ACL Class of 2017

[sparkletarte.]

Thanks buddy!

Yeah the hamstring part sucks. It's hard to- well I just can't- get a normal gait because my hamstring doesn't want to work. It'll come back.

I found this short vid that explains how the acl graft heals. This paper explains it in more detail. Very cool, the graft itself dies and serves as a framework for the the new cells the body sends there, stimulated by the dying graft. I had no idea! That is why there is the loss in strength from around the 6-12 weeks point- the graft is mostly dead, the new cells haven't figured out their new job yet, and the graft is getting new blood vessels.

Interesting in the paper he says that walking a lot in the first 6 weeks can cause damage by loosening the graft too much.

I like learning that stuff, it helps me heal and be patient.

[sparkletarte.]

wow I guess there's only two of us in class this year? how exclusive.

now walking without crutches around the house, started on day 10. test drove yesterday, I can do it so am now self sufficient, yay!

[Marshall Tucker]

Going up stairs "normally" was a big step, after driving, then down them normally. Of course, I had cadiver tissue so my recovery was much faster - good luck buddy!

[sparkletarte.]

Today physio said I am one of the 30% of people who has hamstring pain and issues from the graft. Docs don't know why. So it's going to be slow going at first although I'll get to where I need to be at the right time as long as I work at it. It means longer on the crutches, taking it easy with the hammy rehab, and more work on gait training.

Staples come out tomorrow!

[wyeaster]

patience and perserverence. good luck.

[sparkletarte.]

still chugging along, week 5. Last week was good, got full rotation on the bike. Last 3 days haven't been the best... I think I did too much calf and hamstring work last week and now they are both sore as well as behind my knee. Plus right now in the process my graft would be dead so I guess my body is busy dealing with that. Have spent a good chunk of the past few days on the couch. Lots of strong pressure massaging my scars to prevent scar tissue.

Sure is a longer recovery than the injury!

[yeahman]

Sounds pretty normal to me for hamstring graft. Don't discount the benefits of the soft tissue work at this stage, i.e strong massage, and also K tape for support if you are feeling pain in the knee.

Make sure your kneecaps are tracking freely when you flex your quad muscles and relax...mine got hung up on scar tissue and it took a PT to massage them loose, that made a big difference. There are some videos on YouTube about this. Hang in there!

[margarita]

Hey all, hate to be joining the club here but as of May 1st I get the joy of knee injury bliss!

I would really love some feedback on my progress and doctors actions thus far! I am a 51 year old female on my 26th day of 2016/2017 fell wrong....really wrong. MRI showed a Grade 2-3 tear on my MCL, a 1/3 of my ACL (middle portion all the way through), a small tear on the tendon running from the MCL to the patella as well as severe bone bruising. Referred to Ortho doctor at the Glen Sather Sports Medicine clinic in Edmonton Alberta, was referred to physio and that is where I am currently. No surgery was recommended at this time. Physio is going well, range of motion is greatly improved, strength is improving (short little bike ride on gravel the other day! woo hoo!!).

Im really concerned about long term and would love to hear about anyone else's experience with this type of an injury! TIA

[Marshall Tucker]

^ can't help ya too much. I'm right at 4 months out and last tuesday started at least trying to run again. before that, maybe starting three weeks ago, was running on the treadmil maybe 1-1.5 miles @ 10m per mile, small grade. So last monday-tuesday tried running an easy 2.3m circut around 'hood and steezus freakin christ my back is killing me (shades of MMP). don't know what I did. but, starting to run again a week later/last night and it seems marginally better.

Hit the gymn hard, is all I got.

[mtnbikerskierchick]

Hey all, hate to be joining the club here but as of May 1st I get the joy of knee injury bliss!

I would really love some feedback on my progress and doctors actions thus far! I am a 51 year old female on my 26th day of 2016/2017 fell wrong....really wrong. MRI showed a Grade 2-3 tear on my MCL, a 1/3 of my ACL (middle portion all the way through), a small tear on the tendon running from the MCL to the patella as well as severe bone bruising. Referred to Ortho doctor at the Glen Sather Sports Medicine clinic in Edmonton Alberta, was referred to physio and that is where I am currently. No surgery was recommended at this time. Physio is going well, range of motion is greatly improved, strength is improving (short little bike ride on gravel the other day! woo hoo!!).

