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Author Topic: Is there any way to avoid surgery for this and have normal function?  (Read 2520 times)

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Offline Arity

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Forgive me if I ask a question that has been asked a million times.  I am a 40 yo female, quite active (until this).  In August of this year I was "tackled".  I heard no "pop" or anything like that but the pain was severe..took a while to feel even a little better etc.

Long story short, I received the results of an MRI this week.  The report states that my ACL has suffered a high grade (probably full) tear (exact quote) and that functionally anyway it may as well be a full grade tear.  Ive torn the meniscus in two places (one full thickness tear another smaller tear) and there is an "occult fracture", whatever this means, of my knee.

To say the least this is a little disheartening.  The knee is STILL very sore even 2 months later.  I will do what I have to to get this better, and have been seeing a physiotherapist, and my workout trainer has been very careful to not aggravate anything with our workouts. 

To my question - is there anyway I can get back to NORMAL activity (normal workouts, skiing, hiking etc) without surgery?  I know you guys aren't doctors but I'm sure your vast experiences will help!!

If the only way I'm going to get back to normal is surgery I will do it...because I dont want to resign myself to a life of avoiding activities I love (I'm only 40..not 90!!) ;-), but I am terrified of surgery!  I'm a big wimp! lol

Thanks in advance..I look forward to reading any experiences anyone has had with this!

Cheers.

Offline Clarkey

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #1 on: October 03, 2009, 02:08:33 PM »
Hi Arity,

I am also a wimp when it comes to surgery and thinking about cancelling my scope which is due anytime this month but my MRI scan came up normal while yours has come up with a few problems. Looks like you have torn your ACL and meniscus and some people can live with it depending on how much its affecting them and how painful it is. I think in your situation surgery the only way to get knee back to as normal as possible.

Are you limited in physical activities as I can no longer run since my fall back in October 2007 and are you in alot of pain. I feel you have no other choice but to have surgery which I been told is not that bad its mostly key hole surgery that your OS performs. Its not nice being knocked out which bothers me if I go ahead with my surgery but its not for a long period and mostly are day cases so can go home in the evening. I have been told its not good leaving a meniscus tear untreated as it could do more harm then good to your knee so best to have surgery even  though you dont like the thought of it.

I am not sure what "occult" fracture is but there a fair few problems with your knee and need to let an OS take a good look inside it.

Good Luck if you decide to have surgery and keep us posted.

Nick :) {2009} :)



RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline Arity

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #2 on: October 05, 2009, 03:46:20 PM »
Hi and thanks for the response!

It's sore every day..but not unbearable pain.  I've developed the uncanny ability to predict rain from my knee ;-).  I can function normally and walk but anything beyond that forget it.  Even if I walk quickly and stop suddenly the knee feels like it's going to give (although how much of this is the actual knee and how much of this is mental I couldn't tell you), but its when I forget about it for a couple of minutes it acts up to remind me its still there! ;)

I can't do a lot of the workouts I want as the doc has told me to avoid any kind of squats, lunges, etc. for now..aerobics, skiing, hiking etc.  forget it.  That's why I will fix it if I had to just prefer to avoid the surgery bit ;).


Offline crankerchick

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #3 on: October 05, 2009, 04:16:36 PM »
The decision to have surgery is very personal and its all about your quality of life that you want to live. People live with torn ACLs but what they can do is particularly limited, and there is always the risk of doing further damage to the knee. I'm no doctor at all, and haven't suffered an ACL tear, so I'm just sharing what I have read while hanging out here and doing independent research out of curiosity and what I've come across is simply, without an ACL, any activity that is linear is usually ok, but any activity that involves twisting or cutting, you can pretty much forget it. The meniscus injuries are also something you can live with it, but again, its a question of how the tears affect what you want to do. If the cartilage begins catching the knee, it can be very painful and cause the knee to lock. You can also make the tears worse. There's an intimate relationship between the ACL and the meniscus and leaving either or both unfixed can result in more damage to the knee over the long haul.

My doc does many ACLs a year and on average can get his patients back to sports in 3 months after ACL repair. He usually tells people, if they want to go back to any kind of higher intensity sports like mountain biking, motocross, football, basketball, tennis, skiing, etc then they are better off fixing the ACL. If they are going to be gym rat, hiker, walker, etc then they have a better chance of a life without an ACL. But it's a still a matter of overall stability in the knee. I believe the measure is how much the tibia can move. Too much movement can cause arthritic changes in the knee over time I believe.

