TORN ACL or NOT?

[vickster]

Sounds like excellent news (why do you think the surgeon is wrong when all the evidence supports what he is saying?)

As mmrocker, get PT, get fit and get back to your sport.  You're young, don't spend the best years of your life worrying about something that isn't there

Maybe a (sports/health) psychologist would be of help too?

[kneeProblem]

Well why did the other 2 doctors say it was torn? My first doc 2.5 years ago who did the surgery and another one recently saying it was also torn.  But now this third doctor says its not torn?  That's what is confusing me.  The MRI is also on my side it seems unless it was read wrong by the radiologist and the surgeons but from my understanding and looking at it myself it looks intact in most if not all of the images.

[vickster]

Your first post said the doctor said "it might be 'stretched' or partially torn" - doesn't sound like he was at all sure, hence the MRI?  I didn't see any mention of a second doctor saying it is torn.  Why if you were examined several years ago, have you done nothing surgical or physio wise (as far as I can recall) and now despite a negative MRI, are you now only thinking it needs fixing? 
Maybe muscle weakness is the issue here?  Why not take mmrocker's advice and get physio (do you have to pay for that unlike surgery, I don't fully know how the US system works)?

What are the three doctors advising? I and everyone else who has responded are not doctors, we've not seen your knee...these three surgeons are and have, so you should go with what they advise (usually surgeons are conservative initially).  Or get further opinions if not happy (I'd see a sports physio now and not another surgeon, especially given sport is your aim)

[kneeProblem]

well my very first doctor who originally did the surgery, evaluated me when I came into his office 2.5 years ago when I thought I hurt it again.  He said I tore it but never saw an MRI and I never got the MRI done at that time as I wasnt even thinking about surgery at that time in my life.  So I put off surgery up until now because my insurance ends in a couple of months so I got it looked at again.  Saw another doctor and he said it was torn but said it might be stretched because I dont have any symptoms and ordered to get an MRI.  Once he saw the MRI he advised not to get surgery unless I was symptomatic.  I then went for another opinion my most recent one today and he said it is not torn and everything feels solid and stable.  That is where I'm at now.  I have no symptoms of giving way or no pain unless I run, I start to feel sore.

[vickster]

If there's no pain, no mechanical issues, I certainly wouldn't go through the potential risks of surgery (as mmrocker previously) and post op pain.  I don't think an asymptomatic stretched ACL needs surgery.  Rehab and train to get back to sport if that's the main thing and see how you go.  The doctors all sound wise.  Have they referred you for physio?  Do you do physio at home if not structured?

Can't you get insurance through work or something after the age of 26?

[kneeProblem]

Yes I can but I currently don't have a job that gives me full benefits such as surgery because I work two jobs on a part time basis.  I guess later down the road If I need coverage Ill have a job that can cover me.

No, the doctors have no prescribed physio, but the last one said maybe Im getting sore due to my running stance.  He did say I have a small tear in the meniscus and I believe that is what's causing me to get sore when I run.  I just don't know though about this whole thing because last time before my revision ACL I got an MRI and it also came back negative even though my knee gave out during some light basketball activity coming down from a rebound.  Cant remember if I got that MRI after the knee gave out or before, either way the MRI was negative and knee clearly had a torn acl.  That being said, Ive become skeptical of MRIs and also doctors.

[vickster]

Have you had a gait analysis done to assess your running?  I didn't think you were doing any sport?  Or just not playing soccer?  I didn't think you had any giving way and all the tests for stability are negative, so I don't really follow on the basketball?  When did the knee have a clear torn ACL - before the last reconstruction?

When is the op? If you have the op and then need another to redo the ACL again and your insurance runs out, how will you do all the physio that will be needed after?

It sounds like you have made up your mind and want the operation, so best start the pre-hab asap.

