Going in for ACL surgery have a couple questions.

Back in May I tore my MCL and ACL while wakeboarding Lake Mead. In 3 weeks I go in for surgery on my ACL. I have a question regarding grafts and recovery. My Dr gave me 3 options, Patella tendon graft, hamstrig tendon graft, or achilles tendon graft (cadaver). He says that with the patella tendon I would lose somoe strength there and that there is a 30% chance that I will have chronic knee pain for the rest of my life. The hamstring tendon is a better option as it will cause less secondary issues after recovery but will still add extra discomfort during recovery. The cadaver achilles tendon sounds liek the best option to me. It comes with a bone plug, is really strong and Im not robbing something from somewhere else.

I know there are quite a few people who have had the surgery or know someone personally who have had it. I would really appreciate your input into this before I go under the knife. I will miss the whole snowboarding season but if all goes as planned I will back up and running in time for mnext summer!

Thanks,

Nick

Nick, I am actually going for ACL surgery this Friday. Naturally, I blew it out wakeboarding. As far as the three grafts go, I'm electing for the hamstring.

If you really want to use your knee again, I would suggest against the cadaver graft...that tissue has been freeze dried and is not as strong as your own living tissue. The recovery time is definitely less, and there will be less discomfort after surgery, but I, personally, wouldn't trust the strength of that graft.

The one thing that turned me away from the pateller tendon graft was the fact that I have a very locked-knees style of riding (comes from riding horses) and I don't want to screw up my patella after I get my ACL fixed. My surgeon said that his wife had the pateller tendon graft and he can still feel a gap where they harvested tendon.

The long term strength difference in a pateller or hamstring graft is insignificant, but both have longer recovery times that a cadaver graft, obviously.


From what I've read, the screws that they are using in the grafts now actually promote bone growth around the soft tissue of the graft, and eventually the screw will dissolve completely.

I've read a couple websites, but this is the only one I bookmarked...it's got some good information on grafts.
http://www.orthoassociates.com/ACL_grafts.htm

Good Luck!!!
-jesi

Nick- had same questions a year ago, was having discomfort in knee before surgery so switched from patella graft to hamstring. I was told patella more painful out of surgery but recovers faster. Went with hamstring so not to add more knee pain, recovery went really well, thanks to my wife's awesome care, felt really good after 5 months (released to ride at my discretion) after 6 months good to go all activities as before. With the exception of bruising the same knee 5 weeks ago all has been great. No pain whatsoever! The bruised knee felt better after 2 weeks, although I did have it checked out just in case) all's well. Make sure to follow rehab to a tee, get flexibility back , and you should be good to go. Patience is biggest obstacle. If you go with hamstring just be REALLY careful not to forget to take it easy. Have a few dog's and bending over to refill water dish would just about floor me if I forgot to bend my leg before reaching. Although I'm a huge baby and had to get a nice shot of morphine after surgery,(and swore I was an idiot for wakeboarding in recovery) I've never been happier to be out riding again. It was my second acl miniscus tear so still working on confidence, but would absolutely do it all over. Good Luck

I also went for the hamstring graft for my ACL reco surgery, and the discomfort in that area after surgery wasn't that bad (the PT for your knee after the surgery will make you forget all about any discomfort in the hamstring area, trust me on that one).

I say go for the hamstring, due to my personal experience and also what Jessica said about the strength of the graft.

I used the patella, May 1, 2005 surgery date and i was surfing after 3 mo, and wake skating now. I may not wakeboard again too scary (thats how i blew it out). PT was/is not as bad as i thought it would be. I just get very frustrated that the recovery takes so long. Yeah i could walk but, still dont have full range of motion ie. i still cant sit on my heel or run w/o pain. I think age makes a difference, younger quicker more complete recovery. I am 46.

Nick I had the cadaver graft ACL surgery about 6 years ago and it held fine for about 2 years. I went through all of the PT and stayed off of it as far as riding goes for a full year. I blew it out the following year with a knee brace on but I don't think it matters what surgery you get it will not be as good as it was when it was healthy. You are going to have knee pains for the rest of your life so just get used to it,I am not trying to be negative but it is the way it is. Once your PT is over with continue the exercises on your own and workout as often as you can to keep the new knee as healthy as possible. Good luck with your surgery which ever method you choose.

Nick- being in the sports medicine industry I have learned quite a bit about ACL reconstruction. My company (Stryker) has many options as most people have already poiinted out. With my experience I would say go with the cadaver graft from Regeneration Technologies (www.rtix.com). They have the ONLY sterile allografts on the market Being sterile means that the chance of infection is all but gone now. Other companies say that theirs are sterile but the FDA has granted RTI with the label "sterile". As for your doctor offering only the achilles graft I would say get a Patella Tendon allograft. Achilles allografts are a thing of the past.

