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Author Topic: ACL reconstruction feasible if already have Osteo Arthritis??  (Read 648 times)

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Offline GarethNeath

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ACL reconstruction feasible if already have Osteo Arthritis??
« on: November 15, 2011, 01:26:37 PM »
Hi, I am 40 years old. Tore ACL in left knee when 18 and in right knee when 20.

Had meniscectomies on right knee in 1996, 2002 and 2005 and 2011.
Had ACL reconstructed on left knee in 1999 due to being chronically unstable.

This post relates to my RIGHT knee. While I've NOT had trouble with it being unstable and giving away, I have had meniscus problems with it, hence the previous meniscetomies.

The current scenario is as follows. Twisted my right knee a bit back in May, saw surgeon in August and had MRI. Surgeon recommended meniscectomy and ACL reconstruction sicne he felt the mechanics of my knee were wrong being ACL deficient and the fact that I'd had 3 previous meniscetomies over the years suggested that with no ACL my already damaged meniscus was taking all the strain.

Went in for the operation on 6th Oct. Must prior to going into the operation, the surgeon discussed it with me and said he'd only do the meniscus clean up and would refrain from doing the ACL if the knee was already Grade 4 arthritic. I agreed, but was so nervous about the op I'd have agreed to anything! Sure enough, he only did the meniscectomy and "debridement" on my knee. Surgeon said that the medial side of the knee was OK but that the lateral side already showed signs on OA on the bone and that the lateral meniscus was largely gone.
I asked him why this meant that it was not now advisable to do the ACL when he'd all along said that it was the best for the long term health of my knee. He said that if the bone was already arthritic then there was a risk that the ACL op could cause it to become stiff. Further, he said that the main point of the ACL reconstruction was to protect the meniscus and that it was already mostly gone from the lateral side of my knee.

Bottom line is the op highlighted that my knee is much worse than I thought, but the burning question for me is whether I should still have the ACL done to try and protect my knee longer from more wear and tear. I wonder if having an ACL repair would help the knee become bio-mechanically better so that what's left of my poor meniscus would hopefully last much longer than it would without an ACL? Also, given that the medial side of my knee is relatively OK, I feel that there is a "point" to having the ACL fixed since it would protect the medial side of my knee.

My knee is obviously quite bad already, though it's not stopping me doing anything. I've given up running now and am avoiding loading the joint by doing heavy squats/lunges, etc, but can walk all day, cycle, swim, etc without any pain in my knees other than a bit of niggle now and again. I really dont want a knee replacement by the time I'm 50 and if having the ACL fixed is gonna be a big factor in protecting the knee from wear and tear generally then my gut feeling is that I should go back to see the surgeon about having it done.

The surgeon said that my left knee (which had the ACL reconstructed 11 years ago) is actually a bit laxer than my right knee, but since I had the ACL done on my left knee I've not had any trouble with other than some stiffness in the joint. Guess it's a trade off - have the ACL done and risk stiffness in the joint, don't have it done and the joint "wears out" quicker?

Would welcome any views. Thanks.
1996 - Meniscectomy - right knee
1999 - ACL reconstruction left knee
2002 - Meniscectomy - right knee
2004 - Meniscectomy - right knee
2011 - Debridement - right knee