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Author Topic: Have I retorn my acl?  (Read 4581 times)

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Offline injuredguy

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Have I retorn my acl?
« on: January 15, 2011, 04:18:49 AM »
18 year old male. 3 weeks post op. patella acl reconstruct. i was going down the stairs when my crutch got stuck( still using one crutch, although i can walk) and i ended up putting all my weight on the operated knee. I felt a pop or crack inside . I was able to get up right away and I can still walk . The crack is very worrysome, should i continue on with my exercises and physio? Is there any way I can make sure that everything is ok? I am worried out of my head and I have exams next week. I waited so long for this surgery, over a year, and this would kill me if something happened. no swelling or anything except maybe a bit on the back of the knee. i feel stress when i lift my leg up onto the bed or couch. It has only been a few hours. Please help

Offline Kaputt_Knee

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Re: Have I retorn my acl?
« Reply #1 on: January 15, 2011, 05:45:47 AM »
Chances are not but making an appointment to see your specialist is probably the only way you will re-assure yourself.

The crack can be the breaking up of remnants of the scar tissue from the operation or it can be simply the joint moving explosively after a while of being held in an unnatural position.

Whatever we say here for your own peace of mind you need to see someone who can actually hands-on check out your knee. This is the only way you will be reassured.

Just for your information though, it takes a heck of a lot of force to snap that baby in the initial stages. It is at it's most vulnerable in the period 6 to 12 weeks after implantation, not so early in the rehab as you are currently at.

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 injuredguy

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Re: Have I retorn my acl?
« Reply #2 on: January 15, 2011, 03:27:05 PM »
Thank you so much for the reply Sue ;D, definetly comforted me a bit. I will make an appointment with my OS when his clinic opens up on monday. It has been around 12 hours now and there is still no swelling at all so Im feeling pretty confident that I didnt do any serious damage. I was just wondering what are the chances that I injured the graft or partially torn it? and whould the graft be able to repair itself? Also what are the reasons for the vulnerability between the 6-12 week period? One more thing, I went to emerg last night and the doctor told me that it feels a bit loose and to take off a week from physio. I personally feel fine and I am already a week behind in physio so should I rest up for the week or should I keep going with my exercises?

Offline fischbein

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Re: Have I retorn my acl?
« Reply #3 on: January 15, 2011, 05:18:20 PM »
Since I have seen no one answer your post with M.D., after their name I would suggest that rather than listen to those who know nothing about your case, and are not doctors, you take the advise of the doctor whop saw you at the emergency room.  You hopefully have a long life ahead of you and a week off is nothing compared to taking a chance and doing more damage before you see your Orthopedic Surgeon.  The doc who saw you even though he is not your surgeon knows a lot more after examining your knee than anyone on line.  Take it easy as the doc says and wait to see if your surgeon over rules him/her.

Offline injuredguy

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Re: Have I retorn my acl?
« Reply #4 on: January 15, 2011, 05:47:27 PM »
Thank you, I guess I am just a bit anxious for answers since I can get in contact with the OS  till monday.I will definetly take it easy the next week and just hope that the OS can provide some answers without having to wait months for an mri.

Offline Kaputt_Knee

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Re: Have I retorn my acl?
« Reply #5 on: January 15, 2011, 06:19:05 PM »
Thank you for the lecture fischbein, but if you had actually read the answer I gave, you would have seen that I advised the OP to seek advice and reassurance from his SURGEON.

injuredguy - if (and it is a big if) you have damaged your new ACL, it cannot repair itself as there is no blood circulation to carry the necessary ingredients to the location of the tear. A natural ACL has little or no blood supply, hence it cannot heal itself when torn either. There is a procedure done in some rare cases called Healing Response (someone is running a thread retelling his experience right now on the post-op board). The preconditions for this treatment to work are very precise and well defined and do not actually fit the profile of a full tear. As you have recently undergone a reconstruction, this would not work at all for you.

Try to keep your joint as mobile as possible while maintaining the elevated position. Doing the heel slides, static quads and ankle pumps help this and these can be done passively without putting any strain on the joint. If you can bear it, try passively mobilising your patella so that it does not stick. This is done by relaxing your muscles around your knee and, using the finger and thumb of both hands, gently move the kneecap from side to side. Do not force it, and if it hurts, then stop immediately and ice the knee. The crack you heard when you fell could well be from the kneecap freeing itself from the post-operative blood that tends to leak into the surgery site. It then acts as a glue and you can find it hard to move. I found with both my patella tendon ACL reconstructions that these gentle mobilisation movements helped to free up the knee, but I found it difficult to do in the first week or so, so my physio did it for me until I could bear to do it myself. There is a video in the Cruciate ligament section of the Information Hub which shows you how to do this - look at the ACL Rehab programme devised by Mrs Lesley Hall, the Senior Physiotherapist at the Droitwich Knee Clinic. You can link directly to it from the home page of the Information Hub.

We are all extremely nervous post-operatively so your worry is perfectly understandable. It is always better to be more cautious and see a doctor. It is such a relief when they tell you there is nothing wrong, but to take more care next time! As if we are all throwing ourselves all over the place!!!  ::)  ;)

Do come back and tell us what your doc says.

Good luck and keep icing!

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 injuredguy

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Re: Have I retorn my acl?
« Reply #6 on: January 15, 2011, 06:47:36 PM »
Thanks again for the reply Sue( Kaputt_Knee) About the ACL being to heal itself though, I was asking if it was a partial tear would it be able to repair itself, because I thought( might be mistaken) that if it is only a partial tear then sometimes the ACL can heal itself and I was wondering if it was the same for the graft.

The crack or pop that i felt, it felt like something stiff snapped or so. like when a twig breaks. Would that be normal for the kneecap trying to free itself? Because I also noticed that I could gently move it from side to side but I felt like a little pop between the movements. I cant move it at all right now.

I will certainly look up the Rehab program that you recommended, and I will keep you guys updated after I meet up with my OS.

Thanks again  ;D

Offline fischbein

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Re: Have I retorn my acl?
« Reply #7 on: January 15, 2011, 10:05:40 PM »
Dear Injured knee,
Sorry I upset Kaputt, she should not get so upset, especially when answering your post.  Hope I didn't offend you, but she nedds to take a chill pill, if they don't have those in Germany where she lives I can send her one. 
Really sometimes a little rest goes a long way.
Good luck to you

Offline Snowy

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Re: Have I retorn my acl?
« Reply #8 on: January 16, 2011, 06:21:16 AM »
Once torn, the ACL can't heal by itself - it doesn't matter whether it's a partial tear or a full tear. Same with the graft, unfortunately.

Hopefully your surgeon can put your mind at rest about the step down and crack. As Sue says, it's very unlikely that you've harmed the graft at this stage. If you can, I would also check with your OS (maybe via phone if he can't see you immediately) about the ER doc's instructions to take a week off from PT. Each surgeon has their own individual rehab program, and given the importance of maintaining muscle function after an ACLr your OS may well want you to keep going with PT, or keep up the basic exercises (quad sets, flexes, etc) even if you take a rest from harder exercises or progression. The ER doc isn't your OS, and chances are they're also not a knee expert. I'd take the instruction on this from your surgeon, who operated on your knee and designed your rehab protocol.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA