ACL recon tomorrow!

[Hockey98]

Hello all,

Let me start off by saying I've been monitoring this board for quite some time (since my injury) and have read some very inspiring things that I believe will help me on my road to recovery.  I'm currently awaiting a call from the hospital where I will be having my surgery for them to confirm my time for tomorrow, and to say I'm nervous would be an understatement.  This procedure will be my first "true" surgery, and certainly the first involving a general anesthetic.

I feel like I'm fairly well informed about what is going to be done, thanks in large part to this website and other places online.  While I have faith in my surgeon and trust fully in his ability to repair my knee, he was certainly not very clear on how any of this will be happening.  I went to the office with my new MRI results and they scheduled my surgery immediately.  I think it is the fear of the unknown (anesthetic, pain after surgery, ability to play sports again in a reasonable amount of time) that is making me so nervous.

I initially injured my knee back in February of 2009, when I made a hit along the boards in a hockey game and felt my knee pop and immediately fell to the ice.  The pain was tremendous and I was helped to the bench where, miraculously, after 5 minutes the pain subsided and my knee simply felt, to put it plainly, different.  I returned to the ice and played the rest of the game and 4 more games the following two weekends before our season ended, when I finally went to get my knee looked at.  Between scheduling a visit, getting an MRI and a follow-up visit with the doc, I wasn't informed of the severity of my injury until the middle of April.  At this point, surgery would have put me on the shelf well into my senior season, and being the stubborn guy that I am, decided to rehab my knee and play through the injury, which I managed to do with flying colors.  I worked my knee diligently over that summer and played my entire senior season with only a few incidents with my knee.  At this point I took on the mindset of "who needs an ACL?" and went about my business without one.  That decision finally caught up to me a few weeks ago when, during a hockey game of course, my knee gave out and I was in that same amount of terrible pain.  This time there was no miraculous 5 minute comeback and I ended up further damaging my knee, tearing my medial meniscus.

So surgery is tomorrow.  Patellar tendon autograft. I'll be sure to let everybody know my progress as I'm sure I'll be spending more time than I care to imagine in front of this computer screen.

[sherwooa]

Good luck, Hockey98!  I'm sure everything will go smoothly, as it did for me nearly 2 weeks ago.  OK, I felt a bit nauseous after waking up from the general anesthetic, but they gave me some good IV stuff to take care of that and all was good.  I'm 12 days out now from ACL recon and meniscus trim (mine was not repairable) and feeling good!  I see my OS tomorrow and hopefully will get the brace off and will be ready to start official PT.  Like you, I am eager to return to sports (lacrosse being my primary) and Crossfit training, so I will be working hard on rehab and recovery. 

See you on the other side.

[Hockey98]

Thank you for your response!  It certainly helps being that I'm sitting around by myself just stressing over the impending surgery.  I am hopeful the nausea doesn't hit me too bad, but I feel fairly certain that I'm going to have some difficulty with it.  It sounds like you're doing very well...I can only hope my operation and recovery go as smoothly as yours.  I went back and read your thread and, as with many of the acl'ers on this board, you had a nerve block.  For some reason I will not be getting one, so I'm hoping that I don't wake up in excruciating pain.  But I guess we shall see.

Thanks again for your reply.  I'll be sure to keep the updates coming.

[roo222]

Hey good luck for tommorow! I had my recon 4 weeks ago (hamstring graft) and suffered from nausea, it wasnt nice but soon passed once they gave me something to settle it. I didnt have a nerve block either, when i woke up in the recovery room i was in a bit of pain but again, they soon gave me something which sorted it out!

Dont worry it will all go fine, and remember the doctors and nurses are all there to look after you! I think the fact that you played for a while with no ACL (wow by the way, no way i could have done that!!) will help you a lot in your rehab, because your surrounding muscles will already be pretty well strengthened.

Good luck, let us know how you get on

[Deepclue]

Good luck, buddy. Keep us posted.

[Snowy]

Best of luck with your surgery! I had my ACLr (also first surgery and anaesthetic) in July, and am well on the road to recovery now.

I didn't have a nerve block, and I would emphasize the importance of staying on top of the pain meds. I was a bit slow taking my first oxycodone pills and endured a really horrible few hours as a result. Once I got the meds on track, it was unpleasant for a couple of days but definitely manageable. I was surprised how quickly the worst of the pain passed. A good tip is to set the alarm during the night so that you don't wake up overdue for a dose; that's not a pleasant way to start the day.

