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Author Topic: Does ACL reconstruction have a protective benefit?  (Read 2559 times)

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Offline OptimusGeorge

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Does ACL reconstruction have a protective benefit?
« on: October 28, 2014, 11:44:16 PM »
Hello everyone, This seems to be a wonderful community with so much information! I've read through the site but didn't quite see one that matched my circumstances.

Me: 38 year old male, mild - moderate activity level (running twice a week, soccer with kids, yard work) I tore my ACL playing soccer 3 weeks back and MRI indicated ACL tear and no meniscus damage.

Now, 3 weeks after injury I am able to walk around with a slight limp. I can climb and go down stairs "normally" but I still feel weird in my knee, some times it feels like I might be walking on a stilt. I am afraid to run or walk on uneven surfaces. I am optimistic that this will get a little better

I got two opinions: The first Ortho suggested an ACL reconstruction in 3 months time after prehab. His explanation was that no-surgery is an option only for much older patients and even if I am able to walk fine now, it's better to get the reconstruction and not have an incident which will cause more damage to the intact parts. He seems to think of it as protective action

The second ortho leaned towards no surgery, just physiotherapy to increase muscle strength. His reasoning was that I have a desk job and I should just be careful to not engage in physical activity that will cause more damage. He said things like no hiking, pre-rotate your body when getting out of the car etc

What would more doctors agree with? The surgery or no-surgery option? Is there really a protective benefit to getting the surgery? The protective benefits seem to be from osteoarthiritis and further meniscal tearing incidents. Am I (doctors & research really) right here or is my Ortho just rushing to surgery because it is what he knows to do best

I think getting the surgery has some risk of complications that would lower my current quality of life. I can walk around now with no pain and willing to give up running/soccer but am also afraid that I might just trip and break something, requiring more surgery anyway. Should I risk making it worse by not getting the surgery?

I'm so confused! :(


Offline strangegravy

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Re: Does ACL reconstruction have a protective benefit?
« Reply #1 on: November 01, 2014, 08:21:11 PM »
As no one else has answered, I thought I'd just chip in with my thoughts. From what I understand having an ACL does provide a protective benefit as it keeps your knee stable to prevent any further meniscus damage. If you build your muscles up, that works in the same way, but not sure how effectively and what happens if you don't keep your muscles as strong as they need to be. For me, I'm 30 and getting the surgery was a no brainer to me. I'm very active normally (running, basketball, trail running, football, maybe some rugby once I'm fully fit again) and life wouldn't be worth living if I couldn't go back to normal. I've got two young kids, 6/7 and want to do all these things with them as they grow up instead of just watching and hopefully I'll be continuing some of these hobbies till very old age. So, whether or not to get the surgery wasn't even a thought for me. It's a personal choice really and what you want out of life in the future. Only you can make that decision.

Offline BigKneehurts

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Re: Does ACL reconstruction have a protective benefit?
« Reply #2 on: November 23, 2014, 07:16:04 PM »
For me its pretty cut and dry. If you are going to run, you need the surgery. My doc said I would destroy my meniscus if I did anything athletic.
But understand the recovery is much longer than the doctors tell you. I'm 1 year after surgery and I still can't run for more than a then 5 minutes.

« Last Edit: November 23, 2014, 07:48:05 PM by BigKneehurts »

Offline fraz

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Re: Does ACL reconstruction have a protective benefit?
« Reply #3 on: August 08, 2015, 03:59:10 AM »
If the knee is unstable  ;)eg. if there is any damage to the menisci or articular cartilage then there maybe suspicions of cruciate damage- think ACL PCL

In this case if an anatomical ACL reconstruction were to take place and be done correctly then yes it would be beneficial to the knee.

It may be the case that the only way to regain the stability of the joint would be to perform reconstruction or put another way if you didn't have reconstruction you would probably not have a stable joint ever again.

The gold standard is an allograft but this carries some risks but with well run tissue banks these can be kept to 1 in 1,000,000

Offline fraz

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Re: Does ACL reconstruction have a protective benefit?
« Reply #4 on: August 10, 2015, 03:16:09 AM »
OptimusGeorge,

Hello :)
Nobody can make a decision for you as to the best way to proceed or whether to have surgery or not-
The best thing is to try to learn the relevant facts about the anatomy in question-In this case knees-

From my point of view for me my knee is not stable and there is near 100% probability the cruciate package is "deficient" which is one word for saying the ACL and or PCL are not working correctly and the evidence is presented in the form of symptoms and there are symptoms because there is something wrong and as you can read this goes full circle.

An ACL will not heal itself as it is surrounded by fluid [synovial] and even a partial tear will develop in time to a more than partial tear and a risk of complete rupture eventually - I have experienced some of this already where there are episodes of giving way - This sounds quite drastic but it does not mean one collapses on the floor in agony but just more subtle insult to the structures of the knee that are already injured but adding another layer onto the injury making it that little bit more worse.

Other tissues become affected too after the cruciates are damaged - mensicus tears - cysts develop - the bones become damaged - then deformed very gradually-

These are just my opinions based on my problems -  :) - but this may help someone else to learn a little more about their problems -