Cruciate ligaments :
new and need some opinion!! - - Posted by Jenna4Pack (Jenna4Pack), 17 January 2005
Ok...I am sure you get this all the time, however, I hurt my knee three days ago during a judo class and am not sure if I should follow up with Ortho. Here is the deal...my knee went the wrong way (in toward the inside) at the same time my leg was being swept by my partner. I heard (or felt) a pop and pain that was like fire! I have four children and I can tell you this was 100x worse! Then my leg from the knee down to ankle tingled and from the knee up to thigh was throbbing! It took probably 10 minutes for it to subside enough to even think...they attempted to stand me up ( I felt I could as well) the minute I put any weight on it the leg buckled and I fell....well went to the er got xray that showed no break etc.... Now I am on the third day and it is still swollen and I can not fully straighten or bend. It almost feels as if something is inside. I am SCARED to death to ever feel that pain again...even though it feels a bit better (no pain while resting or moving the ankle etc) could this still be something more than a sprain
!! Sorry so long...but, even the thought of that pain makes me sick to my stomach...Please give opinions. Thanks!
Posted by jbluestein (jbluestein), 17 January 2005
try to get a good clean MRI, an experienced ortho and hope for the best. Instability is a sign of ligament weakness.
In the meantime to self-diagnose try this site:
http://www.orthoassociates.com/knee_lig.htm#injury
good luck,
Posted by Elly (Elly), 17 January 2005
That really does sound like you may have torn your ACL, but you need a professional opinion.
I would follow it up with Ortho or a really good knee Physio.
I thought mine was just a sprain for ages, even though it kept buckling, and I've been lucky not to end up with too many extra problems by leaving it untreated.
If the doctor you see tries to send you away with Ibuprofen (or other anti-inflammitory), insist on seeing a Physio/Ortho.
Hope that helps - remember even if you see them you don't necessarily HAVE to have surgery, but it's worth having their advise.
Best wishes, Elly 
Posted by murtaughdog (murtaughdog), 18 January 2005
I had the same thing in a similar incident in a similar sport - I am now six weeks post-op from a auto-patellar and meniscus repair.
A good MRI will let you know! Good luck!
Rgr
Posted by libertynm (libertynm), 18 January 2005
Jenna4Pack,
It does sound like you may have sustained injury to one or more of your ligaments.
Definitely insist on seeing an orthopedist and make sure the orthopedist tests all of your knee ligaments. If you stilll have a lot of swelling when you go in, the swelling might mask ligament instability, but don't let that possibility stop you from going in as soon as you can. Just keep in mind that it might be worth going in again at a later time when the swelling has died down if no instability is detected. An MRI could be helpful, too.
Until then, Rest, Ice , Compression and Elevation should help a bit. It won't hurt to take some ibuprofen as it may help with the swelling as well.
Wishing you well. . .
Sincerely,
Nesanet
Posted by Jenna4Pack (Jenna4Pack), 18 January 2005
Thanks everyone! I go in this morning to the Ortho. I will keep in mind everything. The strange thing is it does feel a bit better as far as the pain, but still very stiff if I try to bend. I still would not trust it as far as attempting to put a lot of weight on it. I am not sure if that is the knee or my mind! HAHA The swelling has gone down a bit so I hope they will be able to give a good diagnosis. I really want to continue with the Judo (someday) so I want to make sure I know what I am dealing with so I know what I can and can not do in the future. I will give a post when I return.
Thanks Again.
Is it common to "Feel" as if the knee is improving if in fact a problem is still lurking...such as a tear?
Posted by hockeygirl (hockeygirl), 18 January 2005
jenna4pack
I certainly felt as if my knee was getting better. So much so that I tried to play hockey again. (not a good idea) I now know that I had torn my ACL and by trying to play hockey again ended up tearing the cartilage aswell. Hope everything goes alright and you get the right diagnosis.
