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Author Topic: Partial ACL tear - Surgery vs Physio  (Read 2071 times)

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Offline Paul83

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Partial ACL tear - Surgery vs Physio
« on: September 02, 2014, 10:03:03 PM »
Hey guys n gals of the knee world. This may be something hat has been discussed a few times, sorry if it has - been searching with no luck, and at my wits end!

History: I've had knee problems since I was about 17 (31 now) - typical guy story, bad tAckle in football, and all that jazz. I'm not really sure what the original injury was - I lived near a poor hospital at te time and it never got really diagnosed - but I was on crutches for 3 weeks, light training for 2 and then back to playing football - but had to do so with a knee support, otherwise it felt too weak and would buckle.

Fast forward to about 26 and I had to move from playing left back to goal, as I couldn't hack the physicalility of it on my knee anymore.

Then I hung up my gloves at the prime age of 29.

Since then my knee has been up and down, but want too bad. Then around 10 months ago I kneeled on a lighter of all things, got a sharp pain in my knee and it's been bad ever since.

Had X-rays and MRI scans which showed nothing, so they decided to do exploratory surgery, where they found a partial tear of the acl - apparently no weakness to the structure of the knee tho.

I went back to the specialist today who said I should undertake physio for 9 months, exercises of half an hour a day etc. I'm not massively happy with this so I am getting a second opinion, mostly what annoyed me was he spent 2 mins with me, and wasn't interested in much I ha to say and said he didn't want to do acl surgery.

This is my problem with the idea of physio:

My knee hurts every day, without fail. It gets worse as the day goes on. I have sharp pain across the front of my knee cap, and constant aching pain at the back. I had confirmed by a doctor I also had fluid build up under my knee (another thing that annoyed me he didn't even look at my knee today!). Going up stairs, or hills is pretty much impossible. Walking for more than half hour without taking a break is impossible and my knee will be useless for a couple of hours after - I've been doing light excercises, given to me after the op, but these make the pain worse.

The knee still buckles, probably once a week it gives way, and it feels really week after especially long days - although I work in an office and drive an automatic so it's not as bad as it would be.

I have swelling on the left side of my left knee (which is the problem one) under Neath one of the incisions - this was also swollen before the op.

So really, I am lookin for feedback: should I be chilling out a bit and going for the physio, or preserve with the second opinion and try and get a proper exam, them to listen and hopefully the op?

Ps - sorry about spelling mistakes - using my phone to post and have fat thumbs!

Offline laxknee

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Re: Partial ACL tear - Surgery vs Physio
« Reply #1 on: September 03, 2014, 04:20:48 AM »
I've had ACL surgery 5 months ago, and am still recovering. My ACL surgery resulted in excessive scar tissue build up and the pain is worse after surgery than it was before surgery (over 50% tear of ACL). In addition, my knee cap is now titled because of the weakness of the IT band. However, I cannot strengthen because the scar tissue makes it too painful. I still don't have full extension - using a Dynasplit (again, very painful) to get the extension back.

Maybe I'm the small % of people who go through this. I'm close to your age - 30. My suggestion... do physical therapy. AGGRESSIVE physical therapy. Go 2x a week for PT and 2x a week for holistic healing (EMF, laser, etc.) Not a day goes by when I wish that I hadn't gone under the knife. Surgery is always an option and should be your last resort. Recovering from ACL is quite a mammoth task.

Hope you feel better!

Offline Mvbinion

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Re: Partial ACL tear - Surgery vs Physio
« Reply #2 on: September 04, 2014, 06:06:13 AM »
I'm 7 weeks out from acl and also having trouble with excessive scar tissue. Pain is much worse than before and leg is very much weaker. It goes out from under me several times a day. My acl was gone and this was the third surgery in 17 mos after a severe knee injury so that probably plays a part.

I'd try pt first. 9 months sounds like forever but it's actually the quicker and safer fix if it works!

Offline Paul83

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Re: Partial ACL tear - Surgery vs Physio
« Reply #3 on: September 04, 2014, 08:58:45 PM »
Cheers for your messages guys.

