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Author Topic: ACL reconstruction on the NHS  (Read 2804 times)

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Offline linksys77

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ACL reconstruction on the NHS
« on: February 05, 2012, 03:21:43 PM »
Hi everyone

I'm new to this forum. Have just been diagnosed with a torn ACL on Wednesday and I'm looking for advice from people who have gone through ACL reconstruction on the NHS.

Here's my story so far:

I'm a 25 year old female, fairly active (play rugby and football and go the gym). I twisted my knee in a rugby tackle in October 2011. Can't remember the first few seconds after the tackle (did I pass out?), I just remember trying to get up and feeling the worst pain ever on the outside of my right knee. Was helped off the pitch and given an ice pack. The pain disappeared fairly quickly and I could hobble around afterwards, although it hurt like hell when I tried to twist my knee. No massive swelling or bruising occurred, so I didn't think it was anything major (I have never had any serious injury).
Went to a NHS minor injuries unit three days later and had on of the Nurse Practitioners examine my knee. I thought he did a really good job, did lots of test/weird movements with my knee (which hurt like hell...). He came to the conclusion that I sprained my LCL and patellar tendon. He told me to do deep squats and to stretch my hamstrings. No idea why??? He also told me to avoid contact sports for 4 weeks.
I hobbled around for a good week, during which my knee was very stiff and it just felt weird (if that makes any sense...). After three weeks, I could walk normally and I decided to return to rugby training, not a good idea. Twisted my knee again after 30mins, although the pain was not nearly as bad as the first time. I decided to seek advice from a private physio from my university's sport's department. She did all sorts of different tests. I was told that my LCL had healed nicely and that my knee looked fairly stable. I still couldn't extend my 'bad' knee as far as the 'good' knee, which the physio diagnosed as 'fat pad impingement'... Told to do hot/cold icepacks/heatpacks.
The knee got a bit better, but still felt unstable during quick turns and sprinting. So I went to see my GP at the beginning of December 2011. She literally took 1 minute to examine me. Pulled at my leg while I was sitting on a chair and just told me to give it another 3 to 4 weeks.
Still no improvement in January. So went back to see the GP, didn't really examine me but finally sent me to see an Orthopaedic Consultant. Had my appointment last week. He had my lie on a bed and first pulled my good leg in the Lachmann's test and then my bad leg. He started shaking his head and told me that I tore my ACL. I could actually see how much more laxity there was in my injured knee. He also performed a pivot shift test, which made my tibia 'pop out' and move over my femur, eeuuurgh... He told me that he was going to put me on the waiting list for an ACL reconstruction but that I also needed an MRI to see if anything else was damaged.

Now my questions: Has anyone else had the same experience of several wrong diagnoses on the NHS? How long does it take from seeing your consultant to actually get the operation done? And what is the experience of the operation like on the NHS (I am getting a hamstring graft, as this is what my consultant specialises in)? I live in the North Bristol NHS trust area.

I just don't know what to expect... I don't really fancy waiting six months for an operation and walking around with a wobbly knee and not being able to do any of the sports I enjory  :'(

Thanks for your help xxx

Offline MUMofpain

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Re: ACL reconstruction on the NHS
« Reply #1 on: February 05, 2012, 07:30:20 PM »
Hi - this was our experience of the NHS with regard to my son's acl injury, it's long so bear with  :) ....

My 16 yr old son was playing football in Sept '10, his foot stayed planted in the mud with his studs and as he turned to chase the ball he heard a loud pop and fell to the ground in agony unable to get up.  Helped off the pitch by his mates I went  to see what had happened and he couldn't put his weight on his foot.  I took him straight to our local small accident and injury a&e. I couldn't get him out of the car so got a wheel chair for him, by this time his knee had swollen quite alot.

A male nurse, at the end of his shift so in a hurry, did a quick and very unsympathetic exam of my son's knee, pulling the curtain right across my face so I couldn't see what he did.  He was curt and very impolite.  He said my son had done no damage to his knee apart from a sprain and told him to take two paracetamol 4 x a day for a fortnight and if things were not better to see our GP.  He gave us a sheet of some exercises to do.  I asked if we could borrow a pair of crutches (there was an enormous pile of them in the corner) to which  he said 'no, I will decide if he needs crutches or not and he doesn't, it is best he walks on it'.  My son went back in the wheelchair so we could get to the car park. INCORRECT DIAGNOSES 1

After a very uncomfortable night he couldn't get out of his bed so I rang out GP and managed (amazingly!!!) to get a cancelled appointment that morning. As I couldn't get him down the stairs I popped to the drs hoping to get some crutches, they had none and told me to go to the health centre where they had some.  Went to the health centre round the corner and they would not give me any as he had to be measured against them, at which point I think they felt sorry for me and handed a pair over, I was very grateful.

Got him to the GPs and a young locum examined him, tape measure used to measure the swelling and a few tugs and pulls to the leg this way and that (but no latchmans). She concluded no damage to any ligaments and probably just some sort of sprain around the knee, take two paracetamols and add to this ibuprofen.  I was unhappy with him being prescribed so many paracetamols for so long a time. INCORRECT DIAGNOSES 2

A few days later, he was in so much pain and discomfort I took him back to the GP where we saw one of the more snr dtrs. He did not even look at my son's knee and said he needs to have an mri scan, it was no point him looking at his knee as it wouldn't help, a scan was what was needed. USELESS - NO 3!

