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Author Topic: Cruciate Ligament and Cartilage injury  (Read 1983 times)

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Offline kneebadannoyed

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Cruciate Ligament and Cartilage injury
« on: August 29, 2012, 10:19:43 PM »
Hi everyone, first of all thanks to all those that will take the time to read my post, it's greatly appreciated, i'll try to keep it short and brief, so here goes....

10 months ago i was playing football, (centre back, i'm no dribbler) and a bad challenge led to my knee staying in the same place and twisting, heard a small pop, knee filled with liquid e.t.c. So i didn;t play for two months, and like a complete MONG i played again because my friend/manager said, 'but we really need a player we only have ten men.' I did go to the doc, but he said leave it for a couple of months and see how it goes, i played again, same thing happened, very painful....

This time i knew it was serious, so i eventually went to the doc, he said he would give me a referal to the hospital, 3 months pass, i find out they lose my documents, in that time, i went out on the piss, and have NO idea how it happened, but was told by my mate at one point i was on the floor in the club writhing in agony holding my knee. So eventually i get an MRI scan and today i have the results. Here they, hopefully some of you will make sense of them,

'there is a predominantly vertically orientated tear of the posterior horn/ body of the medial meniscus. There is intrameniscal high signal throughout the lateral meniscus, with an intreniscal cyal in the body and likely associated tearing.

The ACL is completely torn with fibres lying in the  intercondyiar notch. There is no positive radiological draw sign.

The PCL, MCL, lateral coliateral ligament complex, extensor mechanism and ilictibial band are normal.

The popliteus and pes anserinus tendons are normal.

There are subtle marrow contusions of the sulcus terminalis and posterclateral tibia. No cartilage abnormailty is seen. There is joint effusion.'

RIGHT, if you managed to get anything from that thank you, but if your aren't a knee expert like me, he basically summed it up to me like so, 'where your cruciate is there is only mush, and smoe of your cartilage which act as your shock absorbers are completely gone, we can try to repair them, but we might not be able to do it.

My knee at the moment i haven;t been able to straighten out for around 6 months properly, it gives way occasionaly now, and it is absolutely excruicating if i try and straighten my leg, i also have a permanenet limp after waiting for so long, and i have been told the waiting list on the NHS is 18 weeks, which isn't good news.

WHAT i want to know is, if you are still with me at this point,

1. What are the risks of the operation? Could it be made worse?
2. Can i play football again?
3. does anyone have a magic genie in a lamp with a spare wish for me?
4. How likely am i to get back to 100%?

Primarily i am simply worried about the op making it potentially worse????

Thank you all for your help!

Offline Lizn8r

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Re: Cruciate Ligament and Cartilage injury
« Reply #1 on: August 30, 2012, 11:57:43 AM »
FIrst off, sorry that this happened to you.  Just be aware that you are not alone in any of this... read or watch sports news and just about weekly there is a story of some athlete with "a knee".

As to your questions;
1. There's risk to any operation...infection, DVT, etc. But they are the extreme, not the norm. Can it be made worse?  Yes, but also definitely not the norm.  Chances by far are that your surgery will be successful and your knee will be stable again
2. You can play football again whether you have the surgery or not.  If you don't have the surgery, you might need to brace your knee for extra support. You will definitely want to keep the musculature around the knee in tip top shape also to help make up for that missing ACL.
3. No genie in a bottle here. It's happened and there is no going back, only forward.  You control the "destiny" of your knee. ;D
4. I don't know the exact percentage or numbers, but chances are extremely high that you will get back to as close to 100% as you can. It's up to you to do the work to get back to that level again.

Again, take a look at any sports page.  Hundreds of athletes have gone through what you're dealing with now and are back doing what they love.  There are 2 players on my favorite (American) football team that recently had their ACL's destroyed, and last night you would have been hard pressed to see any indication that anything had happened to them.

Best of luck to you.

Edit:  Also, head down to the specialist's office, Cruciates board, and read thru some of the posts there. 
« Last Edit: August 30, 2012, 12:03:27 PM by Lizn8r »
Sep '99: Tore left ACL (football) - misdiagnosed
Sep '99-Apr '09: Lived with pain and buckling
Apr '09: New PCP (who listened), MRI and OS consult - proper dx
May '09: LK ACL Allograft and 25% medial meniscus removal
Sep '09: Released from PT and OS ... back to things I haven't done in 10 years!

Offline silverghost

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Re: Cruciate Ligament and Cartilage injury
« Reply #2 on: August 30, 2012, 02:01:38 PM »
I second everything said before!

