ACL Class of 2012

[bendtheski]

First, let me apologize to everyone in Gimp Central for ignoring this forum for the first 2.5 yrs of my TGR experience. Glad it's here now though!

I came across the "ACL Class of 2011" thread while looking for people's graft preferences for ACL replacement. After several hours of reading, I found out that there doesn't appear to be one single graft source that stands out as being clearly better than another, and since I didn't have any strong convictions one way or another, I decided to stick with my doctor's recommendation of a same knee hamstring graft.

The main thing that I learned from the other threads is, if you have a preference one way or another, and it's not what your doctor is recommending/is most comfortable doing, then you should probably seek out a surgeon who specializes in the type of procedure you prefer, i.e.; if you really want an allograft, but your ortho is suggesting autograft, or if you've heard great things about patellar vs. hamstring, but your ortho prefers hamstring, then seek out an ortho who does nothing but patellar all day long.

Of course even if the ortho uses the method he prefers, there is some chance of complications, but I would hate to be in the position of insisting that a surgeon use an approach that he/she is not completely comfortable with, and then having complications arise that might or might not have been an issue if I went with whatever the ortho recommended in the first place.

I'll just add that my personal decision was complicated by the advice of several friends who've been through similar if not identical surgeries, who all said go cadaver (allograft). So guess who's not going to get any sympathy should the hamstring graft prove problematic?

Surgery is scheduled for Jan 4 so that might just make me first in line for the Class of 2012! I'll give Cedrik full credit for the excellent idea of creating the "ACL Class of 2011" thread, and am starting a 2012 thread for people to post their stats; injury dates, surgery dates, rehab progress, and most importantly, their return to skiing/snowboarding dates!

I also really like the idea of an on-snow Class Reunion at a date and time to be determined, for this year's ACL recipients to raise their braces in celebration!

Alright, down to specifics.
Me: 49, been skiing 42 years. First ACL surgery.
Doing hamstring from the same (right) leg.

Injury happened on Dec 2; very small huck into a hard left backseat bailout turn and pop! I put off surgery because deductable resets on Jan 1. Meanwhile, been doing lots of prehab; straight leg lifts, quad extensions, hamstring curls, lightweight squats, heel slides, calf and hamstring stretches, bike for 30-40 min a day, etc. I forget what they call the standing one legged exercises with an elastic band, but I started doing those too.

Pain is very manageable, ROM is right where it should be and swelling has gone down considerably since the injury. All that will likely change next week though…

CPM and TENS unit ordered for post surgery.

The orthopedic explained the procedure last week which includes the use of some PEEK material for the tibial anchor, and some bioabsorbable anchors for the femur.

I found a video for the Aperfix II system. I don’t know if that’s exactly what my ortho is using, but he did mention something molly-like being used for the tibial anchor made out of PEEK material. I think he’s using something different than the Aperfix II for the femoral anchor since the Aperfix II makes no mention of being bioabsorbable, but I could have it wrong. Anyway, if it’s good enough for hanging pictures on drywall…

I wouldn’t wish this type of injury on my worst enemy, but they are bound to happen, and my outlook is, there is much worse news a person could receive from their doctor than; “son, you’ve torn your ACL”. Still, it sucks to have your season cut short for any reason, so I hope this thread will provide some useful information and motivation/inspiration for everyone on the road back to action!



Will update post-surgery...

[bendtheski]

One more thing before I forget:

Prior to this injury I hadn't done any ski-specific early season training beyond cycling for cardio and hiking.

Loveland opened in mid October, so from that time until the time of injury (Dec. 2) the only form of regular exercise I practiced was railing blue cruisers 4 or 5 days a week.

I'm optimistic that rehab and some targeted training might actually help to step my game up somewhat, as many ACL replacement recipients have reported.

[mtl_ripper]

Fkna for your positive attitude. Hope surgery and recovery go well.

