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Author Topic: is acl reconstruction and partial menisectomy a good idea?  (Read 1615 times)

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Offline mtnjim

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is acl reconstruction and partial menisectomy a good idea?
« on: January 25, 2006, 05:01:57 PM »
I first injured my left knee on 1996.  Overall it's been pretty reliable since then, dropping me occasionally, but always popping back in and working very well.It was diagnosed as a torn acl with meniscal tear.  Since it has been so functional, I've never done anything but wrap it with an Ace bandage and go.  I should mention that I'm very physically active, mountain trail running, skiing, climbing (I really like ice!) and general mountaineering, especially high altitude (2nd unsuccessful Broad Peak attempt this past summer). 
It's gotten worse this fall, locking up more often and in situations that it never had before.  Since I'm down recovering from a shoulder dislocation, I am making arrangements to have the knee worked on.  But after reading several posts, I'm wondering.....you see, I've assumed that the acl reconstruction and meniscal repair would make the knee reliable again, that sfter a period of recovery I would be able to jump back into my usual activities.  BUT is that generally the case.  It makes no sense for me to have the thing fixed if it won't improve my performance.  If I have to give up doing stuff,  that I can do without surgery.
Experiences and advice?

harry78

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Re: is acl reconstruction and partial menisectomy a good idea?
« Reply #1 on: January 25, 2006, 07:03:23 PM »
Hello jim,

Well I was diagnosed with the same in the middle of 2004 and I suppose I made up my mind there and then. I did this because as the ACL was torn proximally it did'nt have the ability to heal, even partially and it was giving me hell when doing exercise.
So I went for it and it has gone very well so far (touch wood).
In your case it would be probably an excision of some of the cartilidge and then reconstructing the ACL rather than a meniscal repair (I think its too long since you had the injury) and because the knee has generally felt well even after a ACL tear I would think then the outcome is favourable to you. Being active in your rehab is v important and sticking to the regime is critical never jump the gun and know the limitations. This is what I've learnt so far.
Hope this helps, Harry

Offline blackbeltgirl

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Re: is acl reconstruction and partial menisectomy a good idea?
« Reply #2 on: January 25, 2006, 09:37:55 PM »
If your knee is locking up, odds are something is physically floating around inside the knee.  It could be from the meniscus tear - certain types of tears literally result in a flap of meniscus waving around inside the knee, and ocasionally getting caught.  It could be articular cartilage - if you've had a tear since 1996, it could have work away at the nearby articular cartilage, and some of it could have broken loose and is now floating through the joint.  I don't know about the ACL.  But I certainly wouldn't go up a mountain without confidence that I could get myself back down, and with a knee that locks up periodically, that has to be unsettling.  I'd talk to an OS about the situation in your knee, and YOUR GOALS.  Make sure your dr. is willing to help you reach your goals, and not settle until you do.  (A sports medicine OS would be best.)  After examining your knee, he may decide to send the scope in, and just clean out the floaty stuff, leaving the rest of it alone.  But definitely make sure you discuss possible outcomes.  If you have articular damage, which is likely, some OS's will want to perform microfracture.  Ask your OS about that possibility, and make a decision in advance if you're willing to authorize it.  But basically, talk to the OS first.  You don't have to decide to go ahead with surgery, or exactly what surgery to have, until you have a better idea of what's going on with the knee.  YOu're always free to refuse the surgery offered.

Jess
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline jb-knee-geek

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Re: is acl reconstruction and partial menisectomy a good idea?
« Reply #3 on: January 25, 2006, 09:46:18 PM »
hey mtn, my OS stated that if your knee is not stable, or you have pain from the meniscus tear, then you're a good candidate for surgery.

Meniscus is a shock absorber, the more they take out the less to absorb your bounce. This is an issue for potential athritis.....

Better check with your OS to be sure of your post-op activity assumptions, especially skiing and running....

I've taken up cycling and swimming for fitness and gave up pivot and bounce sports while I sit on the fence about surgery.

ACL/meniscus surgery is usually successful in elliminating pain and providing stability.

good luck, keep posting.
torn RK ACL March 2001, surgery Aug. 14 2006, after 4 knee sprains since Oct. '05.  Allograft, ~40% medial meniscus removed, some wear in the trochlear groove. Everything else looks good.

Post-op diary: http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=29749.

Offline mtnjim

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Re: is acl reconstruction and partial menisectomy a good idea?
« Reply #4 on: January 26, 2006, 03:17:49 AM »
Thanks folks.  More stuff to think about.  I need all the suggestions I can get. Since the shoulder is going to need some work and I'll be unable to work for a few months, I'm going to have to decide about this fairly quickly.
Thanks again,
Jim

Offline UK Girl !

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Re: is acl reconstruction and partial menisectomy a good idea?
« Reply #5 on: January 29, 2006, 02:33:11 PM »
hi Jim
My 15 year old son had his acl and meniscus tidied up in june 2005 - he is just now going back to play sport - although he is not allowed to kick a ball yet - there has to be something to put his foot onto like in running - they say that by april he should be able to get back to full sport ( rugby looney) lots of physio - its not a walk in the park but his reconstruction is now stronger than his other leg ( he is double jointed and has lax muscles)
good luck
1978 - ruptured acl and all cartalidge removed.
several debridements over years
TKR 10TH JULY 2006 http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=28257.0  Aug 07 patellar maltracking - more physio! Still pain - but so much better !
BIOMET AGC  TKR  (with 10 yr warranty !)















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