The surgery you need is common practice and thousands have similar each week.  I went back to football following my ACL tear 20 years ago but from experience and from people on here following surgery you will always be more protective of that leg from now on!  After surgery i was known as the guy with only one foot as i didnt have the control with my right foot i had before the op especially shooting. 

The exception to this i think is pro football and other pro discipline sports athletes, obviously there bodies are superior to start with and of course they can afford top class after care... and they maybe can push there bodies harder than us normal human beings..

All i can say is no pain no gain , you will have a lot of physio and hard work to do but keep at it and you will get the benefit!


SG
'96 ACL reconstruction
'09 Arthroscopy/cartilage repair
Diagnosed with Grade 4 OA no medial cartilage and significant varus alignment
'11 fitted with off loading knee brace
'12 HTO, meniscus transplant, acl reconstruction & microfracture all in 1 go!

Offline Snowy

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Re: Cruciate Ligament and Cartilage injury
« Reply #3 on: August 30, 2012, 06:57:29 PM »
I think it's optimistic to say you could potentially play football again without surgery, given your report on the current state of your knee. You have some fairly substantial damage to the meniscus (shock absorbing cartilage) as well as the ACL tear, and if you can't straighten your leg then it's very likely that a piece of the torn meniscus is caught in the joint and is impeding full movement. This would be unlikely to resolve on its own. It doesn't sound like you've had any improvement in the state of the joint since the injuries, and I would be extremely surprised if conservative treatment (i.e. no surgery) was recommended given the current condition of your knee.

Keep in mind, too, that even if things did improve, there are risks to living without an ACL. It provides lateral stability for the knee, so even in the best case scenario where the knee felt relatively normal and you were able to participate in sports there would be more lateral joint movement than in a knee that wasn't ACL deficient. Over time this can take a toll on the articular cartilage (the shiny stuff that covers the ends of the bones and enables them to move smoothly when you bend your knee), leading to osteoarthritis in later life. Having said this, it doesn't sound as though your knee is in nearly good enough shape for conservative treatment to be an option.

Both ACL and meniscus surgery are very common procedures. That doesn't mean there's no risk involved; all surgery is invasive, and there are always an unlucky few who have complications. But for the majority, these surgeries are successful and they get back to a level of activity they're happy with. With a badly damaged meniscus, the outcome will depend to some degree on whether it can be repaired and if not, how much they have to remove. The less that remains, the more likely you'll have to modify activities in the future (for example, avoiding high impact activities.) But if the meniscus can be repaired or relatively little is trimmed, chances are you'll be able to return to full activity once your rehab is complete. The good news is that your MRI reports no current articular cartilage damage, which is encouraging for the longer term.

It's too bad you have to wait for the surgery, but there's lots that you can do in the meantime to help prepare. Number one is to get yourself a good physiotherapist and start working on some exercises to strengthen the joint. Given your pain levels and restricted extension you'll definitely need a PT's help with this, as you'll need exercises that help build strength without exacerbating the pain or injury sites. The better shape the muscles around the knee are in going into surgery, the easier early rehab tends to be. They may also recommend a brace to help with those buckling incidents.

Definitely use the time to read up on what to expect from the surgery, and how to prepare for your recovery. The post-op diaries section of the board is a great source of information on surgery and recovery. Again, having a good PT to work with on rehab is absolutely key, especially in the early stages when you need to work on regaining mobility but also protect the ACL graft as it heals. A good outcome is dependent as much on your commitment to the rehab process as the surgical procedure. There's no question that it's a long haul - 7-9 months for release to full activity is typical, and depending on graft type and individual recovery it can be longer - but it is worth it in the end, especially if the post-injury condition of your knee is seriously hampering your day-to-day life.

Best of luck! I'm really sorry that you suffered these injuries and will be keeping my fingers crossed for a successful surgery and recovery.
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 kneebadannoyed

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Re: Cruciate Ligament and Cartilage injury
« Reply #4 on: August 30, 2012, 07:55:41 PM »
Thank you Silverghost Liz and Snowy, i can't thank you enough for the time you have spent to initially read my LONG post and then come back witha  response, i REALLY appreciate it, and that's all the information i could want, thanks again, and i'll post up on here after surgery when it eventually comes to let you know how it goes! Thanks again you lot, great bunch of people ;D

Offline MUMofpain

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Re: Cruciate Ligament and Cartilage injury
« Reply #5 on: August 30, 2012, 08:59:32 PM »
Your accident sounds very much like what happened to my son when he tore his acl. Football, foot stayed planted, fast turn - loud pop and agony. He had to wait 4 months on the nhs for the reconstruction. He is 2 years post accident and 20 months post op.

