Advertisement - Hide this advert





Author Topic: ACL & PCL recon?  (Read 1914 times)

0 Members and 1 Guest are viewing this topic.

Offline fuffy

  • Forum Faithful
  • ****
  • Posts: 163
  • Liked: 0
  • To ride or not to ride - What a stupid question!
ACL & PCL recon?
« on: March 14, 2005, 06:01:56 PM »
Has anyone out there had their ACL and PCL reconstructed?

Was it all in one session?

What was the recovery like?

HELP!!!
Arthroscopy in January. Follow up 22.2 05. MRI. Now awaiting ACL reconstruction and possible MCL and meniscus work on April 1st

Offline Nick_Knack

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 533
  • Liked: 3
  • User's Text
Re: ACL & PCL recon?
« Reply #1 on: March 15, 2005, 01:13:57 PM »
Hey,

The ACL is the big one for getting back to sports.  A lot of surgeons do not reconstruct the PCL and let it heal non-operatively.  The PCL is in back of knee where there is a much better blood supply so it often heals by itself. 

Be careful with PCL reconstruction, as it is so much less common of an injury.  If you decide to have it reconstructed make sure you go to someone who has done a ton (over 100; hopefully more) and ask them how many they have done and about the long term success of their patients.

If you want to read up on PCL reconstruction, go to www.pubmed.org, a national website on medically related articles (just the abstracts), and type in PCL and treatment.  A doc who is published on PCL reconstruction is Noyes FR. 

Dr. Shelbourne, one of the best ACL surgeons in the country, treats PCL non-operatively. He has also published on PCL injury.  You can search.

Good Luck,

Nick

Age: 35
1989 rt ACL (+25 degrees ext loss)
1994 rt ACL resection (+ 10 deg)
2001 rt ACL revision (+ 10 deg)
2003 rt med meniscus repair (+10 deg)
2004 rt LOA and post capsulotmy (zero degrees)
2005 rt LOA and tib bone plug removal (even w/ other leg)
2006 rt Fulkerson TTT & ACI Carticel

Offline fuffy

  • Forum Faithful
  • ****
  • Posts: 163
  • Liked: 0
  • To ride or not to ride - What a stupid question!
Re: ACL & PCL recon?
« Reply #2 on: March 15, 2005, 07:10:55 PM »
Nick -

Thanks for your help. :D

 I'll get right onto it.

Fuffy
Arthroscopy in January. Follow up 22.2 05. MRI. Now awaiting ACL reconstruction and possible MCL and meniscus work on April 1st

Offline KJ

  • Forum Faithful
  • ****
  • Posts: 184
  • Liked: 0
  • User's Text
Re: ACL & PCL recon?
« Reply #3 on: March 15, 2005, 09:23:12 PM »
I'm sorry to disagree with the post above but not reconstructing the PCL is fine if that is an isolated injury but that does not apply at all with a multiligament knee injury involving both cruciates at the same time. This is a serious injury causing multidirectional instability and usually involves a collateral ligament also being affected (it is actually likely to be a spontaneously reduced knee dislocation)

I ruptured ACL/PCL/MCL and posterolateral corner whilst skiing and my original surgeon reconstructed my PCL first and then the ACL. This is one option but having read all the medical literature I think most very experienced surgeons would tend to mend all ligaments in one sitting.

After failure of my grafts because the posterolateral corner had not been addressed I eventually saw a great multiligament surgeon who not only revised my ACL/PCL but reconstructed my posterolateral corner AND did an osteotomy all in one sitting. (It was 5hrs of anaesthetic though) It was tough but my knee is now fantastically stable and although I still have soft tissue issues 18m on I would class it as a success

If I could rewind my last 4 years with the knowledge I have now, I would DEFINITELY find myself an extremely experience multiligament surgeon (who has done a number of these rare injuries) and have all the ligaments addressed at once. THen you might avoid the 8 surgeries that I have ended up having (the 9th is next month to remove some metalwork!)

If you have any specific queries you could message me
KJ
ACL/PCL/MCL/PLC rupture April 01
diagnostic arthroscopy June 01
PCL reconstuction Sept 01; MUA Oct 01
ACL reconstruction Nov 01; arthroscopy Jan 03
HTO,posterolateral recon + ACL/PCL revision recons Sept 03;
MUA Jan 04
arthroscopic debridement of scartissue May 04
metalwork removal April 05

Offline fuffy

  • Forum Faithful
  • ****
  • Posts: 163
  • Liked: 0
  • To ride or not to ride - What a stupid question!
Re: ACL & PCL recon?
« Reply #4 on: March 16, 2005, 08:27:30 AM »
Thanks KJ  ::)

It sounds like you have been having a really rough time!!!

My ACL has gone completely,PCL & MCL both partially, and there is some damage to meniscus...I could write a book on instability!

Have a surgeon with a very good reputation in London. Going on April 1st. Have been assured that he will mend everything that needs mending, but that was before I had the results from the MRI and knew about the PCL.

Where did they take your grafts from? I presume they would use the patellar ligament and the hamstring.
Both on the same leg? My consultant says they sometimes use a bit of the achilles tendon?

Wish it were all done and dusted! getting more and more nervous by the minute!!

