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Author Topic: Torn ACL and Meniscus  (Read 2188 times)

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Offline Bruce23

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Torn ACL and Meniscus
« on: March 21, 2008, 04:32:25 PM »
Hey all,

About four months ago, I landed in a twisting motion from a jump and injured my knee.  I heard two loud pops followed by very intense pain for about 20 minutes.  I went to the ER (by then, about an hour later, I was able to walk on it) and the doc did some physical exams and said it was a grade 1 lcl sprain. 

I did RICE for a week and took NSAIDs for about a month.  I could not fully straighten or lock my knee at the beginning but I was seeing improvements everyday.  In about a month and a half I was able to straighten my knee fully with no pain even with full body weight on it.  However, the progress on bending was slower.  I am able to fully bend it now, but I am not able to sit on my leg as the extra flexion causes intense pain.  I haven't started exercising since the accident but things are normal otherwise except for mild pain when I climb the stairs.  I never experienced any instability of the knee at all.

I had an MRI and just got the results.  My family doc said that I have a torn ACL as well as a torn meniscus.  She said the ACL is either partially torn or there is scar tissue around it.  I am going nuts.  My OS appointment is not for another 10 days and I am very worried about what this really means.  Can anyone help answer some questions?

1) Do I need surgery?
2) If I do, how long usually does it take to get the surgery from the first visit?
3) How long does the rehab take?
4) I have a 2-week long mountain climbing trip coming up in 4 months.  It is not everest or anything that straneous, but it is a major trip.  Will I be able to do it if I have the surgery right away?
5) If the answer to # 4 is "no", can I postpone the surgery until after I come back?  ( I will haul myself up the mountain with hands if I need to)

Thanks for your help
Martial arts accident 11/16/07
ACLr + Meniscus trim 4/24/08

Offline jathib

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Re: Torn ACL and Meniscus
« Reply #1 on: March 21, 2008, 05:19:33 PM »
Yeah, you're probably going to need surgery. However, you can live without a torn ACL and meniscus if you don't do anything strenuous or play sports. I wouldn't recommend doing that though. I did it for 17 years and ended up with severe arthritis and a partial knee replacement as a result.

How long it takes to schedule surgery depends on where you are. If you're in the UK that process can take more than a year judging from this web site. If you're in the USA it depends on your surgeon's schedule. With my last surgeon I was able to book surgery four days after I made the decision. Now that he's gone and I have a new surgeon I'm having to wait over a month for a rotator cuff repair.

Rehab is long and hard. Expect six months to a year to be back to normal.

Forget about the hike. You won't be ready after surgery and I wouldn't recommend doing it with a trashed knee. You could end doing more damage and being carried down the mountain. Others may have different opinions but at the end of the day you really need to ask your orthopedic surgeon these questions.

Offline Bruce23

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Re: Torn ACL and Meniscus
« Reply #2 on: March 22, 2008, 01:09:09 AM »
Thanks for your reply Jathib.  My OS appointment is 10 days away and I need to get some info before then. 
Martial arts accident 11/16/07
ACLr + Meniscus trim 4/24/08

Offline Bruce23

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Re: Torn ACL and Meniscus
« Reply #3 on: March 22, 2008, 01:15:59 AM »
Update:

I picked up a copy of the MRI results from my doc.  This is weird.  It says there is a tear of the meniscus, all good.  But then it says there is a chronic tear of the ACL with a thin remnant of the ligament bridging the tear.  I have never had a knee injury before and I have never had any knee stability issues, not even now. 

Is this going to complicate things?  How could there be a chronic tear?  What do they do with the existing "bridged" ligament" during the surgery?

Thanks

Martial arts accident 11/16/07
ACLr + Meniscus trim 4/24/08

Offline Kaputt_Knee

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Re: Torn ACL and Meniscus
« Reply #4 on: March 22, 2008, 07:18:55 AM »
Sorry to throw water on your hopes but you have torn your ACL and your meniscus. If you take part in your trip it could be OK BUT the chances are you will have problems and there is more than a strong chance you will make the situation in your knee worse. Plus you are putting an extra burden on the people with you, especially if they have to bring you out if your knee goes completely during the trip. Are you really that selfish?