Nick.... I had mine done about a year ago, and actually had them take it from my hamstring. The recovery is not that bad. From right after surgery to 85%, the recovery is fast! From 85-100%, it takes awhile. That is the case no matter which way you go.

Cadaver - I suggest staying away from. the tendon is not fresh, and you don't want to put something in your body that isn't yours.

Patela - I have heard positives and negatives from this. Some surgeons only do this surgery... its considered more old school. It definitely leaves a nasty scar.

Hamstring - I had this done. Small scaring, recovery time... not too bad... its a newer method, compared to others. From where they take it, its not the most crucial part of the hamstring tendon.

I'm happy with mine..... as happy as I can be. I suggest either the hamstring or patela.

Hope this helps a little. Good luck!

I had the patella graph the first time and am doing it again tomorrow. In case you guys haven't seen it, here is my experience with my first surgery.. http://www.wakeworld.com/articles/2002/acl1.asp

The 2nd time I blew it, it was a freak accident, but yes, I was wakeboarding.

Anyway, the Patella Graph was extremely strong. I could actually feel it pulling and streching before finally letting go and tearing the 2nd time.

This time, we are going into my good knee to get a piece of my other patella tendon to repair my bad knee.

Oh well!

McFly
Waterski Boats Dallas

Marty.... man, that sucks. Did you have a brace on when you f'ed it up?

Also, now that I re-read the post and saw the comments...

Once I recovered fully and was up to strength, I had zero discomfort and pain in my knee. I was running, cutting, jumping, etc. with zero pain. My knee felt stronger than it ever had before, and I had a very small scar on the front of my leg below my knee where the patella graph was taken.

I also had zero pain with my patella tendon. In fact, that only bothered me one time after my 2nd day at physical therapy. After that, I never even noticed that I had a chunk taken out of it.

Patience is the key. Take it easy and you will be good to go.

McFly

as marty said the Patella is one of the strongest, and the one most Football players go with, if I am not mistaken.

From the little reading that I have done today it seems that the patella is a good choice provided that I am not a tile layer or something. The percentage of complaints from knee pain involving the patella was a bit higher than that of the hamstring variety. And just so that I am on the same page, when you say hamstring are you referring to the DSTG (4 strands doubled up?). The patella seems like a good choice because of the bone to bone fusing that is done instead of soft tissue to bone. There are just so many options out there and its my friggin knee for crying out loud. Gotta make the right choice.

Thank you VERY much for all the help and support here. I love this forum

Good luck to you Jessica and Marty!!

I know two people that have had the Patellar tendon graft, and they both say that their reconstructed knee is healthier than the other knee.

I have a completely torn ACL and I think that is the route I am going to go when I have surgery.

Tore mine may 2004 wakeboarding. had the hamstring tendon for replacement. I live in a place where an acl replacement is an everyday thing (aspen, co). doc said this was best option (dr. pevny, #2 acl recontruction dr. in the US. works with the doc who started acl reconstruction) he also just did the patellar on a good friend after advised pros and cons. recovery going fast, but knee doesn't feel right. I have had a great fast recovery and have a stronger knee than the other. I don't wear a brace and still wipe out w/ the best of them!!! back to having no fear. never any pain in hamstring when in recovery. I would suggest hamstring. just my opinion.

Nick:

Had my ACL done about a year and a half...I went with the Cadaver.. Best move..My PT consisted of 3X PT with 2x water therapy (Swimming Pool PT) That combination was hard but my knee is stronger then it was before.. there were other patients in PT with the same injury and all had the same out come, Except for the hamstring patients. Good, but not so good... Do i trust my knee again...Yeah..but I still gun shy on the Tantrum to Blind..

Note: It seem like every Orth Doc has some connection to some sports team...But that should be your reason to choose them.. Find out who he recommends for Physical Therapy..Check them out and as question about him..It may be a little sneaky, but its your knee..Not his.

Ric Morgan

I had my ACL reconstructed this past April, for me there were no other options than the Patella tendon Allograft.
My reasons:
1- Quicker return to activity as in Daily activities of living. Femoral Nerve block does wonders! Was at full extention and flexion post-op d#2 and back to work 1wk.

2- Why would I want to compromise anything that I need for rehab?
Co worker had her ACL repaired 6 wks prior to my surgery. Her Orthopod gave her only one option the Hamstring/Gracilis graft. Lets just say that her hamstring strength ( which is extremely important for ACL injuries/defiencies) is no where close to mine and nor will she ever get back to full strength. (search Journal of Arthroscopy and other related Surgery and American Journal of Sports Medicine)
3- Let's just say that I did use my own tissue, unfortunately my fears are what just happened to McFly....you only have so many options on your body to tap. I prefer to keep mine and use someone elses.
4- Having worked in the medical Field for over 12 yrs I know the risks and already have been expose to AIDS, stuck with needles. Getting an Allograft is the least of my fears. Plus technology is getting better through time.
All tissue banks are regulated by the FDA and they are region specific.

