KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: katemcplay on July 01, 2012, 08:49:50 AM

Title: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: katemcplay on July 01, 2012, 08:49:50 AM
Hi all
Female, 23 years old
I had ACL reconstruction using my patella tendon graft 7 weeks ago, last week I was doing lunges as my physio instructed I do, I was only on the 8th push when my knee started creaking like an old door and I thought what the hell was that, stupidly I went down again and it was louder and painful, instantly my leg was painful and tendor,  I was hopping like an old lady and couldnt drive, I instantly put an ice pack on it as it started to swell. Went to the physio this Friday gone, not even thinking it could be a rupture and he did some tests on my knee and it had ALOT of momovment and again it was creeking/ grinding.

thats when he said not as blunt as this but basically I am certained you have ruptured it, DEVISTATED! I just cant understand how or why this has happened, I did eventhing they told me to do. I havent played in any sports as I didnt want to push my knee, I havent even started jogging yet!!! I have an appointment with the consultant on tuesday for confirmation and a MRI.

The only thing I can put it down to is that I paid for extra physio appointments outside the hospital, they where pushing my knee to bend by getting me to lay on my stomach with my knee bent and putting their body weight on it and pushing down to get my foot to touch my bum.

I am sorry to go on but I am so upset, Now its a high possibility of going through the surgery again, so My question is this guys.
Does it sound I have ruptured it?
Can he use the patella tendon graft from the same leg again ( btw it was the left leg i injured) or would you recommenced the hamstring?
Has this happened to anyone else before so soon after surgery?
does anyone have any advice on how I can prevent this from happening a second time? :'(
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: joval on July 01, 2012, 04:42:23 PM
Hi,
I hope you're feeling better.  Hopefully it's not ruptured.  It's scary when these things happen! 
I thought I might have raptured mine on Thursday.  My mind immediately went to, oh no, I don't want to do this again!  I was relieved when someone answered my post and let me know what I was dealing with was not unusual.  Great people here that have been through so much.  I have gotten some good advice over the past few months.  After a couple of days of RICE my knee seems to be much better.
I'm not an expert but I'm happy you were not jogging at 7 weeks!  Seems way to early to consider that.
Hang in there.  I'm sure one of the people that have been through this more than once will answer your questions. 
Take care.
Jo
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: Snowy on July 02, 2012, 09:06:45 AM
Hi Kate,

First of all, none of us can tell you whether or not your ACL has ruptured...for this you're going to need an MRI and a surgeon's opinion. I really, really hope not, but from what your PT says it does sound as though this is a possibility.

If your graft has ruptured, you won't be able to use a patellar graft from the same leg again. You can use a contra-lateral (from the other leg) patellar graft, hamstring, allograft, or synthetic graft as an alternative. All have their pros and cons, so make sure you read up on each graft type in detail and discuss the various options with your surgeon before moving forward. The most important thing is not the type of graft but your surgeon's expertise with it and your own commitment to the rehab. From a personal perspective, I had a hamstring graft and the outcome has been awesome - my knee is strong, stable, and able to cope with the demands of backcountry skiing and downhill biking. In fact, it tests stronger than the so-called "good" knee. The hamstring itself remains prone to strains, but it's really not a big deal at all. There's nothing I want to do that I can't do; I just have to be careful to warm up and cool down properly.

The other thing I would stress is that you absolutely must stick to your surgeon's rehab protocol to the letter. I'm not sure if your private PT deviated from this, but each rehab is very individual and depends on a range of factors such as graft type, quality of tissue harvested for the graft, fixation type, and so on. Only your surgeon can dictate when you should and shouldn't be ready for certain activities. It's all well and good to read up on when you "should" be able to start jogging, but there might be very good reasons why that's not okay in your particular case. Keep in mind that ACL rehab is, even in the best case scenario, painfully slow - at 7 weeks out you're not even close to resuming sports activity, regardless of your graft type.

I'm keeping my fingers crossed for you that your graft isn't ruptured, and this is just a blip. Keep us posted on how you're doing.
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: katemcplay on July 02, 2012, 04:17:58 PM
Thanks Snowy
for your advice, I will keep you guys updated. FINGERS crossed it hasnt ruptured and I be able to relaxe! I have cancelled the outside PT, hopefully my consultant gives me good new tomorrow.
Wish me luck  :)
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: higginsj1 on July 02, 2012, 06:42:27 PM
Hi

I had Acl and posterior lateral corner reconstructed back in Feb 2011. My surgeon used a hamstring graft for both areas. It feels very strong and had no problems and now back playing football 3x a week. I know friends who have had patellar grafts by another surgeon but are still struggling to play sport.

I think all surgeons have there own way but i know my surgeon MR Bollen who has operated on alot of professional footballers and rugby players mainly uses a hamstring graft.

If it has ruptured again which i hope not make sure you do your research and get the best possible surgeon to do it. A lot of failures are down to inexperienced surgeons and miss diagnosis of other damaged ligaments. I went to two other consultants before i saw Mr Bollen and they both didnt pick up my ruptured posterior lateral corner and i even had MRI scan.

All the best.
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: katemcplay on July 05, 2012, 03:38:52 PM
Hi all

I thought I update and let you know that it has sadly ruptured, :(  I am getting myself prepare for round two lol If anyone has any leg strengthening tips that would be GREAT.

Thanks again for all your help
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: NIGAV on July 05, 2012, 07:15:36 PM
Sorry to hear you are back to square one again.   :( My surgeon told me the majority of graft failures in the 5-10 week period post op are down to surgeon error in that the tunnels are drilled in the wrong place/angle.  Then its just a matter of time before they fail. 
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: katemcplay on August 09, 2012, 08:21:36 AM
Thank for that info NIGAV
my surgeon was a bit reluctant to give me any information on how or why this has happened and I felt he couldn't get me out of the door quick enough, I am seeing a specialist soon so I am going to get he opinions on things, I just want to how how to avoid this from happing again,
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: Kaputt_Knee on August 09, 2012, 11:19:58 AM
Quote
The only thing I can put it down to is that I paid for extra physio appointments outside the hospital, they where pushing my knee to bend by getting me to lay on my stomach with my knee bent and putting their body weight on it and pushing down to get my foot to touch my bum.
  :o :o :o

Therein lies your answer most likely, I'm afraid. Even the most basically educated physio knows that a reconstructed ACL graft is at its most vulnerable approximately between the 6th and 12th week post op.  :( This is when the revasculization takes place when the tissue from the original graft dies back and the new tissue starts to develop a surface blood supply. Graft failure often occur in this period due to rehab being too excessive or just pure bad luck when you fall or something similar.

If you let people know where in the world you are you may get some ideas on who or what to look for in a revision surgeon.

Sue  ;)
Title: Re: Had ACL reconstruction 7 weeks ago..... its RUPTURED!! :(
Post by: katemcplay on August 09, 2012, 08:21:08 PM
Thank you kaputt_knee
I honestly dont know, the MRI results have shown that it has come away from the screw joint at the top of my thigh, and the surgeon said I am going to need 2 revisions. I am located in the uk near london.

Again thank you everyone for your help.