Cruciate ligaments :
Really, how painful is this surgery? - - Posted by Keston (Keston), 12 November 2004
Hello all,
I have my ACL Reconstruction surgery scheduled for December 9th and I have read that PAIN is a big issue with this surgery. One surgeon in his literature (at the DRs office!) wrote that this is an excruciatingly painful surgery.
Really, How bad is the pain? is this pain continuous?
Posted by hmaxwell (Heather M.), 12 November 2004
Well, I haven't had this procedure so I can't give you any opinions, but just wanted to share what I observed when I had surgery and rehab in a Colorado ski town. Because the injured were all skiers, I'd say I was just about the only person in the clinic who HADN'T had ACL recon. I was blown away at a couple of the folks--they weren't even taking painkillers. Nothing but tylenol and advil mixed together. Now granted, they were all still on crutches, but usually the first 3-5 days post-op are the worst in terms of sharp, drop you in your tracks kind of pain--and this pain can and should be controlled by your surgeon. If he/she gives you something that doesn't work, get another med prescribed. So take your meds as scheduled whether you think you need them or not for the first few days. ACL recon is major surgery, but so many people I know are grateful they had it done. There will come a time post-op when you will ask "Why the HELL did I let myself get talked into this" but it will pass, I promise.
Back to rehab and pain: Things start to improve in general about 5-10 days post op, but I want to warn you that when you start PT/rehab, initially the soreness quotient is really going to go up. So don't get frustrated. A lot of people are off round the clock pain meds for the most part about a week post-op, but still need to take something on those PT days when the knee is sore from being worked.
So anyway, I just wanted to give you some of the information I've gotten through my experience with PT and observing a boatload of reconstructed ACL's. I just couldn't believe these people coming into PT and saying they were taking advil for the pain!! I guess the doctors did a really good job, and the PT's were starting their rehab slow and steady. So maybe you'll be one of those folks. Of course, any surgery is painful. But there's no need for you to endure out of control pain levels...there are plenty of medications out there to help you through this short period of time while you rehab the knee.
Heather
Posted by Gab (Gab), 13 November 2004
First of all, my case was atypical. Right after the operation, they found out I was allergic to morphine and the line of communication between the nurses and the OS was broken somehow and I was not given anything to compensate..So yes I was in a lot of pain for the first 24 hours but I know I would have been much better if I had had been given something equivalent when they found out about my allergy. So as I said: atypical and this case: pain mismanagement.
You'll also most likely experience a high fever for the first 48 hours (especially at nights) as the body reacts to the 'damage' that has been done to the bones when the surgeon drills through your tibia and femur.
Now depending on individuals, you may bleed a lot during the procedure, maybe not, and you may experience moderate to severe swelling depending on how your body reacts, and this will have a great impact on the pain itself. I was on narcotics (oxycotin/oxycodone) pretty much 24 hours a day for the first 10 days because I bled a lot and had a lot of swelling..Then I stopped oxycontin after 2 weeks and oxycodone after 3 weeks post-op.
Then the tricky part was sleeping. Leaving the knee in the same position for hours at a time would result in painful aches which prevented me from sleeping. It would have been great if I could have been able to sleep on my back but unfortunately it wasn't an option. I started sleeping well about 6 weeks post surgery.
I don't know how bad my case was. As I mentioned, the fact that I had a LOT of effusion/bleeding did not help at all. But after 5 months, I'd say it was well worth it.
Don't be afraid, and don't be afraid to take plenty of meds.
Good luck on your surgery, tons of people have gone through it succesfully 
Francois
Posted by jbluestein (jbluestein), 13 November 2004
Keston, did you ask your surgeon how many ACL reconstructions he has done this year? The number should be high, like 50 or more.....
What kind of graft are you getting?
Autografts are more painful due to the harvested site.
This link may help you understand the surgical procedure:
http://www.orthoassociates.com/acltech.htm
Though from reading these boards there seems to be some slight differences between UK and US surgeries......
By the way, what do you prefer UK, England, or Britain? What's a bloke anyway?
Posted by hmaxwell (Heather M.), 13 November 2004
Well, you got me laughing!
One of my favorite expressions about the Americans and the British...two countries divided by a common language 
A bloke is a guy. Where we in the US would say "there was this guy standing there..." in the UK they would said "there was this bloke standing there..."