Hockeygirl
Posted by Jenna4Pack (Jenna4Pack), 18 January 2005
Thanks! I guess I will continue to take it easy as not to risk further damage or sprain. My mri is scheduled for Thursday and then follow up with ortho the following Tuesday. So....it will be a long week. I am sure the mri tech. will not tell me anything. When the otho was moving my leg around I really did not have any pain, just a lot of stiffness that prohibited me from bending the leg certain positions. So....we shall see.
Thanks Again.
Posted by Gab (Gab), 18 January 2005
So, do you have a pre-MRI diagnosis? When I saw the first OS, 2 days after surgery, the knee was still hurting and swollen to the point where he could not diagnosis anything and had to wait for the MRI result to learn that my ACL was completely blown, that phone call sucked lol
Posted by Jenna4Pack (Jenna4Pack), 18 January 2005
No he really did not state anything. He looked at the xray and said the bones looked good, however, he stated that sometimes you can have a hair line fracture or something and the xray will not pick it up. So....he was able to manipulate the knee pretty good with little pain. So...maybe it is just a sprain. I just can not imagine that kind of pain without something ripping or tearing. Honestly I can not even stop thinking about how bad it hurt and I am not a wimpy person!!!
Posted by Wookster (Wookster), 18 January 2005
Jenna I have to say your injury does sound like and ACL rupture - popping noise and buckling are the major symptoms. In fact I dont believe its possible to buckle your knee without rupturing some ligament.
You won't pick up a ruptured ACL on an xray, though you might pick up bone bruising which happened in the incident.
Posted by Jenna4Pack (Jenna4Pack), 18 January 2005
I know you guy's are ONLY giving opinions and that you are not doctors, but I just wonder about something...when you do have a tore ACL or something along that lines are you still able to get around pretty good? I really dont have any pain (day four since injury)at this time.. my main complaints are a strange stifness and the inability to bend correctly as well as a feeling of instability in the knee. It has not buckled anymore since that day, however, I would not trust it as far as putting my weight on it. If when I am walking I accidently straighten the leg too much it hurts like a mother! So does that sound like what you guy's are talking about and or have experienced? I realize I am just going to have to wait and see what the MRI shows.
Posted by Wookster (Wookster), 19 January 2005
on 01/18/05 at 23:06:20, Jenna4Pack wrote:when you do have a tore ACL or something along that lines are you still able to get around pretty good? I really dont have any pain (day four since injury)at this time.. my main complaints are a strange stifness and the inability to bend correctly as well as a feeling of instability in the knee.
I saw my GP soon after my accident as I was in a lot of pain and he suggested I wait 6 weeks before seeing a specialist - which I did but I found that my knee pain got worse. I got around fine after my injury but anything physical gave me a sore knee. I had no confidence in my knee's strength and I was unable to even run up or down stairs after I tore my ACL. I couldn't squat and place any knee on my injured leg.
on 01/18/05 at 23:06:20, Jenna4Pack wrote:It has not buckled anymore since that day, however, I would not trust it as far as putting my weight on it. If when I am walking I accidently straighten the leg too much it hurts like a mother! So does that sound like what you guy's are talking about and or have experienced? I realize I am just going to have to wait and see what the MRI shows.
Torn ACL's mean different things to different people. All seem to have a feeling of instability, some will have regular bucklings others (like myself) will not - my knee didn't buckle when I injured it initially
Posted by libertynm (libertynm), 19 January 2005
Hi Jenna4pack,
In terms of getting around. . .
After my tear, I could kind of walk. "kind of" because I was limping for a number of weeks. When the limp mostly went away, I was still walking relatively slowly (and I used to be quite a fast walker). My boyfriend likes to joke about it now that I'm post-op saying that I'm almost walking at pre-op speed (post injury) on my crutches. In addition, I couldn't walk very far without marked discomfort.
I had much difficulty with stairs and I would often feel my femur moving relative to my tibia (instability). . .
Everyone is different however. For context, I had a major vertical tear (think about splitting the ACL so that you have virtually 2 ACLs), with a lot of fraying and stretching. My ACL was so floppy that it was moving about in the joint causing my knee to catch.