I guess what is stressing me the most is the overall time I have been dealing with knee problems, rather than viewing this as a new one, if that makes sense?  Plus I am getting married next year and I want to be able to enjoy the day and not be in pain.

Maybe the physio will be a better idea, wont hurt to try anyway! Well, hopefully.....

Offline strangegravy

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Re: Partial ACL tear - Surgery vs Physio
« Reply #4 on: September 05, 2014, 08:53:47 AM »
Just to put some balance into this thread, I had an ACLR and meniscus repair 11 weeks ago yesterday and haven't experienced the problems the other two posters have. I've been cleared to start running again, although only 1 minute at a time for ever 4 minutes of walking. Was in quite a bit of pain before surgery which is now better and my only pain I get is at the limit of my ROM, but it's steadily improving.

Try the physio first, but just bear in mind that thousands of people have this surgery a year and I'd guess that the percentage that have problems is actually quite small.

Offline Kaputt_Knee

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Re: Partial ACL tear - Surgery vs Physio
« Reply #5 on: September 05, 2014, 03:27:30 PM »
I'd like to second strangegravy's comments as well!

I've undergone 5 ACL reconstructions over the years and have only had problems as a result of surgical incompetence. If you follow your surgeons rehab programme closely and do not try to rush back to sports you can return almost as good as new within a year to even the most strenuous activities.

The first 2 answers are atypical compared with the tens of thousands of reconstructions carried out each year but indicative of the cross-section here. People come to this site either in advance of their treatment (such as yourself) to inform themselves and look for advice about good surgeons etc. Then they have their reconstruction and never come back because they are fully active again. The other users of this site, and sadly by far the most active in many ways, come here after things have gone wrong for whatever reason. Unfortunately quite a few of these are looking to play the blame game; surgeon, circumstances, Workers Compensation/Industrial Injuries board, whatever. Their own negativity never comes into their equation either! ;-)

Try physiotherapy, it will not harm you and if you eventually decide to go for a reconstruction it will have helped in that your ROM and muscles will be in good condition (always helps to go into the reconstruction with a good ROM and as fairly fit as possible). Depending on the amount torn, you may even get back to a functional knee again. If it is already badly torn or continues to give way, it will most likely tear itself fully during one of the collapsing events. Once it is torn, it cannot heal itself, you can just protected it by maintaining excellent muscle condition and control around the knee. Once it is fully torn you will begin to experience meniscus and other problems, leading eventually to osteo-arthritic degeneration of the joint. How long this takes is dependent on your activity levels and types, your own body's response and your genetic predisposition to arthritis. I've had a fair few problems with my knees, have always been very active sports-wise (field hockey, volleyball, skiing, sailing, paragliding amongst other things), but my surgeon is absolutely amazed at how little arthritis is actually present in my knees. Being such a klutz as well as over 60 years old, he was expecting to have to go in and replace the knees. But to his and my surprise, he found that the condition of the articular cartilage in my knees was remarkably good considering my injury history.

So work at the physio and at the same time inform yourself about the injuries and your knee. Also find out from the physios who are the best specialist knee surgeons in your neck of the woods. Always go to a knee specialist as it is a very complicated as well as important joint. With the best will in the world, a jobbing orthopaedic surgeon who does everything without any speciality is not going to be as update with all the new opinions and techniques available for preserving the knee for as long as possible.

Good luck and hopefully you will come back and let us know how things work out over time!  ;)

 :)
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 Paul83

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Re: Partial ACL tear - Surgery vs Physio
« Reply #6 on: September 07, 2014, 09:59:49 AM »
Thank you to the last 2 posters - it's good to see some balance as well - I was starting to fear the worst :p

I'm waiting on the second opinion, and also the physio things to come through - I was silly when I didn't take works private medical insurance thinking "it'll be ok" then my knee went (and my other half could have done with it too!) - worse case scenario I can join at Christmas, and this policy accepts pre existing conditions apparently, so Iay switch to private in the new year.


Offline Mvbinion

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Re: Partial ACL tear - Surgery vs Physio
« Reply #7 on: September 08, 2014, 04:18:36 AM »
Good luck! I hope which ever choice you make that it all goes well!

And I am atypical :)
Great dr but unfortunately a serious knee injury and tons of over scarring