Im really concerned about long term and would love to hear about anyone else's experience with this type of an injury! TIA

I don't know how the medical system in Canada works, but if you ski, you need an ACL. Otherwise you're highly susceptible chance of tearing your meniscus and other things. So, get the surgery if you can. I rolled for quite some time w/o an ACL this last time around, and I have to say, I'm happy to have it back.

Oh, and what I have to say to above comments - don't go allograft (cadaver). It's SO much more likely to tear, which is part of the reason why I had to have a third repair done. Yeah, the recovery feels great at first, and then not so much, and then... Use your own tissue. It will gain blood supply better and faster. It will become a part of your body better and faster instead of hanging around like a brittle rubber band in your knee. BTB is extremely painful and 20 years later the missing part of the tendon still causes me problems. But, the ACL feels bomber. Last November I had a quad tendon as my graft for my third surgery (opposite knee of the BTB, but the first one in that knee was allograft). It feels amazing. I can lift more weight and do more things at 8 months post-op than on my knee where I had BTB.

I'm on my 3rd ACL recovery now. Feel free to ask questions. That goes for anyone.... I've been lucky to have some great mentors to help me recover in the past. And at this point, I know a hell of a lot about knees. I'm always happy to pass it on.

[uglymoney]

Mtnbikerskierchick knows way more than me, and I didn't want to jump in here with my relatively uncultivated thoughts, but now that she has chimed I totally agree. After my patellar acl surgery my knee feels so much tighter than it was pre blown acl. My surgeon (who does a ton of knees) told me that the newer cadaver tendons are not irradiated thus they aren't as likely to blow as they used to be but I felt more comfortable going autograph after I was peppered with anecdotal stories from people I know and the people they know of post surgical failures from allographs. Also a friend of mine who is a great skier and in his fifties had patellar surgery the winter before and he was skiing strong. Looking back pre-surgery I always had a sharp pain climbing stairs in ski boots and some other weird stuff after a bad waterski jump fall I took years ago (landed sideways going fast...tweaked knee but recovered without medical intervention). My guess is I damaged but did not completely tear my acl then and blew it Feb 2016. Anyway that weird pain that plagued me for years on bootbacks is now completely resolved.

They can wrap your intact but damaged acl with another tendon. Not sure if that is a good idea because a guy was telling me a nightmare story about that this winter where they made the knee too tight but I would consult with doctors to see what your options are. Skiing with a torn acl seems like a sure prescription for future injury to me.

Definitely check out mtnbikeskierchick's blog over at 14ers. Lots of great info. https://14erskiers.com/blog/2017/03/...-knee-surgery/

[Marshall Tucker]

^ to this discussion, I specifically asked for the stud-muffin ACL doctor in the 95+ mega orthapedist practice in my large metro area. That dr strongly recco. allograft / cadiver material (again I'm now 53). I can't speak to the strength of the graft, but I was playing "lighter" tennis about 3 months out without a lot of problems. at almost eaxactly 4 months I can say I'm maybe 90% back to where I was.

When I pushed a bit on the hamstring graft, Stud Doctor was sorta "well why did you ask for me if you don't trust my judgement." I think age has a lot to do with it, and the more I read, if you stay active; ACL repair in your 50s translates to a full knee replacement in your 60s. but, hopefully by then the technology will be better, meniscus grafts, etc.

[yeahman]

^^I don't think I'm going to need full knee replacement. My surgeon seemed pretty convinced the hamstring graft would outlive me, and based on how my knee feels I'd agree. It's solid as can be, and no residual pain at all.

Speaking of my doc, the other day I was coming down the trail off Mt. Helena (local hike) and a guy ran past me going the other way. I didn't really look at him too closely. Then a minute later I hear somebody yell from up the trail, "How's the knee?" Took me a moment to figure out it was my surgeon who just ran by me. "Good!" I yelled back, even though I couldn't see him. "Good!" he yelled back. It was funny.

Kind of speaks to something I noticed about this guy from the get-go, which is that a large part of his self-image and ego are tied up in successful outcomes. It's a relatively small town, so it's probably quite common for him to run into his former patients. Something to consider when choosing a doc. More than one PT tried to convince me to travel to Bozeman or Missoula for surgery, where there are more and supposedly better docs, but I'm glad I stayed in Helena and had this guy do it.

[sparkletarte.]

3 months yeah baby! so happy to make it to that milestone, heard many stories of 10th/11th week retears so I made sure make my acl #1.

everything is going excellently. Just spent 5 days at a rave dancing for hours with a brace on... barely any swellling or pain. rehab testify!