Since my surgery was schedule 4 wks out, I was able to get a near perfect match and a graft that was in pristine condition.......I didn't know that until after my surgery. I even have the pics from the surgery and I have to say I have never seen a graft that clean and in excellent shape.

I have been released after 4.5 mos and am expected to use brace for at least 1yr after that I'm on my own....no brace needed.

Good luck


(Message edited by phantom5815 on September 14, 2005)

Phantom, are you wakeboarding? My son is having his
done on the 21st and he is using a cadavar ACL
and was wondering how you were after the surgery
and what your rehab program was like.

Ok, now I am thoroughly confused! Out of the 17 responses it is virtually split in 3 between the patella, hamstring and cadaver!

Patella here.... 1995 and still "strong as OX"
Yea I would not have been laying tile for at least 18 months, but I was back on my Connelly Blade in about 5 months.
Hamstring injuries are tough to return to 100% from....why would I knowingly let someone cut mine? No dead body parts for me either, untill I am out of my own graphs.

Gordie- I've been too busy to go wakeboarding but I've been roller blading and on the Indo Board alot.
Understand that I'm in my early 40's and I was back walking without crutches after my femoral nerve completely block wore off (2 days later... But the other thing was that I waited 10yrs later to get my ACL reconstructed. I had been active without my ACL - wakeboarding,volleyball and softball .... including sliding on the same knee too!) CPM and ice for the first 2wks.
Minimal pain with the Allograft....occasional tenderness and hyersensenativity around the incision sites.
Rehab program is according to your Surgeons protocol. But mine was running by 6 mos and wearing a Knee brace for activity for up to 18 mos after the date of surgery.

Nick- Mine was a Bone-Bone Patella tendon cadaver graft if that helps

(Message edited by phantom5815 on September 15, 2005)

phantom- looks like a great repair to me.
nick- what you also need to know is that you can get hamstring, patella, and achilles cadaver grafts. in my experiences with the doctors i work with, they dont always tell you of ALL of the options you have.

Malibu36, we don't know as of right now what they
are going to use, should find that out tonight when we take him to his pre-op meeting. Is there any better one to use? (hamstring,patella,etc)We
or going with the cadavar because we were told if your competitive in sports you recovery time is quicker, your rehab is suppose to be a little
faster. Don't know if that's all true, but that's what we were told. Also like Phantom said
if it ever happens again you only have so many places on body to pull from so why not use someone else's. Maybe they will give him parts from a gold medialist. HAHA

Nick.... Just remember that everyones body heals differently. One surgery, might work better depending on the indiviual.

Talk to your surgeon or doctor

gordy- there is no study that says one is stronger than the other. what will make one stronger than the other is the type of fixation used. fixation is what keeps the graft in place while your body heals. on a macro level metal is always stronger than bioabsorbable, however metal does not disolve into the body. if i was having the surgery done to myself right now i would have a patella allograft with fixation screws. but i would make it a point that i get an allograft from RegeneratioN Technologies (www.rtix.com). they are by far the best graft on the market and sterile. remember that you, or your son, have the final say in what goes in your body.

Malibu36, I thought I read somewhere that metal
disolves in 3to4 years? maybe I'm wrong but I'll
ask about the others tonight. Thanks for your help.

I Had a Cadaver tendon done in August of 2001. Recovered quickly, PT fast, Doctor very happy with the surgery.

I have had pain related to a bone bruise(also part of the injury) that has been chronic since but does not hamper performance. I didn't ride for a full year (2002), the memory of the pain of my injury still haunts me.

I would have to say that I am happy with what I got. I have a very strong knee now, probably stronger than before and have no problems with swelling after riding. I will admit that I don't do anything difficult anymore (age 35) but really enjoy just being able to ride and go big on simple things. Love the wakeskate too.

The only problems I have is when I crouch all the way down and put full bend on that knee. I immediately feel soreness and don't have the same power in it when I thrust to get back up. Laying tile would be an impossible job. My knee will never feel the same again, but it is strong and reliable.

Chase, how come you didnt ride for a year, was that just your choice? My son is 15 years old.
What were the first couple days like after the
surgery? Where there any problems that you came across when you first got home or things you suggest he should do? Everybody's input is really helping me, I'm just really nerous for him
because he's a kid who likes to be on the water 4 or more times a week. What should we work on or do to keep him focused?

Gordie

I didn't ride for a year because my confidence was shot, my wife and other family said I was crazy to ride ever again. (I didn't mention that there was a broken tibia as well). Back in the day, they would have called this a career ender. I will say this, I'm riding with the most confidence ever right now - but not doing anything stupid.