If you do indeed have an ACL tear, you might want to take some time to get a good handle on how it affects your everyday life. However, I would take it easy on your knee (ie skipping things like judo). I'm a dancer and a couple of times, my desire to dance pushed aside my common sense and I did dance on it. Today, I am just thankful that I didn't incur meniscal damage on top of the initial ACL injury.
Good luck to you. . .
Sincerely,
Nesanet
Posted by andrewc (AndrewC), 19 January 2005
Hey Jenna4Pack
I am very puzzled by what you report after seeing an "ortho". From the history of your injury, the type of injury and the symptoms of the injury.....he should not even have really been looking at the X-Rays for long if patella alignment was ok as it's patently obvious that it's not a bone break!
Did he not schedule an MRI scan and mention the possibility of ligament damage? What sort of physical tests did he do??
Not wanting to labour on but if I were you I would get a second opinion from a KNEE SPECIALIST......(meaning someone who ONLY does knees!!not general orthopaedics)
This is because single or multi ligament injuries are complex to dignose and treat in many cases and the treatment and possible surgery has to be got JUST right the first time round or things can go majorly pear shaped as some poor individuals on this site will attest to 
At a guess but from the injury you describe I would say you may have torn or partially torn your MCL and by the sounds of it maybe your ACL too.
The stiffness you describe is classical of a meniscal tear which unfortunately is a common partner injury with an ACL tear.
Seeing a good ortho is vital so your treatment is correct RIGHT from the start. MCL injuries often do NOT need any surgery and heal by themselves in conjunction with the correct exercise program... ACL tears (graded 1-3 like all ligament sprains) will not ususally heal alone but dont always require surgery.....
Meniscus tears very rarely heal on their own and often require surgical intervention though their success rate when repaired at the same time as an ACL recon is very high.....
As another poster said it is almost impossible not to have done some quite serious damage if your knee has buckled sideways and it really does need looking at by a specialist....If the OS you saw was a specialist then unless he has MRI's, treatment plans etc in hand then I would seriously go and see another one. Privately initially if you are UK based so you can at least get a proper diagnosis and some good advice....
Hope this helps a bit
All the best
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
Thank you for all the advice. It is funny how valuable you find that your knees are after something like this! The only thing the OS did during the exam was manually manipulate the leg to determine where I was sore (from the outside). I really do not have any "sore" spot on the outside...it appears to all stem from the inside. I will be getting the mri on Thursday...hopefully that will answer most if not all the questions. This is a great board with alon of knowledge! Thanks again.
Posted by Wookster (Wookster), 19 January 2005
Did your ortho do a lachman test?
http://www.emedx.com/emedx/diagnosis_information/knee_disorders/acl_lachman_test.htm
If not then fire him and get a proper ortho. As has been said getting it right first time is critical.
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
Yes, I believe he did. However, he did not do a comparison on the other leg (if that makes a difference). I noticed this morning when I attempt to straighten the knee, I can feel or hear (not sure) a grinding and popping noise. It does not really hurt, but is uncomfortable due to the stiffness. Does that make sense?
Posted by Wookster (Wookster), 19 January 2005
It is important to compare both knees I think. Within 10 mins of seeing my OS for the first time he'd said he guessed I had torn my ACL but wasn't sure until he had MRI results.
Where are you based Jenna? Can you find a proper knee specialist?
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
I am in the US. It has been a bit difficult because my husband has been in Paris on business (he returns tonight). So I have been trying to baby the knee as much as I can until I get this mri tomorrow. I figure that any OS will need to have the mri so I might as well go through with that to see if something shows up. If the OS does not find anything then I will seek further assistance. I really do think something has to be going on, because even though the swelling is going down a bit...I still have the stiffness and trouble bending. Thank you for all your help. I just know the tech who performs the mri will not tell me anything so I will have to wait until Tuesday to see the doctor again. I may try to see if she or he will give me any hints, but I doubt it.
Thanks for all your help.
Posted by Wookster (Wookster), 19 January 2005
Its quite important that the OS that does any surgery (if you need it) is experienced as it is a tricky operation and the graft must be placed very prescisely.