Sent from my Nexus S using TGR Forums

[ICEHOCEY77]

The old man got his done today. Injury occurred in middle of November playing rec volleyball against a bunch of 20 year olds (he's 50). Went with the patellar autograft, also had medial and lateral meniscus tears. In and out in 6 hours. Think his morphine haze is supposed to last another few hours and then oxycontin takes over. Guy that operated on him is the orthopedic surgeon for the University of Tennessee sports teams so he should be in good hands. Says it already hurts like a son of a bitch.

[BoatBound]

I joined the club on Dec 18 cruising down an easy blue at Steamboat, hooked an inside edge crashed hard: disclocated shoulder, Detached ACL and even a sprained ankle! All is good and coming along well. Riding the bike like above, the ankle kinda f's up the leg training but managing well. Looking like its a late Feb early March surgery date. I was thinking about trying to salvage part of the season and cruise easy groomers but I think that's not going to keep me very happy especially after a few days out so now my thoughts are to get it over with and salvage more of mtn bike season if possible. PLus it will make the wife happier so we can do things she likes too. thoughts? Oh, hamstring graft all the way.

[Cedrik]

Surgery is scheduled for Jan 4

Hope all went well! Enjoy the Perc's (don't forget to take the stool softener).

[BoatBound]

Hope all went well! Enjoy the Perc's (don't forget to take the stool softener).

FKNA! perc's suck. I was in the ER and they wanted to give me meds, I told them if it was Perc' no thanks

[bendtheski]

Post surgery pain was a little worse than anticipated, but still manageable with rx. Aircast chyro-cuff with intermittent compression=$$$$$$$$

In two days pain is down to where I'm walking around the house without crutches. Still getting some wierd muscle twitches in my quad. Maybe the block still wearing off.

Sounds like someone tied me for first acl replacement of 2012. Congrats and good luck!

Look at me, I can ski with my feet together!!!

[bendtheski]

They don't tell you about all the cool gadgets!

Or they did and I wasn't listening...

The CPM goes back tomorrow. I've had 90+ flexion for several days now, so this will save a few $$ on the machine rental.

Saw the ortho for follow-up and x-rays monday. Says everything looks good and gave me the PT script. He also gave me a neurotech Kneehab XP unit. Some of you guys might have seen or will be seeing one of these in the near future. I guess it's like a home-tems system. They call it a conductive garment system, whatever it's called, it does the same thing as the machine my PT uses, and the contacts are fixed to the inside of a neoprene cuff, so no guessing where to place them on the knee. It targets the VMO separate from the other quad muscles (sorry, I don't know all the names) and works them at two programmable settings for 20 min at a time. The controler and power supply are about the size of a small cell phone, and tuck into a sleeve on the neoprene wrap, so it's easy to set up and zap away just about anywhere!

Funny thing. When the ortho unwrapped my knee for the first time he said, "yep, looks like you were whacked with a baseball bat a few times, that's about right!"
We lol'ed, but it's a pretty apt description.

[tone capone]

That thing sounds really useful. My vmo really suffered despite alot of effort to get it back. If that thing prevents the total wasting of the vmo then you will have a much easier recovery. Don't underestimate how hard it is to get that muscle back.

[bendtheski]

That thing sounds really useful. My vmo really suffered despite alot of effort to get it back. If that thing prevents the total wasting of the vmo then you will have a much easier recovery. Don't underestimate how hard it is to get that muscle back.

Thanks tone, I'm gonna go session that bitch right now!

[tone capone]

Just make sure you have the p.t. stretch your quad muscle for you, it's gonna be hard the next few weeks.

[wolfelot]

I'm a successful graduate of 2011. Best of luck to you.

[ICEHOCEY77]

Old man got an infection in his leg. Doc explained it was like a rock being thrown in the pond. You have the initial hit and then the shock waves spread out. Apparently the infection had been making a run towards his heel. He's got some high grade anti-bios now and switched him off of the percocets onto some hydrocodone.

[tone capone]

That sucks.^^^ I just wanted to update this with some crucial info for you 2012ers.