I was pretty freaked about the anaesthetic as I hadn't had one before, but in the event it wasn't nearly as bad as I expected. Let them know that you're concerned about nausea and they can give you some anti-nausea medication with the anaesthetic.

Hope all goes well!

[Hockey98]

Hey everyone, thanks for all the support.  Some odd news to report today...

As I mentioned I was a bit nervous about the procedure.  Sitting around by myself for the majority of the day yesterday got me so stressed that I actually got sick, and they won't perform the procedure now that I'm sick.  That being said, the progress my knee has made in the past 2 days has been pretty remarkable as ROM has came back quickly (perhaps swelling finally subsided?) and aside from the absurd amount of atrophy from 2 weeks off my feet my knee is ALMOST back to feeling normal.  I'm not one for omens or anything like that but I feel like it may be in my best interest to work the knee for a week or so, see where I'm at and perhaps get a second opinion at that point.  I failed to mention in my initial post that this re-injury that I incurred on my knee was while playing dek hockey, which, for those of you not familiar is played on feet rather than on ice with skates.  The giving way was caused by an extremely quick cut (too much confidence in my knee at that point...that ended quick).  Anyways, being that my college (and competitive) hockey careers are over and I am now simply playing adult league hockey, I feel like I can get by in the instance that my knee is stable enough.  Ice hockey puts MUCH less stress on my knee than dek hockey as there is no pivoting or quick direction changes that require planting.  So I'm not sure what the final decision will be, I still have to weigh my options and see how much more my knee progresses in the coming days/weeks.  Any input or suggestions would be greatly appreciated and I will be sure to keep the board informed on what is going on.

Thanks again everyone for your support.

[sherwooa]

Wow, sorry to hear that hockey98, though I suppose if it gives you more time to reflect on your options then it's for the better.  As for me, even at 39, and even with my high school and college athletic careers long behind me, I didn't want to continue on in my weekend-warrior sports and regular training with a questionable knee, or have to wear a brace all the time.  That being said, it is certainly possible to go forward without an ACL, and my OS did present that as an option. 

My OS did say that if the meniscus was repairable that he would have to put in a new ACL to keep the meniscus from bearing the full load (it's a secondary stabilizer of the knee), but if it was only a partial meniscectomy that it was my choice.  He said that I could certainly strengthen the muscles around the knee and be pretty proficient without the ACL, but that I would need to wear a brace for any cutting or pivoting activities.  Of course, I would have a lifelong need to keep a decent amount of leg strength to keep the knee from giving way.  Now, I don't imagine that being a problem for the next 10-20 years, but as I get past 65 or so, I'm guessing it will be harder to train at my current level (or at least my levels prior to injury) and to maintain the same amount of leg strength.  For me, the sacrifice over the next 6 months or so will be well worth it to have the peace of mind and confidence in my knee.  Of course, I'm also fortunate enough to have a support system around me and a job that has allowed me to work from home for a couple of weeks post-op.

Anyway, it's certainly your knee and your choice, so you have to weigh the pros and cons.  Good luck with the decision!

[Hockey98]

Sherwooa, I certainly understand all of those points and believe me I have thought about them time and time again since my initial injury last year. I used to be a VERY active individual but now that college is done and most of my buddies back at home turn the weekend-warrior tag into the once-a-year warrior, which is generally a thanksgiving morning football game, the extent of my sporting activity is one or two ice hockey games a week.  However, I do go to the gym regularly and have no problem keeping my legs strong enough to compensate, or at least that's what I credit my previous ability to play without the ligament to.  I certainly understand, though, the fact that I will not always be the gym rat that I am now and if I decide to yet again forego the surgery that I might have problems in the future when time becomes even more limited.  As much as I wish I could have just gotten it over with yesterday and been on the road to recovery, this extra time will allow me to weigh some options, like you suggested, as well as get my strength back to where it was which will benefit me whether I do or do not have the surgery.  It will also allow me, as long as my knee keeps progressing as it has, to get back to work for a couple of days and make some MUCH needed cash.  Unfortunately I don't have the luxury of working from home, unless you consider XBOX work  , so a couple of months off of work is going to become a major obstacle if I decide to go ahead with the procedure.  Hopefully my decision becomes easier in the coming weeks.

[sherwooa]

Fair enough - only you can make the call.  And if you decide not to go ahead with the surgery you can always choose to do it later in life and when/if you decide to get back into sports more heavily.  In my case, I was out of active competitive sports for a number of years after college and came back to it about 6 years ago and really love it.  I just don't want to have to deal with a brace for the rest of my life and could take the short-term hit in terms of inconvenience and 2 weeks of working from home.