I doubt you'll get anything from the MRI techy - reading MRI scans is quite a process and you'll probably have about 10 sheets total with up to 16 scans on each sheet. Its not a 10 min job unless you are a knee expert.
Good luck - keep us all posted.
Posted by Gab (Gab), 19 January 2005
on 01/19/05 at 08:31:21, AndrewC wrote:Hey Jenna4Pack
I am very puzzled by what you report after seeing an "ortho". From the history of your injury, the type of injury and the symptoms of the injury.....he should not even have really been looking at the X-Rays for long if patella alignment was ok as it's patently obvious that it's not a bone break!
Yup, I agree with that. After my injury, the OS I was referred to listened to my story ("...then my foot landed, I heard something 'snap' and I dropped to the floor in pain"), he bends my knee and asks me where it hurts I point about 3 different places since the whole thing was so messed up and he goes "Sounds like you tore a meniscus". At least he ordered an MRI ASAP but when I got the call that the mensicii were fine and the ACL was blown, I packed my bags and went to one of the best ACL reconstruction surgeon in Boston, didn't want to deal with that guy..
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
That is what I guess I am struggling with....I really dont have that much pain now? It is swollen and if I try to straighten I hear/and or feel clicking and grinding inside of the knee. But if I push around on the knee (and behind) I really dont have a sore "spot or spots" It is really strange. Can that be if it is something along the lines of what you guy's have experienced? I can see that the majority of the swelling (now) is on the top left of the knee and runs all the way down the inside. I also have some aching in there today. Who knows maybe with some of the swelling going down maybe it will be easier to tell what is going on in there...who knows. But any comments on the clicking/grinding sensation would be appreciated. Thanks!
Posted by Wookster (Wookster), 19 January 2005
Jenna, you probably won't have a lot of static pain. Once the ligament has ruptured the nerves are torn and the damage has been done. I found I got pain when I did things that aggravated the knee and increased swelling etc. but I didn't have chronic long term static unbearable pain.
Torn ACLs are funny - you can often get around normally, but just cross that thin line and your knee buckles, or do just a bit too much and you get swelling and pain.
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
That is funny the way you put that, because that is exactly how I feel. Everytime I take a step (hobbled step) I am holding my breath to see if it will hold. So I definetly feel that it could go at anytime with the wrong move. Very unstable feeling. I will continue to be careful while I wait....and wait....and wait....!HAHA With a torn ACL is surg. the only way?
Posted by Wookster (Wookster), 19 January 2005
No surgery isn't the only way. A lot depends on how lax your knee is - mine was very lax (grade 3 on a lachman test) and I was a very active person (play lots of squash and kiteboard). This is where comparison between knees is important.
I believe that not everyone is that lax.
Posted by Elly (Elly), 19 January 2005
Wow, this is a popular subject!
A few thoughts...
Crunching and grinding: can be to do with swelling I think, and because your knee is stiff, it's bound to be swollen. The MRI should rule out loose bodies in the joint, but I think that would cause locking. Crepitus (crunching/grinding) is quite common in knees according to my Physio friends.
Pain: I never had much, not even when I did the injury (though I confess I may have been a little drunk...) but the main horrible sensation came from the swelling in the joint capsule - that was a bit stomach churning!
Instability: A thing my Physio said which is very true is this - you may be able to weight bare heavily, run, jump etc in a controlled way, but step on a pebble and your knee just collapses. This was the case once the original swelling went for me.
Going under the knife: your choice - you can really build up your muscles to compensate but I haven't found it very reliable - I've re-sprained my knee loads, and it eventually tears meniscus/cartilage and generally causes more damage. I suppose it depends on your injury and your body whether you can acheive reliable stability without surgery, but it's a tricky one! One thing to remember is if you have instability over a long period of time, you seriously risk early arthritis which is definately something to avoid. I have been strongly advised that if you have any mechanical problem (eg - no ACL) to have it surgically fixed to avoid such long term problems. Surgery has its risks but as I said, you need to weigh up the pro's and cons and make up your own mind.
