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Author Topic: Attenuated ACL, all beginning on the other side of the world!  (Read 365 times)

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Offline tregearwill

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Attenuated ACL, all beginning on the other side of the world!
« on: August 07, 2017, 10:30:56 AM »
Hi All,

So, its a long old story as I'm sure it is for many people with knee injuries (travelling from an acute to chronic injury, in contrast, seems surprisingly quick). Anywho;

Back in March 2016 (aged 27) I came down hard playing basketball in Medellin, Colombia.I landed on my right ankle and went to see physios who said rest and after a few weeks you should be fine (no one suggested getting an MRI). I had planned a cycle trip from Medellin to Buenos Aires, saved all the money, finished work and obviously desperate to go. Anywho, gave it a few weeks and off I went....

Cycling into Quito, Ecuador I noticed something wrong in my left knee, sudden onset on pain but unsure what it was. I continued, and then my right ankle gradually got worse. I rested up in Quito for a few days, able to wake with little to no pain, except my right ankle felt loose.  Eventually, I got an MRI scan on my right ankle in Guayaquil, Ecuador (June 2016). The results; minor tendonitis, give it a months rest. At this time, I had little to no concern about the knee as I only had occasional discomfort.

Fast-forward a year and a bit later, I cycled another 200miles in Huarez, Peru, where pain in both the knee and ankle made me throw in the towel in August 2016 (I was still able to hike mountains and cycle, but was fearful of unknown damage). After flying back to the UK, 8 months of investigation and physiotherapy,  we've now discovered I have an isolated, attenuated ACL in my left knee (originally misdiagnosed as patella tendinopathy) and at least partial tears in all my lateral ligaments in my right ankle.

As advised by my physio, I am on the waiting list for my right ankle for repair/reconstruction (no graft needed) and given its functionality (1.5minutes, 1 legged on a wobbleboard) and my overall health we are pretty confident this will be a success. However, the attenuated ACL tear has flummoxed my GP, Orthopaedic Consultant and Physio. I did not exhibit any classical symptoms of an ACL tear at time of injury or post; little to no instability (I can think of one instance over the last year), ability walk immediately after injury and no locking out (similar to instability; it happened once). Further, the only instance where I can conceive it happening is cycling!!! Which many think is impossible.

 I do have pain daily (hence, I believe, the original misdiagnosis of my knee), stiffness if I have been standing up too long (I'm a teacher) and an inability to play sports (no more basketball and currently a very slow, hesitant return to hiking) or cycle as I used to (both of which can also be attributed to the right ankle).

So, I'm looking for any advice or stories from people with an attenuated/partially torn ACL. Did you opt for surgery? If not, why not? In what ways has it limited you? I'm suspect, that after my right ankle is resolved, my left knee will start to benefit, but let's wait and see

Thank you for reading this long old saga and your help

Offline Navtinho

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Re: Attenuated ACL, all beginning on the other side of the world!
« Reply #1 on: August 21, 2017, 06:48:58 PM »
Hi Will,

I have a post under general questions "Unaware of ACL tear in my stronger leg".
I basically tore both my ACL's a few weeks apart from each other and I was only diagnosed with a tear in my right leg for which I had the ACLr using the hamstring autograft.

A few weeks ago (7 years down the line) I visited and OS just to have a check up on my ACLr leg and I subsequently found out that I had been unknowingly living without an ACL in the other leg. I am now 33 by the way

In those 7 years, I have been strenthening my quads and hammies in the gym and running 5-10 km at least once a week with absolotely no symptoms or pain in the ACL deficient leg. In fact it still feels better than the ACLr leg, the mechanics of which dont feel as natural.
But ever since I became aware of the issue, I have been noticing every little twinge and I have become more wary of the possibility of the leg giving away.
Made me realise what a big role the mental part of it plays.

This is the reason that I am doubting whether to go ahead with surgery or not.
I was diagnosed with a complete tear and I am not a medical professional but after going through one ACLr and unknowingly living with an ACL deficient leg for 7 years, I can tell you that if I was diagnoised with a partial tear I would firstly wait for the ankle to heal so that I could assess the knee alone, I would then try to increase the strength of my hammies and quads (especially the VMO) and  reevaluate the knee stability  before considering surgery.
I would say that the non-surgical approach would at least get you back to cycling and hiking, however basketball would remain a risk depending on how well your increased muscle performance and partial ligament can cope.
I would draw the line after actually having a sublaxation episode with the knee, afterwhich I would go for surgery. What you would have to accept is that you could further damage the meniscii with this approach.

My advice is purely based on a comparison between my ACLr leg and the other.But then again everyone is diferent and you could have better a better outcome with surgery.
I realise I may not have helped you much.......but I sincerley hope that whatever decision you make works out for you bro !

Keep us posted.