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Author Topic: Advice anyone? Am I really too old?  (Read 1900 times)

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Offline macdon

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Advice anyone? Am I really too old?
« on: December 12, 2006, 05:42:54 PM »
Hello Everyone,
 Looking for some experienceand wisdom here, I tore up my knee back in July playing ultimate frisbee and just had an MRI  two weeks ago, It showed a complete tear of the ACL and an undisplaced tear of the medial meniscus.
 I just came back from the knee surgeon today who suggested that at my age (53) I should just get scoped to clean up the cartiledge and take the rehab and try to play from then on with a brace. I have been very active with ultimate frisbee , hockey and squash. I also feel I am in the best shape I have ever been until this injury.  I am somewhat disappointed to think I may continue to have a problem after I get scoped that I would need a brace. On the flip side the surgeon thought I would have stiffness or other problems with the knee later on if he did an ACL reconstruction.
 Any comments would be appreciated. I hope to get a second opinion but it looks as though it will be end of January to see another surgeon.

Offline Audice

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Re: Advice anyone? Am I really too old?
« Reply #1 on: December 12, 2006, 07:09:50 PM »
Hi macdon ~ Welcome to the forum & be prepared for the number of people who will respond that indeed you're not too old for ACLr. I'm 68 & getting along just fine w/o one but my sport doesn't require that I be able to pivot, twist & turn. I'm a horseperson & I can manage just fine (so far) w/o an ACL.

A top OS here in CT, & an acquaintance, told me just after my injury that what he was doing today to provide a better way of life for people with injured knees is above & beyond what was done years ago. And if I felt that having no ACL was a detriment to the way I wanted to live, I'd be running to him & requesting the reconstruction.

At your age, if you're determined to have the surgery, take heed to what some of the people on this forum will advise. I suspect not only will they tell you to seek a second opinion but they'll recommend OSs who will consider doing the reconstruction on us older folk. Wishing you well...Ellie
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline Kai

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Re: Advice anyone? Am I really too old?
« Reply #2 on: December 13, 2006, 08:19:37 PM »
Im almost 49 and I had ACLR in May of this year.  For me, the issue was "did I want to keep doing the things I love?"  It was a no brainer.  I had the surgery and I am my OS's poster child.  More motivated and less whiney than the kids.   Last Saturday, I passed my test for high yellow in Tai Kwan Do just 6 months after surgery.  Yesterday, I started doing flying kicks again.   If the doctor had told me I was too old I would have RAN - not walked but RAN - out of his office to find a surgeon that knew what he/she was doing.   Good luck.
ACLR - (patellar BTB autograft) left knee - May 31, 2006
Partial Lateral Meniscectomy right knee Feb 20, 2008
Partial Lateral Meniscectomy right knee Aug 11, 2008

Offline UK Girl !

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Re: Advice anyone? Am I really too old?
« Reply #3 on: December 13, 2006, 08:47:55 PM »
I had total rupture of my acl when I was 18 and had it not been for such bad arthritis in my knee resulting in a TKR I would still have not had it repaired - always very physically active and sporty - knee suported by strong muscles. Had my TKR at 43.

I blieve though that if you want to go back to sports like squash then you would probably be wise to have it repaired - go for the second opinion - you are too young to give up on these pleasures in life!
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 !)

Offline raquetball1

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Re: Advice anyone? Am I really too old?
« Reply #4 on: December 13, 2006, 11:28:06 PM »
Hi there,

Had bone-patellar tendon-bone acl recon at one month shy of fifty-one.  I too was about as fit as I've been in my life when this acl tore.  I also have a long-standing, unrepaired acl completely severed in other leg and have relied on a custom acl brace when on the racquetball court.   So, I kind of represent both sides of the story, so to speak.  It is interesting to note that the two of the responders who had aclr had autopatellar aclr.  I'm kind of assuming that OS's like having those bone plugs to enhance bone matrix development in the tunnels in those of us who are busy losing bone tissue, given our ages. 

Things to consider:
1.  Most important:  regardless of which way you go (op or not to op), work all your muscles using "knee friendly" machines and techniques now and don't stop until you decide which way to go, then just follow OS's orders from there on. 

2.  Do you have instability in your acl deficient knee?  If not, bracing for sports would be my choice at our age.  I got probably a good fifteen years of pain-free rball play with brace and it didn't inhibit my movement, speed or ability to dive and spring back up.  Only reason I started getting problems with the unrepaired leg is I let the brace slip and didn't re-sit it.  Had a massive lateral buckle which is still problematic for me.  My bad.  (If you wonder why I would make this choice but had my other acl reconstructed, try wearing two braces in squash.  :)  ) 

3.  Aclr is a long time commitment.  Kai is somewhat unusual for aclr re return to sport.  For most, it's a minimum of six months post-op.  I would suspect that for squash you could possibly return at six months...carefully.  If your hockey is ice hockey, i.e. high contact sport, you're probably looking at more like a year before you'd risk taking stick whack or leg/body whack into the side of your knee.  Ultimate frisbee presents the variable of a grass, therefore, uneven "foot catching" type surface, so, again, minimum six months, most probably longer before return to that sport.  Your will have to continue your rehab workouts for the remainder of your time playing these sports. 