I've had this problem too and have had to bite the bullet and give up until the problems are sorted. The more special the trip, i.e. remote, the greater the mental and psychological burden you are placing yourself and your fellow climbers under. Your OS will want to operate and then your rehab time will bite into the holiday any way.

The sooner this is sorted the sooner you will be back to your activities, probably without any problems. The bonus being that if you rehab properly you'll be in a fitter state than before the accident!

I hope you get things sorted out quickly and you will be back climbing soon

Sue  ;) in Germany
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline Audice

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Re: Torn ACL and Meniscus
« Reply #5 on: March 22, 2008, 10:57:42 AM »
Bruce ~ Since the ACL is a fibrous ligament, it's apt to tear strand by strand. Like your MRI report, mine too showed the possibility of a strand or two left. The OS assured me it was ruptured as yours probably is, too.

I'm one of those people who can live w/o an ACL because of my age & my sport. Riding my horse doesn't seem to challenge my knee & being a senior, my OS is not inclined to reconstruct the ACL. Frankly, I don't feel the need to have it done, either. But if you're young & into sports, you're surely going to be held back by not having a functioning ACL with more knee stability than you have now. 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 Bruce23

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Re: Torn ACL and Meniscus
« Reply #6 on: March 25, 2008, 03:56:09 AM »
Thanks for your responses guys.  I understand what you are saying.  i will need to take care of this and miss the trip.

I will see the OS next Monday and will post the results in case someone else has the same issue.  However, I am hoping there is a mistake in my MRI interpretation.  I have _never_ had knee stability problems doing martial arts, racquetball, soccer, climbing, etc and yet they say I have a 'chronic' ACL tear.   We will see.

Martial arts accident 11/16/07
ACLr + Meniscus trim 4/24/08

Offline jathib

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Re: Torn ACL and Meniscus
« Reply #7 on: March 25, 2008, 02:07:01 PM »
Don't get your hopes up. Sounds to me like your very first post is a good indication that your ACL reached its limit and snapped. Kind of like a rope that breaks a strand at a time. Sure, it's gonna hold you for a while, but at some point the stress is too much and it's gone. You seem to be in a bit of denial at this point. Don't make the mistake of shopping around for a doctor until one of them tells you what you want to hear.

MRIs are not perfect. But most commonly they show things that aren't there or don't show things that are. It's less common for the radiologist to make an error in the interpretation. They are experts at such things.

Offline Bruce23

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Re: Torn ACL and Meniscus
« Reply #8 on: April 07, 2008, 07:32:43 PM »
Well, the community replies to my posts were pretty accurate.  I saw an OS and he confirmed I have a torn minescus and ACL.  I am having Hamstring ACL reconstruction in a little over two weeks.

What do you guys think about trimming vs. repairing the minescus? from what I have read repair means no weight bearing for at least 4 weeks and it is not very effective.  On the other hand, trimming large section causes arthritis in a few years.  Is this right?
Martial arts accident 11/16/07
ACLr + Meniscus trim 4/24/08

Offline jathib

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Re: Torn ACL and Meniscus
« Reply #9 on: April 07, 2008, 08:33:28 PM »
What do you guys think about trimming vs. repairing the minescus? from what I have read repair means no weight bearing for at least 4 weeks and it is not very effective.  On the other hand, trimming large section causes arthritis in a few years.  Is this right?

You're likely to get arthritis no matter what you do. The damage is already done and the degeneration of your knee has begun. Meniscus repairs have a high failure rate from what I've read. A long rehab and a good chance of failure. A trim is a quick recovery but since you're going to be doing an ACL recon you'll have a long recovery anyway. Sometimes the decision gets made during surgery since some tears can't be repaired anyway.