Good luck with your upcoming surgery. Hope it goes well and this is the end of all your troubles ;)

Thanks again -  Fuffy
Arthroscopy in January. Follow up 22.2 05. MRI. Now awaiting ACL reconstruction and possible MCL and meniscus work on April 1st

Offline Nick_Knack

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 533
  • Liked: 3
  • User's Text
Re: ACL & PCL recon?
« Reply #5 on: March 16, 2005, 04:29:54 PM »
Hi KJ,

You obviously speak from first hand experience, so it is worth more than my experience. I have only torn ACL's in both knees. 

However, since Fluffy you have only partially torn PCL and MCL, you may want to let them try to heal. I wonder if the surgeon who does your ACL can check out the MCL and suture it and also do this with the PCL to help it heal.  Again, I have no personal experience with this, but it seems like a logical possibility.

Good Luck,

Nick
Age: 35
1989 rt ACL (+25 degrees ext loss)
1994 rt ACL resection (+ 10 deg)
2001 rt ACL revision (+ 10 deg)
2003 rt med meniscus repair (+10 deg)
2004 rt LOA and post capsulotmy (zero degrees)
2005 rt LOA and tib bone plug removal (even w/ other leg)
2006 rt Fulkerson TTT & ACI Carticel

Offline KJ

  • Forum Faithful
  • ****
  • Posts: 184
  • Liked: 0
  • User's Text
Re: ACL & PCL recon?
« Reply #6 on: March 16, 2005, 06:01:51 PM »
Nick
I agree, partial PCL tears are not the same as complete ruptures. The functional and clinical instability would need to be assessed in order to decide what needed surgery
KJ
ACL/PCL/MCL/PLC rupture April 01
diagnostic arthroscopy June 01
PCL reconstuction Sept 01; MUA Oct 01
ACL reconstruction Nov 01; arthroscopy Jan 03
HTO,posterolateral recon + ACL/PCL revision recons Sept 03;
MUA Jan 04
arthroscopic debridement of scartissue May 04
metalwork removal April 05

Offline blaunch

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
Re: ACL & PCL recon?
« Reply #7 on: March 20, 2005, 10:01:48 PM »
Hi Fluffy

I am new to all this and was interested to hear in your post about having found a surgeon with a good reputation in UK. Am wanting to do some research in advance on O/S's  should I decide (if surgery goes ahead) I'm not comfortable with the one appointed to me.
Can you or anyone out there recommend how to go about it? I have a suspected severed ACL,MCL & torn meniscus but the MRI results are not conclusive. Due to the mass of swelling they are uncertain as to the extent of damage..I've had two appts, both with registrars.The first told me to try and walk on it then attempted to fit a brace rather badly.The second registrar was to give me my MRI results but decided to let me read it myself and when ever I asked a question he would disappear into the adjacent room..
I thought I was seeing the consultant but it transpires he was the one in the other room! It was disappointing not seeing the consultant particularly when I find out later that  new patients get to see a consultant on there first visit yet I didn't??
So I'm already seeing cracks in the system which is making me very nervous . I left with the recommendation I rest to reduce the swelling and come back in three weeks for reassessment so I still feel very much in the dark.
 I want to be in a position to request a referral if entitled to it but a referral to who?? Thus the research. My GP has been no help so if anyone can help me it would be much appreciated.
Babs

Offline fuffy

  • Forum Faithful
  • ****
  • Posts: 163
  • Liked: 0
  • To ride or not to ride - What a stupid question!
Re: ACL & PCL recon?
« Reply #8 on: March 21, 2005, 10:24:10 AM »
Babs :D

First of all: Welcome to the Knee Geeks!

I took my injury to A&E. They gave me painkillers (Ibrprofen) and told me I shouldn't have been sitting on a horse in the first place and that I was being a wimp and had sprained my knee. No consultant

Went to my GP for more painkillers and he refered me to the sports physiotherapist, who is also the head of A&E here in Jersey.  He sent me straight to the conultant for arthroscopy. No MRI. Do not pass Go -  Do not collect 200.

Had arthroscopy but nothing was actually mended. PT 4X weekly. Much more mobility but still no life. Threw my dollies out of the cot at the consultant's office, and he referred me to the chap in London and got the MRI done just to give to the guy in London. Which tells us that there is rather a lot more damage than we knew about...

When my daughter broke her arm aged 11, the ulnar nerve was damaged. She was unable to move or feel 2 fingers on her right hand, and they were not going to let me see the consultant!!!

By the way, it helps if you start shouting BUPA early on in the proceedings.

Hope this helps you. Can give you the name and info about the place in London If you like

Best of luck - Let us know how you get on

Fuffy ;)

Arthroscopy in January. Follow up 22.2 05. MRI. Now awaiting ACL reconstruction and possible MCL and meniscus work on April 1st

Offline blaunch

  • MICROgeek (<20 posts)
  • *
  • Posts: 4
  • Liked: 0
Re: ACL & PCL recon?
« Reply #9 on: March 26, 2005, 12:09:09 PM »
Thanks Fuffy

Its slightly comforting to know I am not alone when it comes to 'NOT seeing consultants!!
I have made a personal request to see him next time so we shall see???
Interesting to read you had an arthroscopy first rather than an MRI and quite intensive PT. My injuries seem similar to yours
yet I've not been given any PT, perhaps because theres still alot of swelling? So many questions and no answers, am counting
down the days till I can find out what is really going on.
Yes I would appreciate the info on the guy in London, the more info I can get the better.

Good luck with your visit on the 1st.
Let us know how you get on.

Babs
 















support