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Author Topic: Banged my knee not sure if I've injurred it  (Read 45803 times)

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Offline kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #15 on: January 16, 2011, 08:18:22 PM »
Well, I'm not sure.  I've got the shallow trouchlear and the pronation in my feet but I've always had them even when I could do anything and pronation neer made my knees suffer even when my feet used to hurt a little.

My acl was slightly torn and he basically said that I couldn't aprticipate properly at my old level without a full acl and that I couldn' have a new one because it was unethical to remove the old one.  he had a word with my OS on my behalf and he said he that I'd have to be falling about the plae before I'd be a candidate for acl surgery.

Then he added the bit about dislocations and I'm not sure if a torn acl can in any way make you more likely to have dislocations.  I thought about it and wondered if maybe it was because the acl damae was supressing my vmo and my vmo wouldn't be able to pull properly if the lateral forces tried to take the kneecap to the outside.  Does this sound about right.  Anotehr pt ldid a lachman and said it was within normal limits and couldn't see a problem.

I havn't gone back because of various setbacks but I do intend to.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #16 on: January 16, 2011, 08:33:37 PM »
Quote
I couldn' have a new one because it was unethical to remove the old one

Whoever the "he" is that said this, I think you need to talk to someone else - this is at odds with everything I've ever heard first-hand from doctors and read in the research. If the ACL is damaged to the point where it cannot provide proper support for the knee, of course it can be replaced; in fact most surgeons would recommend it if you want to return to sports at your previous level. Of course there are factors that influence the decision to reconstruct or not (do you mind reducing your activities? Has a comprehensive PT program strengthened the knee to the point where you can participate in sports regardless of the tear? Are you willing to participate in sports accepting the risk of future damage with a compromised ACL?) but it's absolutely not true that it's unethical to remove a partially torn ACL. If my partial tear had been correctly diagnosed 5 years ago, both my OS and PT said they would have strongly recommended a reconstruction given that I wanted to continue high level sports.

Quote
he said he that I'd have to be falling about the plae before I'd be a candidate for acl surgery

Again, this doesn't sound right. The recommendation here in Canada is that if the ACL is damaged and you want to continue participating in sports, you need a reconstruction. I know from my own experience that it's possible to have a very stable leg even without an ACL at all; my leg wasn't the slightest bit unstable after my full tear, probably because my muscles were in really good condition. However I would always have been at risk of damaging other structures in the knee if I fell or injured the leg again, because it lacked the lateral support under duress that an ACL provides.

Then again, if your ACL is so slightly damaged that it tested within normal limits, there's no reason you can't be participating in sports without needing any kind of invasive treatment.

I have to be honest - the advice you've been given sounds conflicting and possibly detrimental to your ability to determine the best course of action for your knee and ensure that you can participate in the sports you enjoy. I would talk to a knee specialist (you mentioned that you have an OS - has he given you an opinion on the ACL?) and see what they say about how damaged the ACL is and whether or not you should be restricting your activities.
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

Offline kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #17 on: January 16, 2011, 09:51:22 PM »
I havn't seen him in oer a year but I could go and see him and ask him about my acl.  he said it didn't need recopnstructing, so I categorically asked him if I could go back to karate and he said yes.  But I never had the proper recovery that I should have.  I got the knee feeling fairly good but it took 8 months, not 8 weeks.  Physio made it as stable as any knee and just as able to turn corners without moving like a robot and I can walk in a figure 8 OK, I'm just not too keen on twisting on it quickley.  The tear I'm told is small, so small that it didn't show up on mri but the leg is a bit awkward at times when making little steps.

Anyway, I've had this discussion before on the board and the fact is that doctors in the UK are just not as gun-ho for reconstruction and as they are in many other countries because they don't see sports are necessary.  If I was a professional instruction I would be offered it or a member of the national squad, but I'm just an amataur who lieks to train and start a non-profit club and that being unnessential for my physical well being is not reason enough to reconstruct my acl.