Sorry for the essay!!!! I hope some of that is helpful or maybe you will just have more questions 
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
Thank you all sooooo much for all the thoughts and opinions. When I think back to any other time that I hurt my knee I do remember a time about 4 years ago when I bent down to scoop my daughter out of her car seat (trying to keep her sleeping) and when I stood up my knee gave way and I had the fire feeling shoot through it. It took a while and I dont remember any swelling, however, looking back now I would imagine that was the original injury. So this latest thing was of course 100x worse....so what will it be like next time!! I will be glad to get to the bottom of it, because I dont want to go through this again. If that means that I have to reduce activity then that is what I will do. I guess I am just afraid that they will say NOTHING showed on the MRI!!! That would flip me out, because something had to create that pain. Well thanks everyone.
Posted by Gab (Gab), 19 January 2005
Hi I can understand the feeling of being afraid the MRI won't show anything!! When I was waiting for my results I was telling people I was hoping they would find something and they were like "What, you hope you got injured??" and I was telling them "No, I KNOW I injured myself, I just hope they'll find what it is that I messed up!". The sound that came out of my knee and the pain that shot through my brain immediately after were pretty convincing..
Posted by Kaz (Kaz), 19 January 2005
Heya, When i ruptured my ligament i had all those symptoms to, I went to the ER and the doc got me xrayed and it showed up bone torn off (though i tore bone off not always the case with general ligament ruptures) i explained to him how my knee felt and he said straight off that i had more than lightly ruptured the cruciate ligament. He gave me an appointment to see the specialist the next day at fracture clinic and The specialist said i had just sprained the ligament and he left me with crutches and a bandage. Thankfully i was a competitive gymnast and had a British gymnastics medical scheme plan that allowed me to go see John Aldridge. He was really good i told him what i did and he had me in the next monday for an operation and he attached the ligament back to the bone. Unfortunately for me its relapsed time and time again n ive ended up having a further 3 arthroscopys and now im waiting for an acl reconstruction. I would advise you to get at least two opinions and maybe try to get to see a respectable specialist or the best one in your local hospital. Thankfully most people do get sorted after the first op but they put mine down to the fact that i was 11 when i had my first op and now im 15 ive grown alot and its stretched the ligament and made it lax so it now needs replacing.
Good Luck and i hope you get sorted soon and back to judo.
Kaz x
Posted by Jenna4Pack (Jenna4Pack), 19 January 2005
Kaz- thanks for your story. It helps me to confirm in my own mind that it is OK and often needed to get a second opinion. I will be letting you guy's know what I find out to see if it makes sense to you who have been through all this stuff. Right now it feels pretty good, however, I have been going up my stairs using crutches but today I let just a little weight on the knee try to pull me up and no way!! It felt very ,very unstable. It did not hurt, but I have a strong feeling it would have buckled. So...no more attempts like that until I know what is going on! HAHA It hink my Ortho is pretty good, however, if it does turn out to be something that may require surg. or be or a more complex type of injury I will look into a dr. that is a specialist in the knee injuries. Again, thanks to all.
Posted by andrewc (AndrewC), 20 January 2005
Hi again jenna4pack
Doe your knee feel it will give way in a sideways motion....??or in a straightforward plane when you are stood up (i.e. in the direction of your feet)??
If it is sideways, it is VERY likely to be the MCL that you have sprained or torn....though maybe the ACL too in a worst case scenario....
The crunching...popping noise could well be crepitus as another poster mentioned but combined with the stifness you described I have to say it sounds very much like a possible meniscal injury.....
As I said in my earlier post I would massively reccomend that you make an appointment with a knee specialist after you have seen your normal Ortho if only to get a confirmation of the first Drs diagnosis!!
Good Luck
Posted by Jenna4Pack (Jenna4Pack), 20 January 2005
Ok...nothing like beating a dead horse here! LOL
I was just wondering if any of you remember your knee feeling really hot, both on the inside and to the touch. Last night my knee started throbbing and became extremely hot to the touch. I went today for the mri...so I dont know if I should report this to the Dr. or just wait until I see him on Tuesday. Thanks....