Recovery was awful for the first couple of weeks. They had me on Percoset which I hated and stopped taking by day two (it was too strong/ bit of an emmotional rollercoaster, frankly). So I did most of the early weeks with the strong Tylenol. Also, I lived in an Ice machine (An igloo lunch cooler converted into an Ice water pump complete with a strap designed to wrap my knee which the water was pumped to. it cost about $100 and I still use it today and lend it to friends. I had my other knee in it the other night for no real reason than it felt like it needed it. Great investment and all my friends love it.)

First physio was day 2 or three, I was shocked at how weak my thighs had become, but full motion was back within two weeks. Because of my age and family life, staying committed to thorough rehab was hard. Probably why it took awhile to restore my confidence. Started working out in the gym regularly in 2003 again and ran and did squats like I always had. Strength was back so I slowly started riding again then. This season has been the best yet and I feel like a kid again. I dream about wakeboarding, watch videos and am back to thinking about getting a boat again. It has been a long way back (had two kids in the interim), but I'm back!

Another thought about the cadaver ligament. I think the investment in a recovery coach would be worthwhile (I wish I had the means to do it.) the brain has to be rewired because there are no signals being sent to the brain from the cadaver tissue. There are times when I feel like my brain reads that knee as having no ACL. Apparently, pro teams spend alot of money on coaches who specialize in overcoming this mental block. From what I've read on this subject and my experience, there is no question it takes a full year (with their help) to become full 100% again. And they say at least 50% of recovery is mental. Just a thought. A lot of people reinjure themselves coming back too soon. A few have mentioned multiple injuries in this post. So be careful. I wouldn't ever want to go through any of this crap again.

So, let me ask this. When I tore it on the lake it was the most excruciating pain I have ever felt. Now, while I didnt squeal and scream like a little girl, I was doing a lot of yelling, shouting, swearing etc. Is that the general consensus here or did most of you just suck it up and bit the pain back? It took me a good 5-10 minutes of agony to be able to talk calmly.

Im going to talk with my surgeon again and bring up all the points that I have read here and elsewhere on the internet and see what he thinks will be the best course of action for my case and lifestyle. It seems that all options have very similar results and risks.

With the patellar allograft, will the bone still fuse together or will that only happen with a autograft patella?

Nick, when my son injured his knee complete tear of ACL, torn miniscus, fractured his knee bone during a contest at canyon lake said he was in some pain and was limping
then the swelling came
iced it took tylnol and he rode two days later
had some pain landing raleys and spins hellside 5s and is using cti2 brace but it swells up and
gets stiff every time he rides for the last month since injury he's only riding twice a week.
But yes he is in pain when he's done, will probally get a lite set this weekend before his surgery on wed of next week.

Chase, did the doctor prescribe donjoy iceman or did find on your own? Thanks for all your input
everyone has been so helpful..

Not much pain at all here. I think that bone bruise and meniscus tears are where the pain comes from, not the ACL itself.

One of the good things IMO of the patella graft is that the pain from the graft removal slows you down a bit in month 2 and 3 when you really feel good otherwise. The problem is you feel good, but the graft is still delicate. (again IMO)

PHantom: For those with no ACL, would you agree that they should get in if at all possible and get the graft done ASAP?? I skied, Bball, etc.. for 8 years with a blown acl and caused alot of other problems with continuous additional injuries each year. Ended up with 3 orthoscopics plus the ACL recon and 60+% of my meniscus removed. Really a dumb move when I look back on it. Still wakeboarding though, but my days are numbered.

Chase: I have similar constraints that will cause swelling. I wear a CTI brace, not for stability, but to help keep me out of that area of extreme compression that puts me bone to bone producing pain and swelling.

I did a 50% acl tear and lierally didn't even feel pain. Was riding again in a few weeks. Nagging problems made me get an MRI to find out i had torn it as much as I did.

When I tore the rest of it I also broke my tibia as well. I'm afraid I screamed like a girl. I was aware of the fact that I didn't look too cool, but I just couldn't control what was coming out of my mouth. Must have been the fracture.

The instant I blew mine, I didn't know whether to laugh or cry, so I got back up on my board, did a baby ollie, and was like "S***, that hurt...if it still hurts after ollie-ing these rollers, I'll quit." I went over the rollers and as soon as my front foot (left) hit the water, I went down screaming...no, not squealing, screaming. I was upset since I knew at that point my season was over. The pain was all around my knee, but mostly it felt like a wet suction cup on glass-just gross. Within a week I was going up and downstairs, and I've been doing some wakeskating/surfing lately. I've strapped my board on twice since I blew it, but I get a little cocky so I don't even take it now. Temptation to do something stupid, IMO.

Right afterwards, I was still a little bit of shock since I had called blowing my knee like three days earlier. The rangers at our lake wanted to call an ambulance, but I just wanted an ACE bandage and my car keys. I ended up driving home and once Tim got home with the boat, we went to the ER.