I had to wait 2 further days for a letter from the dtrs to try and book the scan and when I did there were none available for 4 weeks, so I booked one for then.

11 days after the accident I just did not know what to do with him, he was in so much pain and the swelling hadn't gone down so I took him to our main hospital A&E. 4 hours later, we saw a doctor there who couldn't say exactly what damage he had done, so recommended we book him into a knee clinic. NO IDEA - NO 4

4 days later at the knee clinic we saw the most amazing doctor who immediately, with a swift and efficient examination said he was very sorry but my son had torn his acl and would need an operation and that there was no point waiting for the mri as it wouldn't tell us anything more than what he had already told us. He booked him into physio to start strengthening up the leg for the op and to get the swelling down. 4 weeks later we were back, swelling down and my son was then booked into have his operation (hamstring).  4 months from injury to operation.

He is 13 months on now and he is getting there, it is a long recovery time.

We found out later that this wonderful doctor is the one to have for this type of surgery (in our area) and people can wait for up to two years for him, so thank God we got to see him when we did.

(After his op we had lots of other mishaps with the NHS, too many to mention here, don't want to bore you too much except to say two weeks after his surgery the hospital thought he had a dvt which ended up with him having very painful stomach injections over 4 days until they could so an ultrasound, as there were no staff to do one until then, he didn't have one and suffered this additional pain for no reason other than shortage of funds to staff the department).

Hope all goes well for you though  :)
27th September 2010 - Tore acl at football
12th January 2011 - ACL reconstruction (Hamstring)

Offline linksys77

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Re: ACL reconstruction on the NHS
« Reply #2 on: February 05, 2012, 08:39:43 PM »
Sorry to hear about your horrendous experience.

The doctor that finally managed to diagnose my ACL tear is a consultant orthopaedic knee surgeon who specialises in ACL tears. Took him 30 seconds and two tests (Lachmann and pivot shift) to find out what was wrong with my knee.

Just goes to show that an ACL tear is really difficult to diagnose when you are in a lot of pain and the knee is still swollen. When someone examines your knee and you're in pain you will probably tighten your hamstrings and that will lead to an inconclusive test result. I think an ACL tear can only be diagnosed by someone with a lot of experience and only when you are completely relaxed an relatively pain-free. GPs and nurses probably don't have enough experience to do these tests properly.

Hope your son is recovering well. Did he get physiotherapy on the NHS after his operation?

Offline MUMofpain

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Re: ACL reconstruction on the NHS
« Reply #3 on: February 05, 2012, 09:36:05 PM »
Hi there.  Yes, he has had physio for a year on the NHS which has been very good. The hospital has an acl rehab group who meet up once a week and this really helped, to exercise with a group of other, usually young, lads.

He has just been discharged but his physio said if anything is bothering him to just call and he can pop back for advice.
27th September 2010 - Tore acl at football
12th January 2011 - ACL reconstruction (Hamstring)

Offline miss_sporty

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Re: ACL reconstruction on the NHS
« Reply #4 on: February 06, 2012, 11:49:42 PM »
hi, i might be able to be of help, as i have had quite a similar experience to you. I was misdiagnosed for about 4/5 months before i knew i had torn my acl, and waited a few more months before the surgery.
I have since had 2 ACL reconstructions in Bristol on the NHS. For each one I waited just under the 18 week waiting list target from my appointment with the surgeon when surgery was decided, to the time of the operation.
I had a hamstring graft the first time round, and patellar tendon the second time, and i think i would say that overall i found hamstring easier than the patellar one, but as you said its really what the surgeon is a specialist in that matters.
I know how frustrating it is to not be able to do sports, but the time up until your surgery doesn't have to be a total waste, getting some good rehab in beforehand to get your knee as good as you can really helps for the recovery after the op.

I had both operations in southmead hospital, and physio afterwards at frenchay hospital. for the operations i have had the op in the afternoon both times, so then stayed overnight and been sent home the next morning. i can let you know more about my experience of the op and physio too if you want.
if you have any more questions i would be happy to help :)
good luck with it all.
Torn ACL
Hamstring graft reconstruction
Patellar tendon graft reconstruction

Offline Kaputt_Knee

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Re: ACL reconstruction on the NHS
« Reply #5 on: February 07, 2012, 06:23:39 AM »
WARNING a wee bit of thread drift  ;D

It would be good if you could say who operated on you footballfan. There is also someone from Pembrokeshire looking for a revision specialist.

I had an ACL Revision at the Avon Orthopaedic Centre. also a patella tendon graft, one of the first done there (1992). It was my second revision after 2 carbon fibre ligaments snapped on me in quick succession. In those days it was done via open-knee surgery. Jonathan Webb assisted my consultant (Mr Ackroyd, now retired I believe). Jon Webb is now a Mr. too and has his own knee clinic in Brizzle! Ackroyd still practises privately I believe.

 ;)
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 miss_sporty

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Re: ACL reconstruction on the NHS
« Reply #6 on: February 07, 2012, 09:59:14 AM »
Hi again,
the revision was done by Jonathan Eldridge, who works both for the NHS and privately. I think he is listed as one of the ACL specialists on here?
Torn ACL
Hamstring graft reconstruction
Patellar tendon graft reconstruction















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