I just read a very thorough, very unbiased and very informative tutorial on patellofemoral pain syndrome, a lovely side affect of knee surgery that is now threatening to end another ski season for me.

If you start getting "anterior knee pain" or any kind of pain under or around your kneecap, don't fuck with it. Don't do any squats, don't try to ski, don't try and push through this pain, despite what your dumbass surgeon tells you after listenting to you for 15 seconds.

Don't even put too much stock in all the bullshit your physical therapist will try and convince is helping when it's not (ultrasound, taping, strapping, ice, ibruprofen, quad and hip strenghtening to infinity, ketaprophen, and all the other shit they try and convince you is worth 150$ per hour.)

I had what I felt like a good recovery by months 8 and 9, the kneecap pain was still a nagging issue but lessening, tolerable. I did lot of pt, got back 95% of my strength, went skiing a few times, had great agility and stability.

But then everything this sobering tutorial said came 100% true in every way. At 20$ it was worth more than everything I ever heard my doc or p.t. say. I thought I should push through the last of the mild "annoyance" pain as per the advice of my doctor and physical therapist (that don't listen or feel what you feel, they just want to prove their own personal hypothesis about your pain, period).

At 10 months I thought I had done everything right and that it was my time to claim victory and reap the rewards. I skied hard for 3 out of 5 days and "pushed my pain envelope" a bit, but everything felt great.

But then, just like in this article, the pain started again within about 12 hours delayed onset of those harder ski days, and has gotten progressively worse as I tried to ski "one more time" and continue squats and other knee loading activities. (Again, going with the conventional wisdom of the medical establishment).

Now I sit here, haven't skied for 8 days, no reduction in pain, and it's actually worse than the onset at 10 weeks post surgery. I don't know if I'll even ski again this year at this point.

The moral to the story is that the only thing that I should be trying now is 3 months of no high impact knee loading activities (skiing), and even after that a very gradual return to those activities.

I believe it, because like I said I thought I was done with it, and now my pain level is through the roof and it feels like I have another injury to recover from. The same symptom the physical therapist and doctor said that leg strenghtening and "pushing through pain" would cure. I ain't buying it anymore. I think it's just the truth that the patellofemoral joint is a very sensitive, highly loaded joint that is very susceptible to chronic irritation once the trauma (in my case I believe surgery) occurs.

I only make this long post so you fellas can possibly avoid the pitfall, the viscious, misunderstood cycle of "patellofemoral pain syndrome", as I can assure you without any doubt, will take you off your skis just as definitively as being acl deficient. My new acl works fucking terrific, but I sure as hell ain't gonna be using the knee much anytime soon.

Best Regards and good luck.

[montanaskier]

So much for my advice eh Tone? That sucks buddy...rest up and remember this too shall pass. The rest of you guys just keep on keeping on, it'll come.

[tone capone]

No worries dude, I have just finally got some things through my thick head this last week, I know what must be done now in my best interest. It is clear but sobering. There is nothing more I want in life than to be a skier again and to do that I have to come to terms with the fact that I might have to give up on the rest of this season. (For sure it will dump now).

A doctor can put a new acl in there and give you stability, you can work really hard at getting your strength back, but there are complications assocciated with the trauma casued by surgery and there is no way to predict how that will affect any given individual.

The best acl graft job in the world isn't worth shit if you can't bear weight on a bent knee without extreme pain after 10 months.

Listen to your body, not the hot therapist or the genius orthopod if they tell you to ignore kneecap pain. LAY OFF IT and do the other therapies that doesn't cause that pain cause you WILL fuck it up for the future.

[bendtheski]

ICEHOCEY77,

Bummer about your dad's infection. My ortho had me on anti-biotics for the first few days post surgery. So far, so good. He also gave me a script for Oxycodone (percocet) and Hydrocodone (vicodin) both with acetominophen added. I've been tapering down, but am still taking the percocet at bedtime, as it's really hard to get comfortable long enough to fall asleep, and the wife hates the buzzing of my cryo-cuff all night (cue vibrator jokes). Fortunately, we have a guest room if it gets really bad.
Ice>percocet.

