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Author Topic: ACL laxity 6 weeks post op - Should I be worried?  (Read 2251 times)

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Offline BenRichardMacey

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ACL laxity 6 weeks post op - Should I be worried?
« on: July 07, 2014, 10:07:57 AM »
Hi,

I had ACL reconstruction with a hamstring graft 6 weeks ago along with a lateral meniscus repair, seen the surgeon yesterday and he said by knee 'isn't rock solid but it doesn't need to be to be functional'.

Is this correct considering I want to get back playing football?

Also seen my physio this morning and she done the lachman test again as I was worried and there was more movement than in my good knee. They have both told me not to worry but I'm not sure what to think.

Cheers Ben
August 2013 - Left ACL rupture and Lateral Meniscus tear (football)

May 2014 - Left ACL Reconstruction + Lateral Meniscus Meniscectomy (20%)

Offline rnm37

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Re: ACL laxity 6 weeks post op - Should I be worried?
« Reply #1 on: July 07, 2014, 10:27:55 AM »
I think you need to ascertain what your physio means by "more movement" there is. I think its normal to have a little more movement, or certainly nothing to worry about too much anyway. Both my hamstring grafts have been ever so slightly more lax than my good knee post surgery - I have no idea if this is because i stretched them in my rehab or because it is just very hard to to fully recreate the natural ACL accurately. I also have very lax hypermobile joints which I think has a part to play in this too.
Also remember it can sometimes be difficult to get an accurate Lachman test when the knee is swollen and recovering from surgery.
First off, a mildly lax ACL will not give you any problems in daily life and for most exercises, however some people may experience instability when playing cutting sports like football. I think there is no point worrying about right now, focus on your rehab - at 6 weeks you are approaching a crucial time in your rehab where the graft begins to re vascularise, this is apparently when the graft is at its weakest. Strengthen your leg muscles (ESPECIALLY the hamstrings), work on range of motion, get rid of swelling. Basically all the the things you are probably sick of hearing from your physio.
Much further down the line, assuming all goes well you will be released by your physio to do cutting type sports like football. If there is a major laxity issue in your knee (the words of your surgeon and physio suggest its not) this is when you will notice it. I doubt this will be the case though.

All the best, and for now focus on the all important early rehab - far more reconstructions fail from bad rehab than bad surgery!

Ross
June 2012 - ACL rupture and lateral meniscus tear

December 2012 - ACL recon (hamstring autograft) and meniscus trim

October 2013 - Retore ACL and tore medial meniscus :(!

January 2014 - Revision ACL recon (hamstring)

Offline BenRichardMacey

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Re: ACL laxity 6 weeks post op - Should I be worried?
« Reply #2 on: July 07, 2014, 10:49:26 AM »
Thanks for the reply Ross.

Yeah its just a little movement, the physio has said not to worry, the surgeon has just said he doesn't want me to starting running in-till he sees me at 3 months, originally was going to start running with physio at 8 weeks.

I too have very hyper-mobile joints! My surgeon pre op said he would have to tighten the knee up but it may stretch over time to give some of the hyper extension at knee back, which it already has done but no where near as far as good knee, which I presume is a good thing as helps prevents re-rupture. He actually said once my ACL has fully healed there would be a higher chance of my right knee ACL rupturing due to the hyper extension.

I have been taking my rehab very seriously, also making sure I'm not rushing things but doing enough, I will just concentrate on rehab and try not to worry about it.

Appreciate the reply, good to hear from someone who has been through similar and more!

Ben

August 2013 - Left ACL rupture and Lateral Meniscus tear (football)

May 2014 - Left ACL Reconstruction + Lateral Meniscus Meniscectomy (20%)

Offline MDAL

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Re: ACL laxity 6 weeks post op - Should I be worried?
« Reply #3 on: July 07, 2014, 11:55:11 AM »
Ben:

I would  say it is still premature to make conclusions.

Laxity can be often be misdiagnosed, because there are multiple factors in those tests that make it far from 100% reliable in precision and often give false positives if the physiotherapist or doctor are no paying enough attention to what they are doing. Lachman test is not an exact science, and includes a fair share of technique and result interpretation. Two different people analyzing can easily bring 2 different results or interpretation of those results.

Independently of technique, at 6 weeks, I suppose that there is still inflammation confusing things and the muscles are weak, poorly responsive. It would be far more reliable to make the test and such conclusions, when you get back to shape and have the inflammatory process under control.

After reconstruction, there is an evolutionary phase, everything will try to stretch or contract (right or wrongly), to try to find a balance. That phase is still in progress.

At the end of the day, we all need to realize that after starting the cutting and stitching path, things will never be the same again, there will always be some flaws that we need to learn how to live with...

For now, I think it's better to just focus on physio work. In the end what will be will be, but it's better to make the judgements once things settle down. After surgery, we all make theories, get a bit paranoid, and have our minds going in endless circles. It's unavoidable...

Good luck! Hope it goes for the best!