And all of my British friends called me Yank. I tried to explain to them that I'm from nowhere near the Northeastern US--I was raised in California, but...then they started to copy our Australian friend and call me a Sheila. Again, two countries divided by a common language.
On the subject of ACL recon, it is my impression that they are done differently in Europe in general--not so much the actual procedure as the rehab protocol, bracing vs. cast, etc.
Heather
Posted by jbluestein (jbluestein), 13 November 2004
thanks for the great posts shiela, um heather..... 
Posted by jonnyscaz (jonnyscaz), 13 November 2004
I would have to say I was quite suprised how pain-free the operation was. I had the hamstring graft on 2nd November, and I have to say that I've yet to experience any pain at all in my knee. I've been having problems with calf pain though as there is fluid trapped in the muscle and this feels like bad cramp. I wouldn't worry about the pain, it's just frustrating being on crutches!
Posted by Keston (Keston), 15 November 2004
jbluestein,
I am having an ACL reconstruction and a meniscus repair. Hopefully my surgeon will clean it all up. When I have had steriod injections for the pain, it was hard getting the needle thru all the scar tissue.
Oh boy, sounds like I am in for some fun. But hopefully a year from now I will be running around like a banshee!
Thanks everyone!
Keston
Posted by bohanp (bohanp), 15 November 2004
Hi ,
I cant recall the Operation being that painful .
Of course I had to take pain killers for a day or two afterwards but the pain itself was nothing too bad . If I cant remember it , it cant of been too bad .
Dislocating your shoulder on the other hand .........now thats what i call painfull.
Posted by Spooner (Spooner), 15 November 2004
I think I was on the other end of the spectrum from Gab, so on a normal distribution I guess you could expect to be somewhere in between.
Stopped taking Demerol after 2 days. No pain, just aches in other parts of the body (hip, gluts) from having the leg in one position. The only thing I would consider pain was in the first few days really working on getting flexion. I used a towel under the heel to pull my leg back, and I really pushed each rep to get another 1/8 inch than the last. But nothing I really considered pain--it was more like the exhilarating pain/burn sensation you get from lifting weights.
I'm at 4 1/2 weeks now, and if you can't see the scar or the somewhat atrophied quadricep, you couldn't tell I had anything done. I can walk very fast with normal motion.
I highly recommend it (I had a patellar autograft), if you trust your OS. Ask a lot of questions based on the info from this message board. Ask WHY auto- over allo- or vice versa. Ask WHY some people get different braces on their knee. If he/she can quote statistical and empirical studies about the success of rehab based on one over the other, etc etc. then I'd say they are qualified.
But overall I say it was a very painless experience.
Posted by chaddy (chaddy), 16 November 2004
Hi all,
I considered the 1st week to be quite painful due to the sharp pains shooting through my calf when putting weight on my injured leg. Once this cleared (due to the incision for the graft) I felt the operated leg was pretty much pain free. Like spooner stated, it is difficult to tell after a few weeks which leg went 'under the knife'.
Good luck.
Posted by mattley73 (mattley73), 17 November 2004
Im actually scheduled to have my recon on the 29th which is 12 days from now. I agree that there does seem to be some differences between the proceedures and recovery time between the UK and US.
My brother-in-law has had 2 ACL recon ops now and has said that the only pain he felt from the operation was in the first week but it wasnt as bad as when he actually ruptured the ligaments. He did say that the intensive physio could be quite painfull but only because the amount of effort he had to put in in order for him to recover fast.
I'll hopefully be posting before you go in for your op in December so i'll let you know what the surgery is like
Matt
Posted by christinaz (christinaz), 24 November 2004
I just want to let you know that everyone's experience is different. Depending on the technique used, and individual pain tolerance. I've had an acl recon and 4 and a half years later a rev acl recon. I don't know if I am an unusual case, but my pain was extremely bad both times, but the second time was much worse. I ended up with some nasty complications and more surgery. However, I started PT at the same time as two other acl patients and my post op pain was much much worse than theirs was. They are both gone and I'm still in PT ( almost 11 months now including pre and post op) so I think that it all depends on the individual and diligence when it comes to rehabbing your knee. You have to make it the most important thing at first so that you don't end up with problems later. Good luck to you and I hope that you do well in your recovery.
