ACL reconstruction surgery & rehab

[Lee272]

Hi all,

I have my surgery on Monday to reconstruct my ACL after a Motocross accident in April. These last 6 months seem to have taken forever and I'm still not 100% sure whether or not I should be going through with the surgery! Since my injury I have been able to get my knee back into really good shape and it doesn't hold me back at all anymore. I am able to run, swim, mountain bike etc.. I've decided I need the operation though for a few reasons, probably the most significant is the fact that about 4 months after my injury I did a few laps around a practice track on my motocross bike and nearly hyper extended my knee twice, it just didn't feel right. So I think I know deep down that my knee won't ever be strong enough without the operation no matter how good it feels during normally day to day activities. I'm just not ready to give up the sport I love. I'm also concerned about the long term effects of living without an ACL and the damage to cartilage that this can cause.

So anyway, I have my surgery on Monday. The only good side about having to wait 6 months is that I've been able to do loads of research about the operation and in particular the choice of grafts etc... After a lot of thought I have requested the bone-patella tendon-bone graft. I've spent many hours on this forum and read endless medical journals, this has led me to decide that I can put up with slightly more pain, a longer recovery and pain when I kneel for the more stable end result that the patella tendon graft seems to give. I hope I have made the right choice but suppose that I'll never know!

I suppose it's normal to be having all of these doubts before the surgery. Have any of you guys found yourself with the same doubts before surgery?! I'm a pretty determined person though and actually manage a gym so will be putting 110% into my rehab. I'll keep you all posted because I intend to keep a diary on here about my rehab. I have found other people's really useful over the past 6 months.

Cheers

[Lee272]

Day 1

So my operation seems to have gone really well. It was at 11am yesterday, I was given my own room for recovery and I was able to get a full night's sleep which was brilliant. The pain has been far less than I was expecting, the worst thing has been the feeling of having an awful hangover from the combination of the general anaesthetic and morphine.

I had my first session of very gentle physio this morning and was discharged from hospital at 1pm this afternoon. I haven't needed to take anymore pain medication which is a really surprise, although the hospital have given me oral morphine etc... which I may need to take tonight to help me get another good night's sleep.

I am on crutches for approximately 3 weeks apparently and have been told to wear my brace when moving. It is currently locked to 0% and is quite uncomfortable so I've taken it off while I ice it on the sofa.

So far so good though and I will try some more exercises tomorrow.

[Lee272]

Day 2

First full day at home post-op. The pain is manageable with just paracetamol and ibuprofen. I didn't have too much trouble sleeping last night either.

I've done a session of basic exercises today which were given to me by the physio. It's frustrating as I don't actually seem to be achieving anything. My quad muscles are still 'asleep' and won't contract, I can only bend my knee about 30 degrees and full extension is very painful. I'm sure things will improve with time though, it's only 48 hours since my surgery.

I'm trying to remember to ice my knee as much as possible and wear the compression stocking whenever I can.

Cheers

[Lee272]

Day 3

I'm getting bored of being at home already! Thankfully my wife has booked the week off work to look after me and entertain me, it's made life a whole lot easier so far.

My exercises are going well. They are less painful than yesterday but I'm still not getting much more movement yet. I've been working hard on the heel slides so hopefully I'll start to notice an improvement in the next few days.

Also the ice and compression stocking don't seem to be doing much to reduce the swelling but at least it hasn't got any worse, which is maybe the point. I'm having my dressing changed by the nurse tomorrow morning and I've made an appointment to have my staples taken out the following week.

[Lee272]

Day 4

I had my dressing removed and wound checked today. Apparently everything is healing nicely and I should try to keep the wounds uncovered as much as possible around the house now which is going to seem weird at first!

After the doctors, we decided to have a little wander around Tesco just to get me out of the house for a bit. We borrowed one of their wheelchairs and spent about 30 mins looking at the clothes and DVD's but my leg started to swell up so now I'm back at home on the sofa with my leg elevated.

Got to crack on with my exercises again soon but I'm not expecting any huge improvements today either. Still the pain is far less than I was expecting and I'm really happy with how the first 4 days have gone. 