BTW, if you do continue to play hockey, etc. I would recommend getting yourself a good knee brace!

[Hockey98]

Well, here's an update for the small number of you who offered support and advice in this thread when I initially posted...

Not long after the initial surgery date I went to see another surgeon for a second opinion.  At this time I had regained full ROM in the knee and had spent a fair amount of time strengthening it in the gym.  He asked a number of questions, performed a couple of clinical tests on the injured joint and seemed kind of befuddled by my situation.  He seemed to think that my tear was not a complete rupture because he didn't feel a large amount of laxity in the injured knee.  Long story short, he suggested that I stay away from the surgery until it was necessary.  Well that appears to be now.

In the time that has elapsed since my last episode I have thought a lot about the day when I do need to get the knee taken care of.  During that time I felt pretty sure that, living in Pittsburgh, I would be a maniac to not have my knee taken care of by Dr. Freddie Fu at UPMC.  I have an appointment with Dr. Fu early Thursday morning where we will discuss my situation.  If the option is given and he wants to go ahead with the surgery I am going to undergo a double-bundle procedure, which Dr. Fu has become very famous for.  I'll keep you all updated after the visit.

[Hockey98]

I went to see Dr. Fu this morning and he wants to do surgery immediately due to the fact that my torn meniscus is keeping my knee from fully extending (not even close to full extension, actually).  He wants to do a quadriceps tendon recon.  Apparently my knee is bordering on not being large enough for a double bundle procedure, so I may have to go the single bundle route, but we won't know this until he gets in there and starts prodding around. 

So this coming Tuesday is the big day.  Pretty nervous already but this time I am certain that it absolutely has to be done, so I gotta do it.  I'll keep you all updated.

[Hockey98]

If anybody is keeping up with this, everything went well.  I'm about 18 hours removed from surgery and not in too much discomfort, although I have been very proactive in taking my painkillers and cicrulating the ice water in my cryocuff.  Also, I am not sure that the block has completely worn off yet. As was initially thought, my knee was in fact too small for the double bundle reconstruction (damn genetics).  So single bundle it is, although Dr. Fu assured me that this approach is every bit as effective as his double bundle approach as he goes to great lengths to assure that the reconstruction is as close to anatomical as possible.  The meniscus was also successfully repaired rather than trimmed, as I had feared it would have to be.  If anyone would like, I will provide updates as I have much more time on my hands than I need.

[dannieboy]

Hallo

Greetings from Copenhagen, Denmark.

I got a new acl in 09 using my own hamsting, big mistake I feel today, should have used allograft but I did not know that was an option at the time. Today 3 years later I can push my tibia 7-10 mm out from my femor but fortunatly I have no pivot shift. This is alot worse then before my surgery. I have had no trauma to the knee since my surgery.

Getting the back of my leg ( hamstings ) to feel normal is a challenge im still facing here 3 years later. I hear from my Pt that it could have been worse if I had gone the patella route.

I have had MRI and x-rays .  Graft might be to vertical is what one OS told me. The OS that did my surgery
says it looks fine and and could care less now that he has made his money. Never use Gillhøj privathospital and dr. Peter Angermann. He could care less about you when your not a potential customer anymore!

Anyways..

I am now thinking of traveling to the US to have Dr. Freddie H. Fu. look at my knee.

So any experinces from dealing with him, or getting surgery from him would be greatly appriciated.

Did you get a long and infomative consultation.
Did you get a CT scan?
His postop. care and consultation?
Did he prove to you he has placed the graft or grafts correctly? VIDEO -- PICTURES??
His view on autograft or allograft?

Best regards
Daniel
 

[Hockey98]

So far, aside from the pain I am current experiencing (which is obviously not his fault) my experience with Dr. Fu and his staff has been incredible.  When I initially went in for the consultation I met with a number of people, including Dr. Fu himself.  He personally talked to me for about 15 minutes and explained exactly what we were going to do and showed me my MRI along with measurements of both my acl and two potential autograft options.

So  far I have gotten calls from both his fellow (once) and assistant (twice) just to check on me.  They actually made an appointment for me tomorrow morning because of a slight complication that occurred on the other leg during surgery, which is remarkable considering he is undoubtedly booked every day - as evidenced by your willingness to travel cross-country to see him.  Your age would be a large determining factor as far as graft selection.  He suggested that we use my quad tendon because it is thicker than my patella, provided a more solid double-bundle approach (although we weren't able to go that route) and because I am young and he wanted my own tissue to assure I am able to get back to ice hockey.

And other questions I would be happy to answer.