4.  Getting an OS who will operate on you is really the least problematic for our age group.  More problematic is getting a good PT or physio who understands that a fifty something recreational sportster needs the same intensity and length of PT that an "elite" high school track star or college soccer player needs.  I was told by PT pre-op and post-op that two months PT was standard.  However, I was lucky enough to be doing pre-hab when they were dealing with a state champ sprinter who was five months post-op and still in PT, so I knew better.  Also, I started a career in the medical field at age eighteen and know enough to "get in the faces" of medical professionals and tell them no way you are going to "cheat" me out of full six months rehab.  As I recall, my first "volley" when they were ready to discharge me at three months was "All your sprinter has to do is straight line running.  I'm going back to one of the most knee-stressful sports out there, hard-planting, extreme pivoting, quick burst full out runs from a sort of lax position etc." 

5.  Other than a real phenom (feeney, a thirty something guy I think), I haven't found anyone on the cruciate lig. board who says the leg feels the same as a normal leg after aclr.  You're looking at essentially breaking two major bones to drill the tunnels for graft placement.  If you get same procedure as Kai and I, more essentially bone breaks to get those bone plug connections when harvesting the middle third of the patellar tendon.  [Interesting to note that med. research lit. I've read show that the patellar tendon, in this procedure, is still not completely healed at five years post-op.]

6.  The psychological battle.  This one is hard for ALL aclr's.  We all worry about graft failure or retear.  For the older patient, I think this is exacerbated by pretty much knowing that finding an OS who will do an aclr revision on an older person is darn near impossible and, at our age, if we could find a willing OS, just how much time in our lives do we want to put on hold recovering and rehabbing again. 

Alot of things to weigh in your decision.  Hoping you'll choose what is right for you and that your choice gives you back all you want back.  Best wishes. 

autopatellar acl recon Nov. 2004 at age 51

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Offline macdon

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Re: Advice anyone? Am I really too old?
« Reply #5 on: December 14, 2006, 03:21:08 PM »
Can't thank you enough for your responses, the decision has gotten a lot tougher all of a sudden. I have managed to expedite an appointment with another OS this coming Tuesday. Your input means a lot, Thanks

Glen

Offline Audice

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Re: Advice anyone? Am I really too old?
« Reply #6 on: December 14, 2006, 04:29:40 PM »
Luck, Glen, & please let us know the outcome of your upcoming OS appointment...Ellie
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline Audice

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Re: Advice anyone? Am I really too old?
« Reply #7 on: December 19, 2006, 10:37:45 PM »
Glen ~ How did your appointment go today?...Ellie
April, 2005 - ACL rupture, medial meniscus tear within posterior horn to articular surface, abnormal signal within lateral meniscus, partial tear MCL, bone contusions tibia/fibula, Baker's cyst.
No repairs.

Offline macdon

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Re: Advice anyone? Am I really too old?
« Reply #8 on: January 18, 2007, 02:24:52 AM »
Thanks everyone for your input, I am getting the ACL reconstruction and meniscus repair on Tuesday Jan 23.
 I hope I've made the right decision!!! The surgeon is young and a real go getter. He sounds aggresive with the rehab and fully expects me to be playing again in 6 months with a brace as part of the rehab. I can't believe how much the braces cost.
 I'll keep you all posted :)

Offline macdon

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Re: Advice anyone? Am I really too old?
« Reply #9 on: January 18, 2007, 02:40:20 AM »
And does anyone know what a nerve block entails? I get the feeling it's going to cause some discomfort at some point during this sugery?

Offline iamme6

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Re: Advice anyone? Am I really too old?
« Reply #10 on: January 19, 2007, 02:46:18 AM »
A nerve block isn't all that bad. It shouldn't cause you any discomfort during surgery, you wont be able to feel a thing by then. I don't know if there are other ways to do one but here's what I experienced with a nerve block for ankle surgery. I had to roll over onto my stomach while the anasteologist did a series of poking?? Electrical stimulation?? ( not sure I didn't ask) down my leg to make sure they are blocking the right nerve. I have no idea what they injected me with to temporarly deaden the nerve.  I was sedated.... but not enough. I asked for more and they gave it to me. It was a little uncomfortable but nothing too bad. After the surgery, I couldn't feel anything from my rt hip down to my toes for a good 24 hours. It was almost like my whole leg was dead.
Hope this helps! Good luck!

Offline UK Girl !

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Re: Advice anyone? Am I really too old?
« Reply #11 on: January 19, 2007, 10:58:53 PM »
When I had my nerve block I was lieing on my back and they put a needle in the top of my leg and waited while my leg jerked about to find the right nerve to put the block in, they repeated this to put the block in the back of my leg - it wasn't so much that it hurt but was scary as your leg jolts uncontrollably until they inject the block - and unfortunately they didn't really explain to me in advance how it worked so I wasn't really happy having it done - of course I would know now!

My block lasted about 19 hrs. When it is in it is really strange to walk on - your leg and foot feels huge and like when you sit on your foot and it goes 'dead'.

I found it unbelievably painfull when the block wore off - which when it started to go - it happened all too quickly - but everyone is different I suppose.

I was meant to have the block and sedation but at some stage I ended up having a full GA anyway. I never did find out why - and I didn't even know I had a GA until the OS told me the next day - it was a change made by the anaestetist at the time - and I wouldn't presume to question her decision - she knew what she was doing!

anja
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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