Good luck

[kneeProblem]

NO. The giving out of the knee in basketball was before my last surgery about 5 years ago. I already got that taken care of.  My knee has not given out since my last surgery, perhaps on my last incident 2.5 years ago can't really remember what happened.  That's when I decided to go back in and see if tore anything.  Since then I have gotten 3 opinions on my knee.  The first was right after the incident and went to my original doctor and he said acl was torn, then I waited up until now and went to my second doctor, he also said it was torn, but ordered an MRI to make sure, once he saw MRI he said lets no operate unless you're symptomatic.  Then I got my third opinion today and he said its NOT torn and everything looks stable. So idk what to do as of yet. My knee feels great just a bit sore when I run.  And like I said when I initially hurt it again I cant remember if it actually gave out or I was in panic mode and thought it did.

[vickster]

Knees can give out, for no specific reason, or due to muscle weakness or specific types of meniscus years. Mine can feel a bit wobbly, my ligaments are fine but I have meniscus tears in both knees. Those in the left don't give me much bother except some pain at night when I turn over. The right is painful all the time despite painkillers so it's due to be scoped next week. I lt sometimes feels wobbly especially on stairs but that could be pain inhibition, I don't know. If it didn't hurt, I certainly would be putting it and myself through the stress of surgery

Have you thought to get some counselling to help with the worry as this is clearly a big thing for you? Knee issues are a funny thing and it's all too easy to overthink every little twinge, and to obsess (I've been there often over the last 5 or so)! As mentioned, the mental barriers after injury and surgery are much harder to fix than the physical. There's even a sub forum on here for that reason.

[kneeProblem]

Well like I said my knee has not given out since my last surgery and it feels very stable and like Ive said before I can do high power kicks like a martial artist and knee doesnt move.  The only time it mightve given out but cant really recall was when I believe I injured it 2.5 years ago.  Ever since then I stopped playing sports in fear that it was indeed my acl.  But i seem to have no symptoms and my knee feels a lot more stable than previous tears in the past so we'll see how it goes.

[vickster]

Sounds good and can work towards sport. Or is martial arts what you do? Might want to talk with physio or coach about a support short term, if just as a mental crutch while you get back into it all

[kneeProblem]

No i do soccer lol, i was jsut making an example of my knee being stable

[vickster]

So did your physio not clear you to play again after the ACLR rehab?  Why would you things like high kicks while concerned about the integrity of your knee, unless cleared to do so?

[kneeProblem]

The reason I did the high kicks was to self test my knee and see if I was able to do a tough movement such as a high kick and if I could, I could try to come to a conclusion that my knee is fine.

He didn't specifically clear me or recomend me for physical therapy, he just simply saud nothing is wrong with me.

I'm really concerned about my knee still, last thing I want is to think I'm healthy only for me to blow out the rest of the knee on aquicj cut or jump and the acl not being there.  Everytime I run or use the knee vigorously, I get sore.  Walking and standing on it all day though I dont get sore, just when I really try to use the knee if that makes sense, running, etc.  I'm wondering if thatvsore feeling is me just not being active for almost 3 years now or its because something is wrong

[Snowy]

The reason I did the high kicks was to self test my knee and see if I was able to do a tough movement such as a high kick and if I could, I could try to come to a conclusion that my knee is fine.

I don't think you can really tell anything from this kind of self-testing. When I tore my ACL, once I'd recovered from the initial injury and regained strength in my leg I had no day-to-day instability at all and was able to ski, run and kick without any problems or discomfort. Only the testing done by the doctor showed laxity in the leg. All that self-testing can tell you is that you're not experiencing symptoms from these particular actions; it can't tell you whether the ACL is intact, stretched, or torn.

You've had some excellent advice from other people on this thread. It seems your choice at this point is to go for the exploratory scope, which will mean another surgery but is the only thing that can give you the concrete answer you're looking for on the state of the ACL, or you return to sports (with the aid of a physiotherapist would be a good idea) based on the stable feel of the leg and the last doctor's advice. It sounds as though the thing you're really struggling with is the idea that you may not have absolute certainty on the condition of the ACL if you go the latter route. Is getting that certainty worth an exploratory scope?