Tone,
It's funny, without having read your post, I found myself this week saying pretty close to what you've been saying. Even with the best surgeon, the most successful graft and the most dilligent PT, things might never get back to 100%, and even if they do, it might not be on the schedule originally forecast by the ortho/PT. But I intend to keep at it, as I'm sure you do.

The whole experience just sort of F's with your outlook though, huh?

OTOH, this injury has shown me a side of TGR that I barely knew existed, but that is proving more useful than pretty much all the others combined.

Keep posting the good info. I can worry about where to ski, sidecut profiles, taper, early rise, and who's cooler; skiers or snowboarders, next year!

Now where is this hot therapist you speak of? Pics or it didn't happen!:-D

[tone capone]

Hot, Tall, Blonde, and AUSTRALIAN. You best get yourself your own. Just try not to make eye contact while she's giving the knee rubdown, it can get confusing.

[bendtheski]

Giving new meaning to "let me show you my OH! face".

Look at me, I can ski with my feet together!!!

[ICEHOCEY77]

ICEHOCEY77,

Bummer about your dad's infection. My ortho had me on anti-biotics for the first few days post surgery. So far, so good. He also gave me a script for Oxycodone (percocet) and Hydrocodone (vicodin) both with acetominophen added. I've been tapering down, but am still taking the percocet at bedtime, as it's really hard to get comfortable long enough to fall asleep, and the wife hates the buzzing of my cryo-cuff all night (cue vibrator jokes). Fortunately, we have a guest room if it gets really bad.
Ice>percocet.

Yeah they had him on a 10 day supply of anti-bios after surgery too. He initally was on straight 20 mg oxy and a 10mg/325 percocet. Apparently his issue is a bad bruise running from his ankle to the middle of his hip. Kind of compared it to having a black eye all the way on your leg. The physical therapist said he had never seen anything like it. So now they've got him wearing a compression sleeve on his leg trying to reduce the bruising. Today was his first true day of physical therapy and he was able to switch from crutches to a cane. Was able to get to a 90 degree extension with the ultimate goal of 137 I believe. Said he was pain free after the session but was starting to get some back this evening. But making progress. I guess his PT guys are taking it easy until he gets the bruising down. He's still planning on taking a vacation to spring training in early March, so I guess we'll see if he's able to progress to then.

[bendtheski]

Yeah they had him on a 10 day supply of anti-bios after surgery too. He initally was on straight 20 mg oxy and a 10mg/325 percocet. Apparently his issue is a bad bruise running from his ankle to the middle of his hip. Kind of compared it to having a black eye all the way on your leg. The physical therapist said he had never seen anything like it. So now they've got him wearing a compression sleeve on his leg trying to reduce the bruising. Today was his first true day of physical therapy and he was able to switch from crutches to a cane. Was able to get to a 90 degree extension with the ultimate goal of 137 I believe. Said he was pain free after the session but was starting to get some back this evening. But making progress. I guess his PT guys are taking it easy until he gets the bruising down. He's still planning on taking a vacation to spring training in early March, so I guess we'll see if he's able to progress to then.

Interesting. I've got bruising around my ankle, which I'm pretty sure is just some of the fluid from the knee draining down to the ankle due to gravity. Also some bruising around the knee and thigh, but not all connected. It's amazing the variation of responses to what is essentially the same surgery.
Maybe this is due to different surgery team's accuracy with the baseball bat while you're under anethesia.

90 degrees is good this early on. Hopefully your dad's bruising and infection issues are easily straightened out and don't interfere with the vaca plans. I hope to be golfing with my Father-in-law in NC in April!

