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Offline Clerksrule

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Positive then negative test
« on: February 19, 2015, 02:05:14 PM »
In September of 14 I was playing flag football and went to jump stop and heard a loud pop and my knee grind together. I did not have health insurance at the time so I went to see a doctor who is an orthopedic surgeon of a kid who plays on my basketball team. He performed the Lachmans test and it was clearly positive (there was no end point for the tibia). Fast forward throughr just aquiring health insurance at the begining of February. I went to see a respected surgeon who performed the test and there is clearly an end point now aboit 1-2 mm more than my opposite leg. He sent me for an MRI and when read he said it's partially torn. I  super active so I scheduled surgery but I'm trying to figure out how this happened. There was clearly no end point when I got the test done the day it happened. How can there be an end point now. The surgeon said when they go in hell decide if it needs to be repaired or just rehabbed but I'm worried bc I snowboard and love to play basketball and football and want to be able to continue. Could the initial test have been wrong. Could the 2nd test /mri be wrong because of scar tissue? Any thoughts bc my surgery isn't for two more months and I'm going nuts.

Offline MDAL

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Re: Positive then negative test
« Reply #1 on: February 19, 2015, 02:31:38 PM »
You are failing if you consider these tests to be bullet proof against false positives or false negatives... These tests are subject to a lot of interpretation from the doctor and mistakes can happen often.

Aside that partial torn ligaments have the ability to heal themselves naturally to a certain extent. Ligaments don't have a lot of supply but they do and can heal slowly. I suspect you are still young, with high stem cell counts and hormonal levels, so it is possible that the ligament has been slowly healing in the last 5 months.

If you have PRP or stem cells in your area (and can afford it), I would suggest doing so. There is clear evidence by now that these treatments are highly affective for smaller ligament injuries.

I wouldn't however go too wild on sports for now... especially high impact ones... not sure if you really want to torn the rest of it...

Offline Clerksrule

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Re: Positive then negative test
« Reply #2 on: February 19, 2015, 03:06:26 PM »
I'm actually 32 and want to return to do high Impact sports. Can the acl regenerate if it's only a partial tear. What I don't want is the doctor to go in and asses and determine its fine and then I tear it and have to go through this all over again.

Online vickster

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Re: Positive then negative test
« Reply #3 on: February 19, 2015, 03:34:01 PM »
You should take advice from a surgeon expert in ACL injuries, having discussed your wishes.  If you do go for reconstruction, be prepared for a long, tough rehab and longish lay off.  You could also see a physio and discuss brace options.  Is the knee inherently unstable which is the main indication for getting it fixed :)
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

Offline Clerksrule

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Re: Positive then negative test
« Reply #4 on: February 19, 2015, 05:46:50 PM »
What worries me most is that it translates forward a bit with a pivot shift test. Toe this tells me as soon as I try to make a cut it has great potential to honor, especially if my quad misfires. I am active with a ton of sports plus weight lifting. I don't want to do a power clean and when I move my feet out to land have it explode with 225 lbs racked

Online vickster

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Re: Positive then negative test
« Reply #5 on: February 19, 2015, 05:55:07 PM »
You'd want to know whether that sort of activity will be advisable with or without a reconstructed ACL. It's likely the knee will never be the same again although it could get close

You'll also want to ensure the best graft is used for your expectations, that might determine the choice of surgeon as they have their own preference and expertise. If it's an autograft (i.e one of your own tendons fashioned to create the new ligament) that may well I pact your activity post operatively. There's loads of info out there on acl recon as its a pretty common knee procedure. Plenty of skiers on here for example with experience of returning to the slopes

If the ops not for two months, plenty of time for prehab and research
« Last Edit: February 19, 2015, 05:59:30 PM by Vickster »
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

Offline Snowy

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Re: Positive then negative test
« Reply #6 on: February 23, 2015, 04:01:47 AM »
Quote
Can the acl regenerate if it's only a partial tear

No, it can't. The ACL doesn't have a blood supply, so it can't regenerate once it's torn. Collateral ligaments which do have a blood supply can heal from partial tears, but this isn't the case for cruciate ligaments.

The big question for someone who's very active is whether or not the tear is sufficient to compromise the stability of the knee. If your knee feels or tests unstable, or with greater laxity than normal, then you'll be at risk of degenerative changes in the longer term. Even very small amounts of laxity will have an effect over time, especially in a knee that's subject to high demands through sports. Talk to your physio or surgeon about how much laxity you have in the knee, and what this means given the level of sport you want to be able to participate in.
Mar 11: R Biceps femoris tear (skiing)
Jul 10: ACLr (hamstring autograft)
Mar 10: L ACL rupture (skiing)
Feb 06: L partial ACL tear (kickboxing)
Dec 03: R bone edema (motorbike)
Jan 01: R patellar chip (motorbike)
May 93: R ACL sprain (hockey)
Ongoing: bilateral PFS and OA