Either way, you want to make sure you get an opinion from a competent doc and also you will want to assess the stability of your knee. It's good that you are in pt now and gaining range of motion and leg strength. That will prove very helpful if you do decide to have surgery.

As for being terrified of surgery, if you do decide to go that route, what I've learned is that is so important to be proactive about your options. Knowing your options and making the choices yourself versus blindly following a doctor for me has helped with my fears immensely. There are a lot of decisions to make when it comes to ACLs and being your own advocate for those choices might help you be less afraid of the procedure and the outcome. A competent surgeon is key, whichever ACL reconstruction you choose.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline Kaputt_Knee

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  • [Ed: Sue sadly passed away in 2016]
Re: Is there any way to avoid surgery for this and have normal function?
« Reply #4 on: October 05, 2009, 05:38:59 PM »
Long and short of it is you want to be active and never have to think about your knee giving out unexpectedly, have the operation.

If you can live without sport, always slowly and carefully walk in straight lines, never pivot, jump, stop abruptly, then don't worry, you don't need the operation yet. However you will probably need a new knee sooner rather than later as the amount of movement that your knee is having, minus its anatomical anchor is going to result in cartilaginous surfaces (meniscus and articular cartilage) being damaged over time. Once they are gone, arthritis moves right in.

A good knee specialist who regularly does ACL reconstructions will get you back to work within 4 to 12 weeks (depending on the nature of your work) and back to your sport within 6 to 9 months. A lot depends on that time-line as to what your sports/activities are, what your tolerance for pain is and how hard you rehab.

Everyone is nervous of being operated on, it is a natural survival instinct. But I would rather have my life back than give up on so much I enjoy.

Just my 2 cents worth.

I've been through 5 ACL reconstructions and would not think twice if I had to go through another. I would just make sure I had the right surgeon for me. An experienced surgeon on the same wave length as you is the key to success in any operation.


Sue  ;)
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 mollyc

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #5 on: October 05, 2009, 06:59:05 PM »
Before I ruptured my ACL, I had never had a sports-related injury. Never had surgery. Never been on pain meds! All of these things made me pretty nervous. But, I have to say, that surgery and rehab hasn't been that bad at all. It's been very straightforward and the rehab has gone very smoothly. I think the key...if you decide to go that route...is to be very well prepared. You'll need a lot of help for the first week or two.  It helps if your house or apartment is set up so that you have the things you need near you and can get around easily.  You need someone to drive you around for a while, especially if it's your right knee.  And, for me, understanding a lot about exactly what was going to happen, what the risks were, what to look out for, what the rehab was going to be like, what I was supposed to do...knowing all those things really made me feel better about the surgery and helped me be productive in the rehab process.

Of course, it is your decision and you need to figure out what is best for you. I just wanted to let you know that as far as surgery goes, this is not too bad.  Good luck with your decision making. Molly

PS. I'm 41, so I'm in your age range. I decided I had about 30 more years of active lifestyle in me, so wanted to do what I could now, while healthy, to make it possible to continue to be active as I get older. 
Ski accident 2/14/09
Ruptured ACL, MCL sprain, bone bruise
ACLr allograft 5/27/09
Knee now 100% fine...skiing and playing tennis regularly

Offline Arity

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #6 on: October 05, 2009, 07:21:56 PM »
Thank you everyone!  I really appreciate all your responses :).

I stopped seeing the physiotherapist about a month ago pending the results of my MRI and have continued with the exercises he gave me.  Once I got the results last week I made another appt and will be seeing him Thursday to devise a plan now that we know exactly what is wrong (he pretty much knew after examining me but we wanted to be 100% sure).  I'm in Canada and our wait times here are terrible so who knows when I will even get in to see an OS.   I just want to have a plan in place with my phsyio to a) either be able to rehab it enough to not have surgery or b) if this is not possible (and I honestly dont think it is as much as I wish it to be so - I will not accept never being able to ski again - I live near the Rocky Mountains lol) what I can do while I'm waiting to minimize my recovery time.