I go for my pre-op in an hour, and surgery is tomorrow at 9 (pacific). I'll make sure to post some really cool pictures, though. (I wanted really good video, but Tim has a super-super-weak stomach!!!)

-jesi

Troy - All I can say about getting an immediate repair vs waiting........is that it all depends upon where and what your are doing with your life at that moment.
To be honest if you look at these pics...they are 10yrs out and there is absolutely no signs of arthritic changes. I was fully active too. If you look closely at the bottom left pic, that is a false ACL formed from the stump that scarred down. Otherwise my articular surfaces and meniscus did well without an ACL for the time being.


I also have to confess that in my past profession that I was an Athletic Trainer. Having done rehab on many ACL injuries I was in pretty good shape prior to my injury and knew what I needed to do exercise -wise for an ACL deficiency.
Let's just say that I got lazy and slacked on the exercising......and that's why I needed to get the reconstruction.
Again, not everyone needs a reconstruction, it all depends on your level of activity and age.

Took my son to his pre-op and went over everything his going to need next week after surgery, just wondering has anyone ever had to stay over night after surgery? His the first one of the day check in time is 5:00 am but they want him to stay til around noon the next day.
I think it's great they can monitor the pain and
give him antibiotics, I sure hope I have as good as insurance as they must be thinking.

Phantom - No ACL here, completely blew it on 8/20. Doc recommended some PT, and a Cti2 before committing to surgery. I'm 23 very active, wakeboarding and snowboarding mostly. what do you think?

Nick - when I did my ACL (8/20/05) it really didn't hurt that bad. I was just shocked at how much my knee displaced when I did it. The first time I injured my knee (Oct '02) it hurt worse, but wasn't excruciating.

Doc and Therapist both made the assumption, based on my symptoms, that I partially tore my ACL in Oct. of '02, and just finished it off 8/20/05.

Gordie- Is your son having his surgery in a Hospital or Surgery Center? Anyhow find out if they are calling it an admission or 23hr observation. The latter is treated the same as an outpt charge.
BTW- They already know what your insurance will cover the minute you walked through the door.

Thane- That's almost the same scenario with me.Throught the years of softball and sliding, I had been slowly tearing my ACL, then finally one day I torn the last fiber. But that also cause a medial meniscus tear
It's up to you to push for the surgery. It all about how dedicated you are with working on PT/Proprioception on a daily basis. When you slack off you'll know it. You have been active with the boards sports with the ACL, but you have you been able to test it now since your injury? This will change the picture signficantly.
Look at it this way is coming towards the down season ( you still work for UPS?) but your job may prevent you from getting the surgery. Or you can try the therapy and still get the Surgery early Jan......then again you may have an insurance deductible you need to start all over with.
Too many variables to deal with and if they are financial that may answer the question about surgery for you.

(Message edited by phantom5815 on September 16, 2005)

When I tore my ACL my MCL and meniscus went with it. Fortunately for me, my MCL seems to be healing quite well. I injured my knee in May and my doctor / surgeon kept having me come back so he could check out my MCL prior to surgery. His reasoning was that the MCL is much more difficult to repair. Apparantly, the MCL is more of a fan than the ACL's cord like shape, so it poses more problems for attachment. The pain was definitely unbearable and I couldnt put any weight on it for quite a while. Even with percoset and lots of alcohol I had a difficult time sleeping that first night. I still feel slight pain in the knee if I, say, fall down the stairs wrong (It was dark and I couldnt see the last step, give me a break!). I have been able to get up behind my buddies boat for a surf session or two and I had no issues at all. Im going to stay away from bindings at this point though.

When I recover I am going to take a clinic through the Carlsbad Lagoon I believe. Hopefully, working with professionals at the begginning will help me eliminate bad habits, and gain my confidence back.

The first time I blew mine, it felt just like it feels when you pop a knuckle. It didn't hurt, just a quick pop and that was it.

The second time there was 3 pops..the first was my knee popping out of place, the second was the tearing of the ACL, and the 3rd was the knee popping back in place. But no pain. Just the shock that I had done it again.

I had my 2nd ACL Reconstruction again yesterday. We used my patalla tendon from my good knee this time. The surgery went just fine and was a success. However, since I did have a nerve block put in each leg, I had to spend the night. I got up at 6 this morning, was seen by my knee doctor at 7:45 and left at 8:30. I am now sitting on the couch with my legs elevated with the ice machines pumping cold water around each one of my knees.

I am able to fire both quads, and I can do very strong straight leg raises on my good "graft site" knee, and can do minimal straight leg raises on my bad knee. I am also getting around on crutches fine now.

I am going to work on extension later this afternoon (which is the most important part of your home exercises), and will work on a little bit of flexation as well.

Feel free to bounce questions off of me if you would like. I am just hanging out at home!