Love, Christina
Posted by XxSkittlezxX (XxSkittlezxX), 25 November 2004
Hello, I'm 17 years old and I had my ACL Reconstruction a week ago yesterday. My pain, speaking from experience, is not bad at all... everyone's different however. As far as medicine goes, I've had... 2 percocets, threw them both up... and over the course of a week, maybe 10 ibproufen all together. I have a high tolerance for pain, so that could be it but really, the pain's not bad at all I don't think. I'd say the worst day as far as pain for me was probably the night after I had the surgery... I was in tears it hurt so bad. I have bruises around my shin/knee area and walking around hurts too, but it's not to extensive, I think the more you stay off your leg - right after surgery - the better the pain will obviously be when you do go back to walking on it.
Good luck with your surgery...
Posted by neuchcat (neuchcat), 27 November 2004
Hi,
I had my ACL surgery 5 wks ago (hamstring tendon graft) in Geneva. I would agree the worst pain is in the first week.
If you are able, have the anthesiologist give you a femal nerve block right after the surgery. This is an injection into the femal nerve so that you are able to wiggle your toes and feel your feet, but the area between the mid-thigh to mid-shin is still numb for 24 hours. This was great - i didnt even need morphine for the first 24 hours. But once it wore off - wow - painful to the point of tears. DONT BE AFRAID to ask for pain meds - i put it off too long. Once i had the morphine, it was ok. I used morphine 3 times over the next 2 days, then down to pain pills and by day 6 (when I was sent home) I was down just to paracetamol (like Advil). By week 2 nothing at all.
What has surprised me on this is the time it takes. I thought i would have more flexibility and mobility by now (going into week 6). I thought i'd be back to work by week 4 but am still just able to handle part-time as sitting at the desk causes swelling pretty quickly.
Be prepared for LOTS OF TIME doing exercises, electrode therapy, physio, and of course REST and ice.
Good luck!
Posted by stevea (stevea), 6 December 2004
Hi Keston
I had ACL reconstruction on my left knee in early May. I had a quadricep graft (still a pretty new approach but my surgeon had a lot of experience with this graft. Steadman Hawkins in Vail also likes this approach). I had local anethesia--not general. They gave me a femoral injection that lasted for roughly 36 hours and a spinal that lasted for only a short while after the operation
I recomend the local anesthesia instead of the general if you can deal with it mentally--it is much easier to come out of than general.
I had very few problems with pain. You should definitely get the femoral--that takes you through the initial period. After that, I had oxycodone twice a day for five days--I took it whether I needed it or not. It is important to prevent the pain before it gets severe--so you really need to take the meds on schedule at the beginning. I also had some percocet that I could take if I needed it, but that only happened once or twice. After the five days, I think only only took pain medication once or twice
I used one of the range of motion machines for roughly two weeks for 6-8 hours a day. I also had a cuff that kept cold water flowing around the knee for about a week. Those could have helped
Good luck with your surgery and reply if you have any questions
Steve
Posted by vik (vik), 7 December 2004
Hello Keston
I'm having an ACL recon and meniscul repair on Thursday 9th too. I'd be interested to know how you get on.
Vik
Posted by Wookster (Wookster), 6 January 2005
I have to say I think everyone's experience is different.
For some there is hardly any pain but for others (like me) the pain is intense. A nerve on the front of my chin was irritated and for the first 6 days I had constant white hot pain down my chin. It brought me to the point of tears a numebr of times, due to its sharpness and its constant nature. I was only able to manage short sleeps and would awake in the morning in utter agony.
This eased of greatly on the 7th day but I still get the odd bit of pain on my chin, especially when I stretch.
Sadly I think this has had a negative impact on my recovery as I had less mobility for longer and I estimate I lost 65% of my quad muscles though I'm now getting them back (the reconstrcution was early october 04).
I guess its just different strokes for different folks and all that. I was unlucky, you may not be.
Posted by estogirl696 (estogirl696), 6 January 2005
I had ACL recon on October 4th and a minesectomy (sp?) also. I was told that i was an unusual case becasue I had absolutely no pain at all. They used the Patella, and even there, I had no pain, just a little soreness. Rehab has also been relatively pain free, just some muscle soreness every few days. I was also in great shape before surgery and I think that helped. Good Luck on your surgery and I hope i helped!!! 
Posted by murtaughdog (murtaughdog), 10 January 2005
I had auto-patellar and meniscus repair on 12/2/04. The first four days were complete misery, and every hour and day thereafter it has improved exponentially. Good luck.
Rgr
Updated Sat Sep 6 2008