[Lee272]

Day 5

Woke up in quite a bit more pain today, probably about a 6-7 out of 10. I couldn't understand why and it was worrying me a bit until I took off my brace and compression stocking to see my leg starting to go yellow. It seems like the swelling as started to go down and the bruising has started to come out. It's this bruising that's causing the pain, especially when I go from lying down to standing up and the blood rushes to my leg. I suppose this is all normal though and the pain is still bearable.

Been continuing with my exercises and using ice afterwards. Not sure if my lack of flexion is normal so I've just decided to persevere until my physio appointment on Tuesday. I have read on here that getting full extension is harder and so it's more important to work on this initially. I am pleased to say that this is no problem and I've got full extension already.

Cheers 

[jarv]

I remember well that rushing of blood sensation when getting up, particularly when taking a piss. Hurt like hell!

[Lee272]

Day 6

Almost a week since my operation, I remember how scared I was this time last week! It's such a relief that the operation is over.

My leg has gone some really dark shades of purple, particularly behind my knee! The pain is still quite intense when I stand up. Luckily my wife is off work so I've been able to spend most of the time on the sofa today and I haven't had to take any of the oral morphine that the hospital gave me...it makes me feel really sick.

Despite the pain I've done my exercises twice already, so I'll probably have time to do them 4 or 5 times today. I'm happy with the way they're going and today I've finally managed to 'wake up' my quads in my left leg which is a weight of my mind. Until today I've been trying to contract my quad muscles but they've been like jelly!

[Lee272]

Day 7

No further progress today, all in all it has been a pretty boring day stuck on the sofa!

I've done my exercise 4 times but there doesn't feel like there's been any improvement. I've got physio in the morning so it will be good to find out whether my range of movement is as expected.

[MUMofpain]

Hi. You sound like you are really doing well post op.  I hope all continues to be so good and you recover to full health and strength.

My 17 year old son tore his acl last year in September playing football and had his hamstring reconstruction in January.

He is Motocross MAD and just before his injury we bought him a Yamaha 125, got a tow bar put on the car and purchased a trailer so we could get him to a track. 

Unfortunately due to the injury, he hasn't yet been out on his bike at all but at the weekend we bought him some Dom joy braces.  He is going to have a go on his bike as soon as the braces are sent to us (should be tomorrrow).  I'm a bit of a nervous wreck and am hoping these braces live up to all the hype about them protecting the acl.

When all is healed up and well with you, are you going back onto your bike and will you wear braces? 

[Lee272]

Hi. You sound like you are really doing well post op.  I hope all continues to be so good and you recover to full health and strength.

My 17 year old son tore his acl last year in September playing football and had his hamstring reconstruction in January.

He is Motocross MAD and just before his injury we bought him a Yamaha 125, got a tow bar put on the car and purchased a trailer so we could get him to a track. 

Unfortunately due to the injury, he hasn't yet been out on his bike at all but at the weekend we bought him some Dom joy braces.  He is going to have a go on his bike as soon as the braces are sent to us (should be tomorrrow).  I'm a bit of a nervous wreck and am hoping these braces live up to all the hype about them protecting the acl.

When all is healed up and well with you, are you going back onto your bike and will you wear braces? 

I hope all goes well and that he loves his Yamaha, I had a YZ125 a few years ago and it was a brilliant bike! I'm sure his knee will be fine on the bike, especially with a pair of Donjoys, but if there's any sport where knee braces won't save you it's motocross! My physio has told me that he isn't convinced by knee braces due to the fact that they only attach to your skin. The skin has so much movement in relation to the bones that the braces will move enough to snap the ACL even when they are done up as tight as possible...especially when doing 30 mph, wearing heavy motocross boots and with the momentum of a 95kg motocross bike. For proof of this look at all of the pro motocross riders who have snapped their ACL wearing custom made carbon braces worth over £2000!

That said, I will CERTAINLY be returning to motocross when I'm healed. I can't get it out of my system that easily......although my wife wishes I could! I've made the decision to wait at least a year, partly due to the fact that the patella tendon graft which I had takes slightly longer to heal. So it will be Nov 2012 or more likely spring 2013 until I'm back on a bike! I will also be investing in a decent set of knee braces like you have done for your son. Despite what my physio told me and despite the huge cost, I think any added protection for my operated knee is essential. I also know a few riders who have twisted/hyper-extended their knee and claim that it was the knee braces they were wearing that stopped them getting injured......everyone has their own opinion on knee braces.