Now I'm on plyometrics, hiking, swimming, weights, more biking.... time to get stronger!

[uglymoney]

Nice sparkle! Keep us updated. You'll be dancing without a brace soon.

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[wyeaster]

3 months yeah baby! so happy to make it to that milestone, heard many stories of 10th/11th week retears so I made sure make my acl #1.

everything is going excellently. Just spent 5 days at a rave dancing for hours with a brace on... barely any swellling or pain. rehab testify!

Now I'm on plyometrics, hiking, swimming, weights, more biking.... time to get stronger!

way to go!

[ma176e]

I'm a member of the club no one wants to be part of! Tore my ACL in 2017 (Jan). I do not think I'll be "graduating" in 2017 however.

[ehigh]

Joining the club.

I tore it on Mount Shasta at the end of May. Finally got an MRI at the end of August. Still undecided on which graft to get. I'm 24 and besides skiing do a lot of mountain biking, running, yoga, and have thru hiked the PCT and would like to do a couple more thru hikes. I've been reading through here and still haven't figured it out. Just checking in.

[gnargnarshredski]

Joining the club.

I tore it on Mount Shasta at the end of May. Finally got an MRI at the end of August. Still undecided on which graft to get. I'm 24 and besides skiing do a lot of mountain biking, running, yoga, and have thru hiked the PCT and would like to do a couple more thru hikes. I've been reading through here and still haven't figured it out. Just checking in.

Talk with your doc about hammy vs donor vs patellar. I have torn my right knee up twice and did a hamstring the first time and a cadaver the second (opted for a hamstring again but a medical error resulted in using a cadaver - I'll get back to that). Depending on your age (I am 31, was 27 & 29 at the time of my injuries), there is no definitive answer about what is best for whom, but in my discussions with my docs, they shared studies where basically it was determined that in younger people, using your own tissue is advisable (be it hammy or patellar vs cadaver) as there is no risk of rejection of your own tissue and it's going to be very strong. As you age, the theory is that a younger donor's tissue is likely stronger than your older-age tissue, and a cadaver might be a stronger/better outcome. In theory. Where this tipping point is is relatively unknown but believed to be around 30 - again based on this study I was told about -Might be worth trying to find more info on that if you're curious.

In any case: I had a buddy do a patellar graft in 2006 - he has this big old scar down the front of his knee and the scar tissue still gives him some trouble and pain and he's always had trouble sitting on his knees ever since due to the discomfort. Having had both my hammies removed, my scars are like 1.5 inches each on my shins and not noticeable or ever uncomfortable. My hammy graft after my initial surgery (skiing accident - blew up ACL/MCL/LCL) was great - I was back to 100% at about 6 months (which is fast) and feeling great, did not use a brace (another discussion topic) but felt back to 100% and as good as new. At about 18 months, long after I'd stopped even thinking about my knee as an issue, I was playing lacrosse in a men's club league and got hit hard by some 220lb douchebag right as I planted my leg to pick up a groundball and pop, blew the ACL and my meniscus folded over (they had to trim out 75% of my medial meniscus in surgery) - I believe this would have torn my knee up whether or not my knee had been operated on previously.

Second operation, I opted again for my hammy but from my other leg - again, it seemed like the best option and I felt that the second tear was inevitable whether I had prior knee injuries or not. In surgery, an OR tech was to hand the surgeon scissors -
the scissors were caught in sutures made in my new ACL graft and when picked up from the table, the graft came with and fell on the floor during operation - out of fear of infection, they opted to use a donor graft - fun stuff! But regardless, the second injury took me about 9 mo to heal and I do now wear a brace -while you can still tear an ACL in a brace, it does provide support in certain ways and considering my history I prefer to use it.

More than you asked for, but my point is - I had to rehab my knee and hammies twice - one hamstring in each leg. My hamstrings are certainly more prone to strains/pulls now and I have to be pretty careful about stretching them before activity (I'm way more flexibile in my hamstrings now lol), but I would certainly recommend over the patellar based on my buddy's experience and based on discussions with my doctor's and physical therapists who seemed to unanimously agree that the patellar graft is a higher likelihood of long term discomfort.

[uglymoney]

I had the patellar graft and I have a small scar that is almost invisible on the front of me knee. You have to be looking for it to see it. Also no pain kneeling or other issues from the front if knee @ 19 months. 46 now 44 at time of surgery.

