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Author Topic: have I torn my ACL  (Read 987 times)

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Offline sprat123

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have I torn my ACL
« on: January 15, 2015, 06:08:51 PM »
Injured my knee skiing 2 1/2 weeks ago, popped no pain and unstable. Doc in France say positive lachman and jerk test. Said complete tear ACL. Physio agrees. Orthopaedic surgeon in UK disagrees as felt no difference in anterior drawer between right and left leg. Didn't check other tests. Said ligaments in both legs lax. Now awaiting NHS MRI.
Leg not right but can weigh bear now and swelling gone down. Is it likely to just be a minor soft tissue injury or not?
Thanks

Offline Kaputt_Knee

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Re: have I torn my ACL
« Reply #1 on: January 15, 2015, 06:31:21 PM »
Depending on where you are in the UK, it is better to get a knee specialist rather than a jobbing (aka general) orthopaedic surgeon if you can. Ask your physio for a recommendation and pay for a consultation if necessary. You can always be transferred to the NHS list for the same surgeon if you require surgery. The standard tests are Lachman and Anterior Draw, usually with a pivot shift test as well. http://en.wikipedia.org/wiki/Pivot-shift_test

The Information Hub contains lots of information about ACL injuries as well as lists of specialist knee surgeons in a variety of countries - the list for the UK is pretty comprehensive by the way.

If you are who I think you are (snowHead 8)), Jonathan Bell will be along soon and give you some advice! ;-)
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 sprat123

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Re: have I torn my ACL
« Reply #2 on: January 15, 2015, 07:05:10 PM »
Thanks

Offline MDAL

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Re: have I torn my ACL
« Reply #3 on: January 15, 2015, 07:27:26 PM »
Injured my knee skiing 2 1/2 weeks ago, popped no pain and unstable. Doc in France say positive lachman and jerk test. Said complete tear ACL. Physio agrees. Orthopaedic surgeon in UK disagrees as felt no difference in anterior drawer between right and left leg. Didn't check other tests. Said ligaments in both legs lax. Now awaiting NHS MRI.
Leg not right but can weigh bear now and swelling gone down. Is it likely to just be a minor soft tissue injury or not?
Thanks

Looks like it's best to wait for the MRI and rely less on palpation guesses... if you are not in pain, swelling has gone down and you can walk on it, it's probably nothing serious, but it's best to wait for it and check the entire structures ligaments and meniscus. Here we can only throw guesses...

Offline Kaputt_Knee

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Re: have I torn my ACL
« Reply #4 on: January 15, 2015, 08:08:44 PM »
MDAL: doctors in medical centres in ski resorts see these type of injuries every single day, sometimes in double figures per day. They know their stuff. As do the physiotherapists who work on the patient's knees and see them on more than one occasion for longer than 10 minutes max!

The standard, pre-MRI examination required a case history, X-rays to exclude bone injuries and the 3 tests mentioned. I walked into the hospital when I had my first injury in Austria 1989 - that was the ACL, both meniscii, MCL, LCL and a partial rupture of the patella tendon as far as I remember. I was operated on within 24 hours which was when the pain finally kicked in (on waking up in the recovery ward). I also had relatively little swelling although the accident had occurred a couple of hours earlier. I was out of action for 6 months, 3 of which were spent in a wheel chair once I had left hospital after 5 or 6 weeks.

I would expect any surgeon, consultant or Houseman, to carry out as a minimum all three tests on both knees to ascertain whether there was an injury to any of the soft structures.

Every time I have ruptured the ACL since, primary diagnosis was always by means of the three physical tests, X-rays and then an MRI to confirm the primary diagnosis. I now have a lax ACL/MCL in the right knee but they were able to differentiate enough to confirm without recourse to an MRI that I had ruptured my ACL in my left knee in 2006. The MRI confirmed the damage to a degree but missed a lot of other damage too.



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 MDAL

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Re: have I torn my ACL
« Reply #5 on: January 15, 2015, 09:56:08 PM »
I understand your point to a certain extent Kaputt, but what can he/she do if the surgeon doesn't find anything much and wants to wait for the MRI...

I also understand that MRIs don't show precise results, but it's better to wait for it and have a better idea of whats going on, than doing a sort of "exploratory surgery" that may lead into nothing... there are no absolutely certain tests...

He/she says not in pain and swelling went down already. Many people can go for years without an ACL, so it can wait in order for the surgeon to make a more informed decision with some extra images.

I have had plenty of knee surgeries and based on this story, I wouldn't rush into it without being certain that the surgeon had an MRI on hands.

If you ever have an exploratory surgery for cartilage or meniscus for example and wake up amputated from the inside without your information or consent or even an MRI to start with, for something that wasn't causing you any symptoms in the first place, but the surgeon thought it would be great to have a shaving marathon on it, you would know why I feel this way... Let them get the MRI and surgery if needed can wait...

Offline sprat123

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Re: have I torn my ACL
« Reply #6 on: January 16, 2015, 09:41:32 AM »
Thanks everyone. I will carry on treating it like an ACL injury doing all the rehab/prehab. At least I will be in the best possible shape whatever. I tend to agree that its the french doctors bread and butter so he should know his stuff. The NHS guy who on the hospital website is listed as/a knee specialist barely took any history or did any examination other than anterior drawer. Btw he is not listed on knee guru. I wish I had done more research to find a good knee doctor 1st. Stupidly presented  myself to A+E on return to UK rather than going via the GP. I didn't want to wait 2 weeks for him to write/a letter.

Offline Vickster

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Re: have I torn my ACL
« Reply #7 on: January 16, 2015, 09:44:15 AM »
My knee specialist isn't listed on KG either but he is excellent and extremely experienced, only doing knees, so I wouldn't go solely on that :)

Hope you get sorted with the MRI soon
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up















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