Healing Response acl surgery

[mightyjack]

I completely severed my ACL playing in a basketball tournament.  My O.S suggested the Healing response procedure since the tear was high on the ACL.  Basically it is micro fracture surgery that will create a super blood clot via bone morrow. The idea behind this is to allow the ACL to heal itself. I agreed to this procedure and am in day 2.   I tried to find some information on the internet regarding this type of surgery. Unfortunately there is not much out there.  Has anyone else had this type of procedure and was it successful? 

I will continue to note my progress. Perhaps it might be useful information for anyone else considering this method .

[Kaputt_Knee]

If you do a search on here for Healing Response, there is a link posted to the Steadman Clinic in Vail, Colorado, where Richard Steadman performed this on Bode Miller (top US Alpine skier). Both the clinic and Miller web sites have reports about the treatment.

My understanding is that it is not often performed as the pre-conditions are fairly tightly defined if you want a good chance of success. Miller was back skiing and winning races very very quickly though.

Good luck

[mightyjack]

Thanks for the suggestions.  I found the information that you pointed out and it was very helpful.

Prior to my surgery, my O.S told me that he has known Dr. Steadman for 30 years and that he himself has done the procedure 25 times with good results. He did mention that this type of procedure required certain conditions.  I gave him the green light to perform the H.R surgery. He cautioned that he may have to replace the ACL depending on how the knee looked once inside.   I found out after the surgery that he went with the H.R option.  Considering the information you pointed out, I feel better about the procedure.

[savke]

Hopefully you are still there....

I had microfracture healing response on ACL in Sept. 2011.  My rehab has gone slow, and my left leg is still much smaller than my right.  I am also having some pain inside my knee espicially when I am working out.  I do not have instability or giving out symptoms.  However I have not been running or doing any jumps since my surgery.  My most recent MRI showed that I have an ACL tear, which my OS still brushes it of saying that he thinks its fine.  When he did my meniscus and ACL, he diagnosed it as a partial tear after the surgery.  It has been 10 months since the surgery and I am hoping the knee will get better, but it seems very unlikely.  Please share your experiences with the rehab and the symptoms afterwards.  Thanks.

[mightyjack]

Hello savke,

I do check in now and then and am happy to provide you with my experience.  I have included the link to my post op diary this goes into pretty good detail as to my progress.  You mention that you had the healing response surgery and then a follow up MRI after the surgery.  How long after surgery was the MRI?


After reading your post, I would say that I was probably at the same point you are 8 months after my surgery.  I had weeks where my knee felt like it was doing great and weeks when I wasn’t sure that the surgery had any effect at all.  I would say that even though I was not progressing at the level that I thought I should, I kept plugging away and worked on strengthening my muscles. If you read my thread, you will see that I probably tried to run and jump train too soon in my re-hab and would probably have been better off taking more time.


Fast forward to today, 1 year and 9 months after my healing response surgery:
I ran a 12k on May first and trained about two times a week for about two months prior to the run.  If I did not stretch out prior to running I would feel pain while running. I would use a neoprene brace that would help quite a bit.  I have also been playing basketball weekly since September of 2011 and will say that each week I played, I felt the knee get stronger (even though there were a few bad weeks). By the last month of basketball season, I had moved from my heavy duty brace to a lighter brace and my knee did hold up. 
I will say that I am not jumping off my right leg with full force yet but can pivot just fine.  I run sprints once in awhile but again if I skip the warm up, there is pain.

The quad muscles in my repaired leg are still smaller than the other leg. So again, I think what you are experiencing is pretty normal.   
I had a follow up MRI about 8 months ago that indicated the ACL was intact.


I think the most important part of your post is that you say your knee feels stabile. If you’re ACL was compromised, it probably would not feel stabile.  If your OS says there is a small tear in your ACL, I would agree with him and say that you can function at a high level as long as most of the tendon is intact. 


There have been some interesting developments/news regarding the HR procedure that came out after my surgery that I mention in my post op thread.
I would say that considering my knee is stabile, that my HR surgery was a success.  I know a lot of people that have had replacement ACL tendons that even two years later still feel pain and those that have no pain at all. I think each individual is different and that each outcome will deviate from the other.   
Sorry for the long post but I hope this helps you with any questions from a fellow HR patient.  Let me know if you have any other questions.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=53296.0

[savke]

Mighty, thanks for the link and the feedback.  I guess after 10 months you would think the knee should be fine, but its a bit of assurance to know that you felt the same way.  My initial MRI in June 2011 showed full ACL tear.  When my OS fixed my meniscus, at the same time he did the healing response because he said the ACL was still hanging on.  The most recent MRI I had was two weeks ago showed ACL tear again.  My OS does not think anything of it.  He told me to build up the muscles and that the pan would go away.  He also mentioned that my meniscus could not have healed properly.  Last two months I have been working legs pretty hard (not heavy weights, mostly ball squats, step ups and leg extensions.)
I get shooting pain down my calf when I bring my leg into fully flex position..Lastly, my most recent MRI also showed irregular mophology and tears involving posterior body and posterior horn of the lateral meniscus....know anything about this??  thanks for your advice.

[mightyjack]

I don’t know much about issues with the meniscus.  I know that my OS thought he saw an irregularity with the meniscus on my last MRI and wanted to go in to take a look but I passed on the exploratory surgery and was hoping that it might heal on its own.  The pain I feel could be an unhealed tear with the meniscus but I really don’t know at this point.  My suggestion to you would be to search the site or ask others with more severe meniscus issues and compare notes.  It sounds like you are doing everything you can to rehab your knee which is really the most important thing you can do.  It might not hurt to get a second opinion as well just to be on the safe side.  Keep me posted on how you are doing. 

[savke]

MIghty, thanks for the link.  I have gone and read the pages.  Very similar recovery. Just like you I am having knee stiffness, in the morning espicially.  Some days are better than others.  hope everything will be ok.  Thanks again.