McFly
Waterski Boats Dallas

Phantom - I still work for UPS and have pretty good insurance so I don't think my financial situation will be an issue. I haven't strapped the board back on since the injury. I wouldn't do that without a brace. I'm pretty dedicated with my PT and my proprioception. My legs are killing the Therapist worked me for 2 hours straight last session.

How much pain are you in?

I am not in any pain. To me, its not really the pain, but more of the discomfort that gets to you. Really the first 2 days are the worst as far as the process goes..and its not the pain that makes it bad. It is the discomfort.

Right now, I just got done walking outside. It is a slow process getting off of the couch, trying to get on my feet, finding my balance and testing my strength, and then getting the rythym with the crutches. My left (bad) leg is braced, so I actually take steps with both feet and support myself on each side with my crutches. I feel no pain when I put pressure on my bad leg because the leg is braced so well.

I also have only had one pain pill today. I took it so I could get some sleep, not because of pain.

McFly

Sounds like your doing well then. keep us posted on how the recovery goes.

Thane- the only reason I asked about your activity since your injury, I was active for the past 10 yrs without any type of Knee brace. It just wasn't feasable for me to slide with a knee brace on.
I did know my limits though, I did not ski or attempt to snowboard during that time. Come to think of it I don't I ever will. Just not a snow bunny.
Since I do have a brace now ( DonJoy defiance with the special springs) I will wear initially until I start feeling like it did in the past. Probably will use it strictly for wakeboarding from there on out.




(Message edited by phantom5815 on September 16, 2005)

Well I went out and decided to test my knee a little bit by jumping on the trampoline, since I felt pretty good. Bad idea. I did a couple spins, a couple flips, then I tried a backside 3 and came down and my knee displaced again. Now I hurt. I think it's gonna be surgery for me.

Thane.... sorry to hear that. I guess i should have told you ( or your PT) that you need at least 2-3 months of PT that will slowly integrate you back to that level of activity. That's about how long it took for me after my knee scope and meniscal cleaning.
That's one of the biggest problems with any injury, is that the minute you start feeling great - you attempt to try things you body is physically not ready for. Proprioception does not happen overnight. It takes time to re-train your brain and muscles to react/recruit/balance/compensate for a deficiency.

Marty, Havn't heard from you in a few days, just wondering how your weekend went, and how your feeling let us know. My son goes in Wed morning also Jessica had her surgery fri had not seen any post from her hope everything went O.K.

I just had my ACL redone on last thursday. the 15th. So I'm layed up right now. I went with the patella tendon. No real pain yet but I know when I start rehabbing it it's going to hurt. I did a lot of research and found this way to be the strongest and steadiest after rehab. I guess we'll see. I hoping to be snowboarding in february. Thats my goal.

I did the same thing as most. I actually hurt it snowboarding. stayed off it 2 weeks felt great and we got some warm spring days. So I went wakeboarding. Very first jump my knee buckled and I was really done. I was actually out with Evan from this board, hell of a way to go out with someone for the first time huh? Oh well ended up driving the rest of the day wich I like anyways.

Well, I am doing quite well. Saturday afternoon, I stopped walking with the crutches. Sunday, I stopped walking with the crutches and the brace..I was very suprised, but still took it very easy until I went to get evaluated at Physical Therapy..

When I woke up this morning (Monday, Surgery was Thursday), I felt really good. Got up and got walked into the bathroom and began brusing my teeth before I realized I didn't have the brace on.

I got ready and caught a ride to PT just in case. I felt really good but didn't trust my reflexes behind the wheel just yet.

Got to PT and did the evaluation. My right knee (harvest site) had an extension of 1 degree and a flexation of around 80 degrees. The actual ACL repaired knee had an extension of 0 degrees and a flexation of 110+. They told me the main concern was extension, and I passed that with flying colors.

I got on the bike for 10 minutes and could make a full rotation with the pedals the first time. Last time I did this, it took me almost 3 visits before I could make a full rotation.

I have no idea why its so different the second time. I am much stronger this time that I was before. Last time, during my first PT session, I could not do straight leg raises, and it seemed to take forever to get off of the crutches and out of that brace. This time, I was doing straight leg raises in recovery, and was out of the brace and off of crutches within 3 days. Really weird.

I know that before this surgery I focused on a few things. For one, I made sure I had 100% of my range of motion back. Each time I finished working out, I would go and strech for about 10-15 minutes. I bent my bad knee as much as possible, then I straightened it and focused on 0 degree extension. I also spent a lot of time firing my quad and doing straight leg raises. Your mind WILL forget how to do both of those things after surgery, so you have to really concentrate on getting that function back. Do it repeatedly before surgery so its almost like second nature. It is very hard to do so after surgery.

I am still swollen, but not nearly as bad as last time. We also worked on moving my knee caps around today to make sure they have good mobility. Usually with excessive swelling, you can not do that yet.