I suppose it all boils down to the risk. Are you and your son prepared for him to snap his ACL again? Is motocross worth it? For me it is. I get so much enjoyment out of motocross that I'm prepared to take the risk of injury.

Anyway, tell your son to enjoy himself......I'm seriously jealous! 

I

[Lee272]

Day 8

Today has been a good day. My first proper physio session and it couldn't really have gone better.

She measured my knee flexion at 90 degrees and extension at 0 degrees. Apparently both of these are good for a week post-op. She was very pleased with how much the swelling had gone down (thank goodness the chore of getting frozen peas in and out of the freezer has paid off!) and the fact that my muscle tone in my quads has started to return already.

As such she has given me the option to get rid of the brace altogether (I have made the decision to keep it just for sleeping for another week or two, especially whilst I've still got the staples in). She watched me walk with crutches without the braces and has given me some pointers. Then she showed me some more exercises to recruit and strengthen my quad muscles so that I can start walking unaided sooner. These were VERY basic and it was almost laughable that they hurt so much! Basically they revolve around standing behind the sofa for support, standing on both legs equally and then transferring my body weight from one leg to another. Then a very shallow squat, again holding the sofa for support and finally standing calf raises holding the back of the sofa. All the time making sure that my operated leg is doing an equal amount of work.

I'm obviously going to carry on with my heal slides etc too and hopefully by Monday next week (2 weeks post-op) I will be able to walk unaided. This is my aim anyway. From that point it should all be plain sailing I hope. The biggest thing for me at the minute is definitely to be able to walk and carry things at the same time, like a cup of tea or my lunch!

Anyway, we went out for a pub dinner to celebrate as well. It was good to get out of the house.

[MUMofpain]

.... For proof of this look at all of the pro motocross riders who have snapped their ACL wearing custom made carbon braces worth over £2000! 

aghhhhhhhh I FEEL SICK 

[Lee272]

Day 12

I've made some really progress this morning, I managed to walk from the lounge to the kitchen without my crutches touching the floor! It may not sound like a lot and my knee is aching a bit now but at least it's something. I've just got to keep making these small improvements everyday and then I'll be back to the gym before I know it, doing proper rehab exercises like the stationary bike and doing squats and lunges etc... I can't wait!

One thing that has really struck home lately is that I need to be doing my exercise slightly more often but for shorter periods of time. I've been doing my whole routine 3-4 times a day but for up to an hour at a time. I think this has been putting too much stress on my knee and making it tighten up too much in between. For the last couple of days I've tried doing the heal slides etc about 5-6 times a day just to keep my knee loose and it seems to be working. After each time I've been trying to walk a few small steps without my crutches too.

I also had the staples removed yesterday, 26 in total. Hurt a little bit but was over in 3 mins so I can't complain really. It seems really weird now that there is nothing holding the incision together, I keep half expecting it to burst open when I bend my knee! I know that won't happen though and the nurse said that my wound has healed really nicely.

[Lee272]

Week 2

Things seem to be going really well and walking is getting easier. I can now walk around the house without my crutches which has made everyday things like carrying drinks much less hassle.

I had my next physio appointment earlier today and my physio seems really happy with the way things are going too. Although I feel like I've been struggling with my heel slides, she measured my flexion as 100 degrees so at least there has been some improvement since last week and apparently 100 degrees of flexion at this stage of my rehab is completely normal. What's most important is getting full extension, which I already have. I can do straight leg raises with ease and now have full quad control again.

After showing me a couple of new exercises, the physio then gave me a really good massage all around my knee especially focusing on the scar tissue on my patella tendon where they took the graft. This was VERY painful but it felt great at the same time, very relieving. And after the massage my knee felt much better and much more comfortable to walk on, so I'm going to start trying to massage my own knee each day for this reason.

Lastly she did the Lachman test on my knees which is the first time it's been done since my operation. She said my operated knee has a distinct end point and is actually more stable than my good knee...so this has made me feel even better about going through with the operation.

On Friday I see my surgeon for the first time since the operation for a follow up appointment. I'm looking forward to seeing him because I have quite a few questions. One of them is about driving, initially he told me it would be 2 months until I could drive and return to work but my physio thinks it could be much sooner than this due to my rehab. Guess I'll find out on Friday