Posted by Gab (Gab), 20 January 2005
Oh yeah...I had to ice mine up to 6 weeks after my injury. And if you actually tore your ACL and get it reconstructed using the patellar tendon autograft, prepare yourself for some serious 'Fire in the hole' in the front of your knee!
Posted by lshale77 (lshale77), 20 January 2005
Hi, I am new and have been reading your posts...I just had the surgery about 11 weeks ago now done to my right knee. Everything you have said Jenna reminds me of everything I went through....and just to let you know was the best thing I could have ever done. My hubby is the one to convience me to have the surgery. I didn't want to.
Just to warn you also, don't think I read it on this post, that after the sugery you may have some nubmness on the right side of the scare. I have had numbness since I got home, but it has started since to go away and the
O S told me it was normal. I agree with the above person's post somewhat about the front of the knee hurting. My knee did hurt for the first couple of weeks or so. Then it was sore. I still can't fully put pressure on it. Hopefully I will be sooner or later. Anyways...Let us know what happens and I am sure we can all continue to give you a bunch of advice on recouping.
Hope you don't have to go through it, but if the O S says you do, just take it one day at a time and before you know you will be up and walking around and feeling back to normal.
Posted by Jenna4Pack (Jenna4Pack), 20 January 2005
Ishale 77- Thank you for telling me your story. I will definetly keep everyone posted. I really hate waiting until Tuesday! I really thought I would be able to get the tech to tell me something, but of course they wont do that. My swelling is almost gone so I guess that is good, however, today I am having some sharp shooting pains going through the back of the knee when resting it. I would imagine that could be some kind of nerve..maybe trying to regenerate. Or is it possible that once the swelling goes I will feel more of the actual pain from the injury? What is your experience there? Thanks again.
Posted by lshale77 (lshale77), 20 January 2005
I had shooting pain as well in the back of the knee. Usually took some pain meds and it would go away. It will be interesting what your doctor says after the MRI. I did physical therapy first, because I was off my leg for three weeks or so before they figured out what was wrong with me. Also had to wait so darn long because I had HMO insurance. I tired the same thing as you did trying to get the tech to tell me something, lol. Your lucky though at least your swelling went down it seems....I had mine for at least a month.
Posted by Jenna4Pack (Jenna4Pack), 25 January 2005
Hello everyone! Well you guy's really should be doctors, because you nailed it. I got the results of the MRI today and it wasnt good. I have indeed blown the ACL and also have complex meniscus tears. It looks like I am having surgery on the 10th of Feb. using the patellar autograph....? I may be spelling wrong, but you get the idea. So tell me my trusted friends...what am I up against? Thanks!
Posted by lshale77 (lshale77), 25 January 2005
Well lets see.....lol. The surgury it self isn't really all that bad. When I had mine done went in early in the morning, they got my IV going. Then once I got into the operating room they nummed my leg and that is the last thing I actually remember. I woke up in recovery and spent sometime in the recovery room until it looked like I was completely awake and could keep foods down. They did give me a pill before I went under to help with nausa. Went home the same day. Was there from quarter to eight in the moring and left for home around 1pm. The first 24 hours after it happend wasn't too bad because my leg was still num. But, be prepared for at least the next 48....It will be hard to get in and out of bed and going to the washroom. I started PT 3 days after surgury. Everyday was better and better!
Posted by Jenna4Pack (Jenna4Pack), 25 January 2005
Thanks for the information. The doc. said he would keep me over night and that I would have a "machine" at home that would keep my leg exercising for two hour intervals He said crutches for about two weeks. Here is the question that will probably make you REALLY laugh, but how long until you can drive?
Posted by lshale77 (lshale77), 25 January 2005
Oh yeah I completely for got about that......I had a stimulator at home and an Icechest, called polar care. Gave me constant cold on my knee. The stimulator help ALOT!. I had to use that for about two or three weeks. Still got the cooler that one was great to have around as well.
I was on crutches about 2-3 weeks and used one crutch for probably up to 6 weeks on and off. Just depended on the day I was having.
Updated Mon Oct 6 2008