I am very stoked so far. I am not walking normal by any means, but I am getting closer each day. That will happen once all of the swelling is gone.

And, no, still no pain. I only got up once Saturday Night after I went to sleep, and Sunday Night I slept all thru the night.

McFly

***Also, please remember the first time I did this surgery, my initial recovery time was slower than what I described above. Everyone will be different, with some of you recovering faster than me, and some recovering much slower. Work with your doctor and your Physical Therapist when walking off of your crutches. Your first few weeks are very cruital and you are more of in a protective stage at that time than anything else. Don't push it..be patient and the recovery will come in due time.

i have a ice Man chryotherapy pad that i am selling for $80 plus shipping (worth $225 new)...for those who dont know its a ice chest that you fill up with ice and water and it has a pump and it recirculates the cold water threw the pad and keeps it cold for at least 4 hours..i had acl surgery this year and didnt have any swelling after surgery using it.i was walking on my 2nd day!!.i have also been recovering faster and better than most patients who have a acl surgery..i highly recomend you get one..its was well worth my money and now i dont need it ..it has a temperature adjustment also ..one good thing it the unit keeps your whole knee ice cold ..not just a patch like a ice bag ..which are leaky...e-mail me at Leykis1o1@aol.com if your interested i accept pay-pal

Iceman SOLD!!

Marty. sounds like recovery is going awsome, I'm
glad to hear that you don't have any pain.
My son goes tomorrow at 5:00 am I'm a little
on the edge hope his pain isnt to bad he's 15
and thinks it will be a breeze, I just dont want him to get disapointed.

Well, feel free to e-mail me as he progresses. Just make sure he takes it slow!!!

McFly
marty2kp@aol.com

blew my ACL, MCL and Miniscu 08/04, had to wait for surgery until after elections (dang job), so surgery was 11/04 with an off center hamstring graft. I think it went marginally well. I was off crutches in a week, out of the brace within 9 days, PT 3X a week for 4 or 5 months, and still going strong. I think I was boarding at 3 months, although, I dont condone or recommend it. You find yourself pissy that recovery is taking so long, and you want it to go so much faster. You have to push your body, but at the same time, listen to it too. Go for bike rides a lot, that helps with the recovery blues. By two months post op, I was walking 10-20 miles a week, and biking 150-200 between the stationary and outside.

Its been 10 months now. I am still leary wakeboarding (how I blew it), but I still enjoy getting out there. I have a Don Joy, and it manages pretty well. Occasionally, I still have problems with where they took the graft from. It swells, and is tender to the touch. Ice and massage work well.

Question for those that have had the same one, do all of you have loss of feeling from where they cut thru nerves? I have a large area that I can no longer feel (appx 8" X 12"). Just wondering if the feeling ever comes back or not.

Gordie,
Good luck with your son...I'm sure he'll be fine. I just had my ACL surgery last Friday at around 0900. I opted against the femoral block, though. I don't think I'll do that next time, I just wanted to be walking ASAP.

Right afterward, I was able to put all my weight on it and make small (5-6") steps. I used my crutches for about three days just as a back up, and now I don't use them at all. Oh, and wasn't ever in a brace, just a bandage. I kept it elevated and iced for the first two days, now I just take Motrin to help with the swelling.

I got the hamstring graft, and, right now, that is where any localized pain occurs. My knee is still pretty stiff, but I attribute that to the swelling.

If your son is really down immediately after surgery, tell him it WILL get better. I almost regretted getting surgery when I was on the way home. My knee hurt so bad (I think all the painkillers had finally worn off) that I didn't think I would walk again!!! Well, maybe not that bad, I'm a bit of a drama queen ;). Now I can already tell the difference in stability.

Anyway, that's enough rambling...

Good luck!
-jesi

Misty, your feeling will slowly come back over time. About 60% of mine came back within the 3 years between surgeries. The area will continue to get smaller and smaller...it just takes a while.

McFly

Jessica, glad to hear everything is going well,did'nt see any post from you in the last 3 days was just wondering how it went. My son goes in bright and early tomorrow. I'm going to video tape as much as they will let me of the surgery
and his recovery and make alittle clip to post for all of the future injuried to see what you go thru from surgery thru PT if he let's me. I'll
keep everyone posted on how it goes. Glad to hear both you and Marty are doing so well.

Any update, Gordie/Jessica?

McFly

I hope Gordie's son is doing well.

I'm actually doing really well. My friends and went out earlier this week, and I was able to pull off wearing heels as well as some 'dancing' ;). The swelling is slowly going down. I'm going to take some pictures and post them soon. Not even my hamstring area is sore right now, it's just very stiff on the inside of my knee.

Walking overall has become much easier, I was able to run in place this morning. Although, I've also had to start really focusing on how I walk to avoid any further atrophy in my quad.

