skis in february. we'll see!

man, i wish i could ski this year. oh well.

that's all for now.

Originally Posted by ikkin

spent nine hours on my feet yesterday working at EMS and nothing bad happened. knee feels really good today and it isn't more swollen than normal, which is totally encouraging. i'm psyched to get on snowshoes and may xc skis in february. we'll see!

Nice 9 hours. Everything is normal here also. (Just about 5 weeks out)

Good to hear things are going well. It's interesting to hear the recovery story from a patient's perspective. I'm about to become a physical therapist... graduate in May with my DPT; in one of the final rotations now. Just gotta pass the licensure- one big hurdle left! I've seen a bunch of people with postop ACLs in my clinicals, and most people are super motivated to get back to doing what they love which of course helps with recovery time. It is crazy how the quad atrophies so quickly, eh? It's definitely important to be happy with your PT. I try to keep those things you describe in mind when working with my patients... we can cram our schedules with a million patients, but if we don't have quality time for each individual, those patients likely aren't coming back. It's something we don't often hear in the clinic, but it's interesting to see what patients really think on the outside. Good luck with the rest of your rehab and getting back to skiing.

I just hit 6 wks post op - ACL reconstruction(allograft) w/miniscus repair @ same time. Just got out of straight brace into permanent bendable brace. Feels weak but great to be bending with weight bearing again. I still have what appears to be too much swelling to me. But hate laying around w/my leg above my heart.

My regiment is much like yours. Expect Place of Torture (PT) to step it up a notch now that I can begin weight bearing excercises. Aptmt w/surgeon next week. Lots of questions...like what can and can't I do this winter. Accept that there will be no tele skiing, but would much like to take walks w/my dogs in the snow, some moderate snowshoeing - and what about snowmobiling? Its snowing today, and feeling incredibly antsy!

Keep the updates coming. I'll enjoy hearing what IS or ISN'T instore for me!

Sounds like things are going well. I relived a lot of my surgery and PT from reading this.

And percs made me so itchy it was unreal!!!! Head to toe. And a few hot flashes too. Men aren't supposed to get those right?

And I too came out of surgery shivering. I was cold they said, through the whole surgery. They had heated blankets on me. Wierd.

7.5 months out, have been boarding once at Solitude (2 WROD) and did fine, all day. Took a few needed breaks as the muscles just are not there totally yet.

Sore for 2 days after, but muscle sore, not ligament sore. Feels fine today.
Just got to get more muscle. More boarding Sunday!

Originally Posted by kathymuench

I and what about snowmobiling?

Keep the updates coming. I'll enjoy hearing what IS or ISN'T instore for me!

I would suggest NO on the sled. IF you get thrown, you could mess it all up. Patience sucks, but is needed.

My 2 cents.

Originally Posted by ikkin

my "demographic" info:

tele skier, snowboarder, hopeful future pound dog owner, lover of ice cream.
female, 28, 5'3'', 125
injury is a complete ACL tear, everything else looks good.

Reading your "demographic" info was like reading my biography, except I don't tele...yet. Sounds like you're making good progress. My graft was tissue bank cadaver, too. It took a season away from me, but now my operated knee is stronger than the other, which I've heard is pretty common.

I know several other people who didn't stick to PT as religiously as I did, and they have problems and little hangups. Keep it up!

thanks to all for the encouragement and good stories. it really helps keep me motivated and hopeful, especially now that its DUMPING on the east coast. it's so WEIRD to not be skiing!

but anyway,

Originally Posted by snowfire

Good to hear things are going well. It's interesting to hear the recovery story from a patient's perspective. I'm about to become a physical therapist... graduate in May with my DPT; in one of the final rotations now. Just gotta pass the licensure- one big hurdle left! I've seen a bunch of people with postop ACLs in my clinicals, and most people are super motivated to get back to doing what they love which of course helps with recovery time. It is crazy how the quad atrophies so quickly, eh? It's definitely important to be happy with your PT. I try to keep those things you describe in mind when working with my patients... we can cram our schedules with a million patients, but if we don't have quality time for each individual, those patients likely aren't coming back. It's something we don't often hear in the clinic, but it's interesting to see what patients really think on the outside. Good luck with the rest of your rehab and getting back to skiing.

snowfire, props to you for reading this board! my only advice to you, from a pure patient perspective: don't overlook the benefit of explaining things and laying out goals for your patients. all the protocols and progressions will probably be old hat to you- you studied them and you'll work with them every day- but the same protocols and progression will usually be totally new to each patient. they won't know what to do/when to do it if you don't explain it to them. and if they're like me, they'll want to know how they're doing. "you're doing fine" is not a good answer. "this is where most people are at this point, and this is where you are compared to them" or "this is where you are compared to the protocol" or "this is where you are compared to whatever and i think you can afford to push it _this_ much" are all better ones. good luck!

stay healthy everyone! more updates to come!