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[Marshall Tucker]

I'm back playing tennis as hard as ever (4.0). Running 5 miles or so. I'd be a liar if I said I didn't "feel" the joint. I do think I'm as good as before but before. well. I was 52. now I'm 53. Don't nothin work exactly how I want it to no more.

I don't wear a brace or anything. Obviously from above donor material. I was in the weight room pretty hard, every night, for I guess 3 months. pretty much stopped after that when I felt ok running again and playing tennis. I live a long way from the slopes. probably won't ski this winter, by choice. unless a big storm comes through this area. for me, sking = cocaine. Expensive and worth every penny. Just can't do that much based on where I live. Tennis = weed. What I do all the time. Running = Beer. When the other two arn't available.

YMMV.

[Alaskan Rover]

Ah Fuckity fuck. After skiing 10-30 days a year for the last 35 or so years...beleive I have finally punched my ticket to this club. On a tiny jump on a wet southeastern slope about 3:00 PM yesterday. Doc drew fluid this AM, said it was bloody and that is pretty damning for either ACL or bad meniuscus tear. waiting for MRI to be scehduled. He said given my age (a litl bit north of 50) recommends Cadiver tissue, doesn't like pateller and hamstrings are for kids in thier teens/20s, so he says.

So i did a little reading, I gather they schedule surgery off just a bit, you work out pretty had bulding muscle before surgery, then lots of PT after. Others go the Cadiver route? continuing to read...

I'm an alumnus of the college of ACL twice! 1984 and 1999....same knee.

First was an open hamstring autograft... Successful. This was from just a silly fall while traversing mid-slope to get better aim at some mogels. But sometimes that's how it happens!!!

Lucked out and got the team surgeon from a major school to do the repair.

This open totally non-arthro hamstring autograft was a complete and full success.

1999 - snapped that ACL again......but this time from physically abnormal circumstance....my friends were helping me move my old antique grand upright piano (those things are heavy!!!) on a ramp into a van to get refinished....and the damn thing was about to go off the ramp and crush my friend..so I used the biggest muscles in my body to counter that...my leg muscles. Tweaking my knee in the process.

This time got lucky with another team doctor...this time Dr. Pedegana from Seattle Mariners and UW. He opted for a arthroscopic patella ALLOgraft. 6 months physio at UW PT Dept, and the allogtaft has been a COMPLETE success. Still rematkedably tight and strong 18 years later!

So I've had success with both autografts AND allografts. The only reason I went into detail on what had caused the 2nd ACL reconstruction was to show that was an abnormal situation with an abnormally heavy weight. Prior to that incident, the original knee recon was tight and strong for all outdoor activities.

Sure, there is a bit more laxity in the operated on knee than in other knee...but no surgergical intervention will get you 100℅ pre-surgery levels...that is what both surgeons always told me, anyway. And it is really only laxity noticeable in a Dr.'s office, not in daily sports activity.

Lessons:

1) Always try for a sports surgeon, preferably a team surgeon for a well-respected team ( figuring the surgeon will have already been very thoroughly vetted).

2) USE A PIANO MOVER!!

[sparkletarte.]

6 months baby! hard to believe it's been that long. Feeling good, patella is doing way better so I can do more stuff. Rehabbing daily. Muscles are returning. Went for a 5k hike in the snow last weekend, felt pretty solid.

Saw my surgeon today who said I shouldn't ski/ride this winter. He said my graft is in great shape, and my knee is otherwise too, but he still says not a good idea. Maybe at 10 months would be ok but still. he doesn't believe braces are all that effective.

Contrast that with my physio who said I could do easy groomers in a month. With a brace. She said it's mainly mental at this point.... the doc's comment doesn't help that. I re-injured it a month after the first time- on an easy groomer- on very bad physio (different one!) advice, so mental is a thing.

I'm making an appointment with the sports doc to see what she says.

Honey bought my pass and didn't get cancellation insurance on it.

so yeah. ???

[::: :::]

Go V!!

[uglymoney]

My doc said 6 months but I wasn't ready then. Did a barefoot waterski set around 7 months and it scared the shit out if me and everyone in the boat. Finally in on the snow @ 9 months and could ski groomers fine. Some heavy powder in January in Utah was tough, had to pick my way through it. By March (12) I was skiing most everything at JH but slower than before. This summer my slalom skiing essentially returned to normal around 16 months out. It takes time. I think you can be your own decision maker.

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