You all have been very helpful and I'm a little less worried and I'll be sure to do my research! :)


Offline bozza

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #7 on: October 05, 2009, 08:57:55 PM »
During a basketball game I torn my ACL. I took a quite a long time for me to find a right person to do a proper diagnosis and surgeon to operate it. Before that knee swelling settled and I did not have any pain. However, I started to play sport but my knee started to give-up (at sudden movements, twists, etc) and that is when I decided to go for a surgery. Also, someone suggested to get custom-made brace rather that surgery, but since I was in mid 20s I decided for surgery. I took about 6-7 months for the full recovery, and I returned to sports. I was prescribed a custom made brace for some period and after that it was not necessary according surgeon. Since then repaired ACL has been very strong...but I must say the surgeon was well known for his work. Today I got some minor issue with the meniscus, but ACL is intact. Get yourself a custom brace. I does provide extra physical but also mental protection.


Offline Clarkey

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #8 on: October 06, 2009, 07:16:04 PM »
I was going to say the same thing as Sue as if you leave knee untreated it could lead to a TKR which is major surgery while ACL reconstruction and meniscus repair are routine and a fairly minor surgical procedure. Stick to physio afterwards for it to be a success. You should be able to do the things you use to like doing again that you cannnot do right now or limited in what you can do once your have had your surgery.

I think I will be going ahead with my surgery as I am too young never to run again and its not right to feel catching and sharp pain inside the knee. I am very worried and concerned about my 1st every surgery like you, but sometimes we just have to face our fears as the hospital and OS are there to help us out when we are in need of their help. Its only 1 day of your life that not going to be nice to remember but at least you being helped out.

Get it done sooner rather then lator as the longer its left untreated the harder it is for the OS to get it right again. You say you worried about surgery but if you leave it untreated you will end up with even more then one scope on your knee so best get it over and done with.

Nick :) {2009} :)
« Last Edit: October 06, 2009, 07:19:46 PM by Clarkey »
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming

Offline heyannie

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #9 on: October 08, 2009, 02:02:44 PM »
To agree with what everyone else is saying, getting the surgery is completely up to you.  But, from everything that I have read, skiing could be something you would have to stop doing if you don`t have the surgery.  The constant cutting motion of skiing could cause your knee to give out and do more damage.  Some people, depending on what they do for work or activity, can live without an acl.  But ignoring the meniscus tear can also cause some serious early arthritis of the knee which would also make it hard to ski.  Everything that I have read and been through would suggest the surgery if you are an active person.  I had a bone patellar tendon bone ACL reconstruction and partial medial meniscectomy done about 6 weeks ago and like molly said earlier that its really not bad and rehab isnt too bad either.  I also agree that researching everything is an easy way to help make your decision.  I wish you the best to a speedy recovery.

Annie

Offline Arity

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #10 on: October 08, 2009, 05:14:29 PM »
Thanks again all!  Saw PT this morning he pretty much said the same thing you all are saying (I knew you guys were smart!).

So, I'm just waiting for the phone call from the OS. Who knows when that will be.  Luckily, my ROM is about 98% so if I had to injure my knee I lucked out that way.  Will just continue to stretch and wait...and wait...and wait

;-)

Edit: btw, I asked what an occult fracture was as I had no clue.  He said that when the ligament tears your bone moves in ways it shouldn't and when it reduces it causes the fracture.  It's healing...that part won't need any intervention ;p
« Last Edit: October 08, 2009, 05:17:38 PM by Arity »

Offline Clarkey

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Re: Is there any way to avoid surgery for this and have normal function?
« Reply #11 on: October 08, 2009, 07:28:22 PM »
Hi There,

I am pleased you are listening to your Physio and taken his advise and going for a scope which is not too bad I been told and will try not to chicken out of my scope as I also like to be more active again.

I warn you that you may have to wait a while for the surgery as I saw my OS on 30th June 2009 and still not got a surgery date and ment to be this month but dont think it will be anymore. The NHS are fantastic in emegencies and for cancer patients but for routine surgery a little slow.

Nick :) {2009} :)
RK: PFPS, Arthrofibrosis, Tendinopathy, Five cortisone injections
16/01/18 Anterior interval release, distal patella excision, lateral meniscal repair
18/07/14 Anterior interval release  
16/11/09 Medial plica excision, fat pad trimming















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