As far as PT, I'm mostly just doing heel slides, hamstring stretches, quad sets, straight leg lifts and very little time on the bike. I'm just going once a weeks since my insurance only allows 20 visits/yr. I'm going to try to make those visits count though. Deep tissue massage, assisted stretches, etc. I don't need to pay someone $150/hr to tell me if I'm doing my leg lifts right, I want them to work on the things I can't do at home, maybe show me some new stuff each time, and l'll take care of the actually doing them part on my own time.
Turns out without skiing, I have a lot of spare time on my hands...

[Axelerate]

Turns out without skiing, I have a lot of spare time on my hands...

I did to. I finally got around to making some skis
And I've been working on a version of the TTS (I'm a tele'r), which kept me productive. The only big benefit of my system over TTS is that I've integrated it, thus making a Telemark Integrated Tech System....
(I'm ACL Class of 2011)

[bendtheski]

That is pretty rad! Way to make good use of the down-time!

I'm pretty much focusing on PT and shopping for bicycle parts. I imagine it will start snowing here right around the same time I get my rebuilt Talas back from fox. After 5 years it was time for an overhaul, and I'm finally going to have the X cartridge replaced with an RLC. The X just never seemed active enough for me.

I'm sorry, what were we talking about? Oh yeah, knees. I got two of 'em. One's kinda sore...

[lookinback]

Please please please please find a new PT, you should not be pushing through anything. The collagen in tendons actually changes structure and vascularization during tendinosis which can be a serious condition...

That sucks.^^^ I just wanted to update this with some crucial info for you 2012ers.

I just read a very thorough, very unbiased and very informative tutorial on patellofemoral pain syndrome, a lovely side affect of knee surgery that is now threatening to end another ski season for me.

If you start getting "anterior knee pain" or any kind of pain under or around your kneecap, don't fuck with it. Don't do any squats, don't try to ski, don't try and push through this pain, despite what your dumbass surgeon tells you after listenting to you for 15 seconds.

Don't even put too much stock in all the bullshit your physical therapist will try and convince is helping when it's not (ultrasound, taping, strapping, ice, ibruprofen, quad and hip strenghtening to infinity, ketaprophen, and all the other shit they try and convince you is worth 150$ per hour.)

I had what I felt like a good recovery by months 8 and 9, the kneecap pain was still a nagging issue but lessening, tolerable. I did lot of pt, got back 95% of my strength, went skiing a few times, had great agility and stability.

But then everything this sobering tutorial said came 100% true in every way. At 20$ it was worth more than everything I ever heard my doc or p.t. say. I thought I should push through the last of the mild "annoyance" pain as per the advice of my doctor and physical therapist (that don't listen or feel what you feel, they just want to prove their own personal hypothesis about your pain, period).

At 10 months I thought I had done everything right and that it was my time to claim victory and reap the rewards. I skied hard for 3 out of 5 days and "pushed my pain envelope" a bit, but everything felt great.

But then, just like in this article, the pain started again within about 12 hours delayed onset of those harder ski days, and has gotten progressively worse as I tried to ski "one more time" and continue squats and other knee loading activities. (Again, going with the conventional wisdom of the medical establishment).

Now I sit here, haven't skied for 8 days, no reduction in pain, and it's actually worse than the onset at 10 weeks post surgery. I don't know if I'll even ski again this year at this point.

The moral to the story is that the only thing that I should be trying now is 3 months of no high impact knee loading activities (skiing), and even after that a very gradual return to those activities.

I believe it, because like I said I thought I was done with it, and now my pain level is through the roof and it feels like I have another injury to recover from. The same symptom the physical therapist and doctor said that leg strenghtening and "pushing through pain" would cure. I ain't buying it anymore. I think it's just the truth that the patellofemoral joint is a very sensitive, highly loaded joint that is very susceptible to chronic irritation once the trauma (in my case I believe surgery) occurs.

I only make this long post so you fellas can possibly avoid the pitfall, the viscious, misunderstood cycle of "patellofemoral pain syndrome", as I can assure you without any doubt, will take you off your skis just as definitively as being acl deficient. My new acl works fucking terrific, but I sure as hell ain't gonna be using the knee much anytime soon.

Best Regards and good luck.