ACL Avulsion Fracture

[Jared4567]

I tore my ACL (avulsion facture, unusual for 34yoM) last year on December 8 (first day of my season) at Mammoth. I didn't hear the classic "pop" or feel immediate instability but it swelled up like a grapefruit and, after a week when the swelling had not subsided, I had x-rays taken at UCLA where the avulsion fracture was diagnosed by Dr. David McAllister. I returned to New York where I had an MRI and was examined by Dr. Michael Kelly at the Insall Scott Kelly Institute and by Dr. Andrew Rosen, at Empire State Orthopedics.

I saw Kelly because he had operated on a friend and came highly recommended -- he's one of the leading authorities on knee surgery, in New York, probably throughout the US. Rosen is much younger, but had completed a knee surgery fellowship with Kelly and had treated me several years ago for a minor running related overuse injury to my hip. I ultimately decided to have Rosen perform my surgery because: 1) he has a background as a serious marathon runner which I think allowed him to better understand the level of recovery I wanted; 2) I was happy with his previous medical care; 3) he gave me a very honest opinion about allografts that made me comfortable choosing that surgery (I had originally planned on autograft surgery based on what I had read on the internet, particularly in this forum); and 4) he's a very likable guy, especially for a surgeon.

I had allograft surgery with Rosen on January 8 at Mount Sinai in NYC. I took two vicodin before going to sleep that night and naproxen thereafter for about a week. I never really had much postsurgical pain or discomfort either at home or in PT. PT (Richard Geismar at SportsPT) was able to get me off the crutches, out of the brace, and back to full range of motion all ahead of schedule. After 6 months my scars are probably the smallest I have seen -- and I do not believe that I have any less tendency to scar than average so I think Rosen must have been very neat and clean with the cutting and sewing.

Happy to discuss my surgery with anyone via PM.

-Jared

[Edited for two type-os]

[pattyc]

Hi, I was wondering how long it was before you were getting around after the operation. Did they immediately have you stand on it? Did you have lots of Physcial Therapy? I was skiing on Wednesday 03/09/11 and fell in an ackward position and heard a pop and they have xrayed me and said a piece of my Tibia popped off where the ACL attaches. I had an MRI yesterday so I don't know the extent of my ACL; however, the PA thought it was intact. I was just getting ready to start golfing and playing tennis so I am really bummed. Any thoughts, suggestions, etc. would be appreciated. Thx, Patty

[avclark86]

I had an ACL avulsion fracture last year at the end of May. I've read that some people make a full recovery after 6 months, but for me I'm still struggling and probably always will. I was a competitive road cyclist and triathlete when it happened. It was 8 weeks post surgery before I started weight bearing, another 5 weeks to ease into walking and begin cycling again. I got major anthrofibrosis during the 8 weeks when it was braced. Overcoming that was awful, it took 4 weeks of unbelievable pain to get to 90 degrees, after that getting the remaining range of motion wasn't bad. I have a lot pain from the fracture area when my knee is hyperextended and the ACL is under stress. My surgeon can't explain why, but according to a post surgery MRI I got the fracture didn't really heal correctly and 50% is a fibrous non-bony union between the bone. That might have something to do with it.

I'm sure you've already had you surgery by now, all I can say is keep your head up and take comfort in the fact that other people have had this happen, active people. This is much worse than an ACL tear, as far as recovery time. 8 weeks immobilized is a killer. Be prepared for a very tough battle, but the progress you'll make with physical therapy is very uplifting.

If you have trouble regaining your range of motion, send me a message. I learned an incredibly useful way to regain my remaining range of motion past 90 degrees(now ~160 degrees), as well as a great method for 0-90.

[sagar]

Hi avclark86, I need your help. I had an ACL avulsion fracture in Jan. my knee was immobilized for 4 weeks and it is almost 7 weeks i am undergoing physiotherapy everyday. Intially bending (flexion) and straightening (extension) was very stiff and painful. Bending has now improved a lot, however extension is still a big problem. i still have stiff capsule and hamstrings. Physio and even walking is still very painful. I limp while walking, bcoz i dont get full extension and it is painful too. Please suggest what can be done to achieve the remaining range and reduce pain as well.

[sidewall]

I had an ACL avulsion fracture/bone contusion in March 2010. Two different surgeons wanted to do ACL recon but third doc re-Xrayed it and the bone was healing on it's own.

Range of motion was tough for a while- I didn't get full extension back for maybe 3-4 months. Didn't get full flexion back for probably 6 months. Strengthening quad muscle made a big difference in terms of overall joint stability IMO.

Hang in there. I just finished my season snowboarding and everything went fine.