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Do you think I should get ACL surgery?


Author Topic: Should I get ACL surgery?  (Read 2048 times)

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Offline jfong252

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Should I get ACL surgery?
« on: August 18, 2009, 01:59:35 AM »
So...I have now injured my knee/ACL a total of 4 times in the past 7 years. 3 times 6-7 years ago, and then again last month. In the past few years, I have felt instability in my knee when I work out on the elliptical and while I'm dancing (Chinese dance, similar to ballet). But I have always been able to catch myself and avoid another injury...until now. 6 years ago I saw the sports doctor and he diagnosed me with a partially torn ACL and I had two options: surgery or PT. At that time PT was a better option for me since I was 14 and still growing. Now, 6 years later and almost 21 years of age, I am again faced with the same two options. The doctor told me that my ACL is still hanging in there, and I could still risk it and not do the surgery, but since the knee is so unstable, it can easily give out and damage the knee even further (complete ACL tear, meniscus damage, arthritis, etc). I am determined to continue to dance as much as I can since it is my number one passion.

So my question is, with a partial tear, is it better to get it surgically repaired, or stick with physical therapy. And if I do get the surgery, comparatively would it be significantly stronger than the torn ACL I have now?

And apparently my patella isn't exactly lined up with the groves in the femur and tibia. Does that also cause knee instability? If I get the surgery, will my messed up patella still be able cause me to injure my ACL?

« Last Edit: August 18, 2009, 08:11:37 PM by jfong252 »


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Re: Should I get ACL surgery?
« Reply #1 on: August 18, 2009, 02:24:05 AM »
OK, I've only just injured my ACL for the first time, but several kneegeeks have been very helpful providing me with reading material.
So, this is as layman an opinion as they come, but I have read that your reconstructed ACL can be just as strong as your native ACL, but that it all depends on the graft chosen, and on the surgeon's skill with that technique.  It seems the way to go for active people like ourselves (my passion is riding horses, among other things) is to have it reconstructed, and to choose a patellar tendon. The patellar tendon is the strongest, because it is removed from the host site with a plug of bone at each end.  This allows a stronger attachment to form to the sight they graft it to, which is also bone.  The bone to bone healing is faster and stronger than tendon to bone, which you get with other grafts.  I also read that if they take the graft tissue from your own body (autograft) it also heals better and faster,  then aparently the strongest and fastest technique for very active people who are rearing to go back to their no-knee-issue lives is to get the patelar tendon from the uninjured leg.  That allows the recovery to progress the fastest.  This technique was made popular by a surgeon named Shelborne.
OK...sorry.  I probably sound like a student writing an essay for a test.  LOL!  But I have been trying to learn all this stuff and my head is now filled with all of the homework I was given.
OK.  Back to your question: should you get the ACL reconstructed.  I think yes, if you want to remain active and are having instability.
Good luck,

Offline jfong252

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Re: Should I get ACL surgery?
« Reply #2 on: August 18, 2009, 02:35:53 AM »
Thanks for your reply :) Most people I have been asking think I should get the surgery, so now its pretty much a matter of when I should get it. I think the doctor said that the best option for me is an allograft (transplant from a cadaver) because its the quickest recovery and should be strong as well. They also choose grafts from the cadaver that is the strongest (patellar tendon or achillies tendon).

I'm more worried about my slightly misaligned patella for which my doc told me "don't worry about it, its just how you are built". I don't want to get the surgery and then have my patella screw it up again.  :-\
« Last Edit: August 18, 2009, 03:32:24 AM by jfong252 »

Offline Ferris

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Re: Should I get ACL surgery?
« Reply #3 on: August 18, 2009, 09:40:03 AM »
I had a partial tear in my left knee caused by a fall while skiing in December 2002 (first day of holiday).  For the first two years, the surgeon and physio felt that it was too stable to warrant reconstruction so I followed the conserservative route of just physio in that period.  However, during the end of the second year I began to develop an ache around my knee cap especially on the medial side.  During the third year it became a constant pain and I began to lose strength and performance in that knee.  I eventually went to see my physio again at the end of 2004 and she suggested that I went back and saw my surgeon which I did at the beginning of December 2004.  The physio said that the pain was caused by the knee cap moving around offline as the knee was too loose due to the partially torn ACL.  The surgeon confirmed this and suggested that it was now time to do an ACLr before it did any other damage to the knee.  He suggested that he do a hamstring autograft as he was not keen to touch the patellar tendon in that knee because of the tracking issues that I had experienced.  I agreed to this and had the ACLr in January 2005.  I did pull the hamstring tendon several times in the beginning but that reduces as time went on.  I can kneel heel to butt which is more difficult (if impossible) with the patellar graft.  I am a keen athlete - rowing, running and swimming and have been able to continue with these on a regular basis including rowing at a competitive level and have taken part in two Races For Life (5km run/walk in aid of Cancer Research) - I ran it this year in a time of 27.03.  I make sure that I do hamstring curls in my weekly weights session and haven't had any issues with it in ages.  I don't think that having the hamstring autograft rathather than the patellar tendon autograft as I am not a professional athlete.


Offline Audice

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Re: Should I get ACL surgery?
« Reply #4 on: August 18, 2009, 12:29:49 PM »
Although I've not had ACL reconstruction (because I'm beyond an age where an OS thinks I really need one) my response to your question would be - YES - get the ACLr done. You'll otherwise need to alter your lifestyle & you're too young to have to do that. 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 luvmy4girls

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Re: Should I get ACL surgery?
« Reply #5 on: August 19, 2009, 02:36:11 PM »
Hello.  I had my first ACL reconstruction when I was your age and did great.  You are go ahead and have the surgery to prevent future problems with your knee.  I re-injured my ACL last year and am 8 months post op of ACL reconstruction revision.  But, my knee did great for 18 years before my re-injury.  So my advice is not to wait and go ahead and have the surgery so you can be active without worrying about your knee all the time.

Good Luck!

2/1991 -  Rt knee torn ACL & MCL
3/12/1991 - Rt knee ACL reconstruction
6/2008 - Rt knee re-injured ACL
12/17/2008 - Rt knee ACL Reconstruction Revison