How do I know if my ACL graft failed??

[Queenie]

First some history...

9/2003-Complete ACL tear and medial meniscus tear with tibial fracture after a footchase and fight...Surgically repaired with a patellar tendon autograft. medial meniscus repair and was back to work in four months. No issues whatsoever.

10/2005-After a footchase and fall, I thought I tore my medial meniscus again. Went to the doc and just RICE'd it for a week and was good to go again...or so I thought. Dealt with a chronically unstable knee with intermittant swelling for about two years when I finally said enough! Went to the same doc, had an MRI that showed a complete rupture of the ACL and another medial meniscus tear. Had my 2nd ACLR 9/24/08 and the removal of all but about a third of my meniscus. My surgery lasted 4.5 hours and the doctor said in recovery that had he known how bad my knee was going to be prior to beginning this surgery that he would have replaced my knee! Jeez! I'm only 42 but he showed me pictures and the damage to the articular surfaces was extensive.

Ever since I started PT, I have had pain on the medial side of my knee (almost constantly) inside the joint. The doctor's answer was "that'll probably never go away completely." WTF? I also have a positive Lachman's (sp?) test which he tells me he couldn't fix...At week 8 in PT, I started working on lateral stability exercises but the pain is terrible so I've backed off doing those. My knee feels more unstable now than before I had the surgery and there is a definate shifting and popping each time I take a step. I have pain in varying degrees all of the time and swelling. Having gone through this surgery and rehab before, this go-round is very different than the last time and I'm concerned that the graft may have failed. At what point can the determination of graft failure be made? The thing is, that if it's already gone south then I'd rather fix it now that wait longer to have to do this over again.

Any ideas???

[drmark]

MRIs of ACL grafts are very unreliable.
The best answer is with instrumented knee laxity testing-the KT-1000 or KT-2000.

Find a doc with one.

[Queenie]

Thanks Dr. Mark...I'm going to figure out a way to tactfully bring that up when I see my OS tomorrow. If he doesn't have a KT machine then I'll go to my case worker (this is a work comp injury) and tell them what's going on. Hopefully that won't be necessary...