The only advice I can add to the great wisdom above is to do as much physio you can do as advised by your physiotherapist. You will want to get that leg as strong as you can before the op because afterwards it seems common that the thigh muscle gets very weak and rapidly looses strength.

Motorcross, sking and football, these seem to be the sports that seem to tear the acl the most, nearly every top motocross rider has torn theirs (at least once).

Apparently one of the paraolympic judo guys (got a bronze today) tore his acl 7 weeks ago! he hasn't had it reconstructed just worked on strengthening it for the games - amazing and also risky for the remaining ligaments I would imagine.

Wishing you all the best, and keep phoning the waiting list department as cancellations to crop up every now and then (my son got his op a month earlier because someone had a cold and couldn't have an anesthetic so he got his place). :)


27th September 2010 - Tore acl at football
12th January 2011 - ACL reconstruction (Hamstring)

Offline kneebadannoyed

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Re: Cruciate Ligament and Cartilage injury
« Reply #6 on: September 26, 2012, 08:17:55 PM »
Hi 'MUMofpain' hahaha, nice name, well i have my OP tomorrow guys! I've been pushed along 16 weeks early...i think it is due to going to my [re-op medical seeing the surgeon and him telling me, 'it's one of the worst knees i've seen on a person your age' is probably the reason for being pushed along. I'll keep you lot updated and ii'll post a couple of pics pre and after op....how is your son now after 20 months poost op????? Must be better now right? I am SO determined to exercise on it as much as i can, mymuscles around my leg are still pretty big as i cycle nearly every day, and generally do what i can...determined, not gonna beat me......  ;D

Offline Snowy

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Re: Cruciate Ligament and Cartilage injury
« Reply #7 on: September 26, 2012, 08:25:42 PM »
That's definitely the right attitude to have going in! Best of luck with the surgery, and don't forget to stick to your rehab protocol even when it's boring you silly (which will happen!) - that's the key to a successful recovery. :)
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 silverghost

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Re: Cruciate Ligament and Cartilage injury
« Reply #8 on: September 27, 2012, 09:57:09 PM »
Hope your surgeries gone well im sure you will be out within the next day or two and feelin a bit sore! if your around let us know how its gone and your rehab schedule so far...

good luck anyhow

regards

SG
'96 ACL reconstruction
'09 Arthroscopy/cartilage repair
Diagnosed with Grade 4 OA no medial cartilage and significant varus alignment
'11 fitted with off loading knee brace
'12 HTO, meniscus transplant, acl reconstruction & microfracture all in 1 go!

Offline kneebadannoyed

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Re: Cruciate Ligament and Cartilage injury
« Reply #9 on: September 29, 2012, 09:38:24 AM »
Hi guys how are we?? I'm back....Umm, so i'll roughly go through what happenned....

My main concern was getting my manoeuvrability back in my knee, the ability to straighten it was a big thing for me, so when the surgeon said it was 'highly unlikely' that i would ever be able to straighten my knee again i got kind of pi**ed off in no fewer words....He said that if the Meniscus is stuck in the joint we can remove it, if its scar tissue which it most likely is there is nothing we can do about it, but he did assure me that even though i may not be able to straighten my leg i'll be able to run and play sports evetually after physio.....

So after the op felt groggy, had loads of morphine!!! Which was pretty cool, and when i eventually spoke to someone about the operation, it was someone who wasn't in theatre but was just reading my op notes, and he read it, saying that there was no note about scar tissue in there, so from what he could see i 'should' be able to straighten my knee again eventually. I left the next day and was given Tramadol and some anti-inflammatory which takes the pain away and i'm kind of in cloud 9 so to speak  ;D which makes it easier to do my exercies....I see the surgeon in 2 weeks and get my bandages removed in 2 days time because i haven't seen my knee yet, and there is a lot of numbness down the inside of my knee which is what i was told to expect....

Anyway, thanks for all your support, i'll do my best and get back 100% in no time, hopefully, right, i'm gonna do my exercises the tramadol and other tablet thing has kicked in!

Offline kneebadannoyed

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Re: Cruciate Ligament and Cartilage injury
« Reply #10 on: October 02, 2012, 02:34:11 PM »
Its now day 4 and i am on one crutch and i can already straighten my leg more than i could before, so in general happy, on the painkillers and been killing the exercises, absolutely fighting through the pain which seems to have worked! I'll keep you updated

Offline Snowy

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Re: Cruciate Ligament and Cartilage injury
« Reply #11 on: October 03, 2012, 05:15:22 PM »
Congrats on getting through the op! It sounds like you're doing really well. Fingers crossed that your recovery continues to go smoothly.
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















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