Back to my other question and I would really value your opinion on this one Snowy, Does having a slight acl tear put you at any greater risk of dislocations if you were to spin or twist on it, or drop to the floor very quickly.  Would it make it difficult to jump in the air and landin a crouch.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #18 on: January 17, 2011, 01:07:24 AM »
I have to be honest, I'm not exactly sure of the answer to that question. I've done a bit of digging around online and the two key pieces of information I've found indicate that:

a) ACL rupture is typically referred to in the literature as a consequence of knee dislocation
b) ACL deficiency leads to greater knee laxity, leaving other structures in the knee - especially the meniscus and cartilage - at greater risk of a shearing injury if excessive lateral force is placed on the knee

Here's what I'd take from that, keeping in mind that I'm not a medical expert and I'm relying heavily on information that I've been able to find in a relatively brief search.

The ligaments essentially act as stabilizers within the knee. If you're missing one of the stabilizers, your knee joint will inevitably not be quite as secure overall. However, the forces required to cause a full dislocation (defined as complete displacement of the tibia in relation to the femur, with disruption to three or more ligaments) in an otherwise healthy knee are pretty extreme. Those of us who frequent this board probably think of knee dislocations as a lot more common than they actually are, given that the demographic here is heavily skewed toward people with knees that have injuries or abnormalities. The Mayo Clinic, for example, cites 14 knee dislocations in more than 2 million admissions (1); eMedicine states that "the knee is a very stable joint generally requiring high-energy trauma to produce dislocation," (2) and WebMD says "knee dislocations are rare. They usually happen only after major trauma, including falls, car crashes, and other high-speed injuries." (3)

In other words, although I haven't been able to dig up an article that talks specifically about a correlation between ACL deficiency and knee dislocation (I'm not sure if such a study has been done or not - I may have another look at work tomorrow, where I have access to a wider selection of licensed databases) it seems likely that ACL deficiency would slightly increase the risk of a dislocation, given that dislocation occurs when at least three ligaments fail and a ruptured ACL would already have taken one ligament out of the picture. However, the degree of force required to dislocate even a completely ACL-deficient knee would be quite significant; it doesn't seem very likely that the activities you describe (spinning, twisting, dropping down quickly) could cause such a traumatic injury. The real risk of ACL deficiency is meniscus or cartilage damage resulting from excessive lateral movement of the leg.

Having said all of this, if the test that showed your knee to be within normal parameters is accurate, your ACL deficiency is so minimal that you're probably at no more risk than someone with two intact ACLs. Martial arts isn't an especially safe activity for the knees (I got my partial tear after an awkward fall kickboxing) but then again, Tez tore her ACL coming down stairs in high heels - there's no guarantee that you're 100% safe from injury doing anything. Given the rather confusing advice you've been given, I'd say that the first thing to do is establish whether the very small tear that you have in your ACL is the source of any deficiency, and if so how much. Once you know that, you can figure out what to do next. If the damage is going to keep you from the things you enjoy then you have every right to push for a reconstruction, regardless of what the doctors say about professional vs. amateur athletes. Just think of all those NI contributions that you've made to the NHS over the years - you deserve the right treatment for the needs of your knee. :)

http://emedicine.medscape.com/article/1250829-overview (1)
http://emedicine.medscape.com/article/823589-overview (2)
http://www.webmd.com/pain-management/knee-pain/knee-dislocation (3)
http://www.sportsci.org/encyc/aclinj/aclinj.html
« Last Edit: January 17, 2011, 01:58:51 AM by Snowy »
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

Offline Snowy

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Re: Banged my knee not sure if I've injurred it
« Reply #19 on: January 17, 2011, 02:08:44 AM »
This is what happens when you ask a librarian a question they don't know the answer to. ;)
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

Offline kscope09

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Re: Banged my knee not sure if I've injurred it
« Reply #20 on: January 17, 2011, 12:39:26 PM »
Well, good news is it wasn't the size of a watermelon this morning, it isn't even spongy, just the bruise which is starting to go through the colours.  So it seems OK for now, just a bit sore.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline vickster

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Re: Banged my knee not sure if I've injurred it
« Reply #21 on: January 17, 2011, 12:43:40 PM »
All good then :)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up