That's all for me for now. Hopefully, tomorrow I'll get some pics!

-jesi

Marty, Larry had his surgery yesterday and it went great, they kept him overnight even though his surgry was at 6:00 am. they had him on CPM machine about 2 hours after. He was eating eggmcmuffins right after and ordered breakfast from the hospital. After lunch he was on the cructhes and going to the restroom, today went to
pick him up he was doing some leg exercises, walk
to the restroom without his cructhes and his Mom
got mad. Know he his at home doing what he is suppose to CPM, and leg lifts and resting. He says there is not much pain and very liitle swelling as of right know. Marty thanks for asking and hope your recovery is going well talk to you later today.

Gordie - he had the cadaver right? Was it a cadaver ACL or what? I have to have my ACL replaced sooner or later, I'm exploring all my options.

Good to hear, Gordie. That sounds great!

Jessica, please remember how incredibly fragile your new ACL is. Take it easy! Glad to hear you are doing well!

McFly

So you guys were not having much pain after your surgeries??? That is amazing and confusing!

I had a torn MCL (almost completely) and Meniscus and went under the knife two years ago. They didn't even have to make any incisions...only 5 holes. I really perceived the surgery as much minor that complete ACL reconstruction. That being said, I tried but could complete a full day of work until about 2 weeks after surgery...and that was with my leg elevated on my desk the entire time. I also don't think I had a full night's sleep for more than a month (probably closer to 6 weeks). It was a miserable experience and it confuses me how people have ACL reconstruction which is much more invasive than mine but hardly have any pain. Explain this to me!!!

Keep in mind that I'm not a complete wuss either...or least I think to think not. I have shattered a tibia and fibula, broken ribs, broken my wrist, broken ankles, etc. and the lingering pain from the MCL surgery was misery. Do explain!

By the way, I wish no pain on ACL patients but I would have liked to share in their (general consensus) lake of pain and sleepless nights!

Thane Dogg, Yes We chose the cadavar. For Larry
it seemed liked the best choice, like you we did all types of resreach, and even at last min we
still had questions.

it was a cadaver ACL or a cadaver achilles like Nick said in the first post in this thread?

It was a cadavar pattella, from a 20yr old.

I just had my ACL reconstructed on Tuesday (hamstring method). Im just wondering what to expect as far as rehab goes. My doc says I'll be in this brace and on crutches for 4-6 weeks, then rehab 5-6mos. My doc hasnt been very liberal with info. Is there anything I could do in the meantime that will help speed up the process without being risky. Ive heard of people doing leg extensions and such. It also seems some people on here are already walking days after surgery! My knee is still feeling pretty sore at this point.

You should of got a CPM from your insurance co. It is a machine, you just put your leg in it and it bends and extends your leg for you to keep it moving while you are laying down or sitting up. You will only improve in rehab as hard as you can push yourself. Of course at the beginning you will be limited by the therapist. I was walking without crutches after 3 weeks and running off the treadmill after 2 months. Everyone is gonna have different outcomes after this surgery, make sure to not let this frustrate you...rehab sucks the first month. Be patient and it will be all good.

Jethro,
From my little experience, I would say try to get off those crutches ASAP. If you only had ACL surgery, I don't really know why your doc would put you on crutches for that long. I was off my leg basically for two days and the atrophy in my quad is astounding. I am also not in any kind of brace, just an ACE bandage. Even after the initial injury, I was only on crutches for like five days.
I go for my post op on Monday, and then after that, I'm supposed to start regimented physical therapy. Until then, I sit on my couch with a couple pillows under my leg and then pull them in to my chest to work on bending. For extension, I just push the back of my knee toward the pillows. I'm already getting it completely straight !
I completely agree that every has different recovery rates, and knowing your own limits is a MUST. The flipside is that it is hard to only rely on what your doc says. Maybe try just bearing weight on it, totally flat footed. Progress from there: baby steps.

Gordie,
It's great to hear that your son is doing well. My husband was chiding me for walking w/out crutches, too. I'm sure Larry will heal up without any complications. Send him my luck!

Good luck everybody. Maybe we should start a wakeboarding-knee-injury-support group ;). Just kidding!!!

-jesi

Wow! There are quite a few people here with recent knee injuries. We should have found one dr and gotten a group rate or something!

I scheduled my surgery for Oct 6th so I am using remaining time to try and strengthen my leg muscles as much as possible pre-surgery.

Nick,
Good idea, and good luck!!!
-jesi

I hurt my knee in June and the dr.'s told me the i just dislocated my knee cap, so i did therapy and all that fun stuff and they released me to wakeboard. I kept riding and kept getting hurt so they went in for pettela realignment and when they got in there i had a torn ACL. I was riding all summer. I also cheer so this surgery knocked me out of alot of things nationals , and i also had the surgery 3 days after school had started so i missed alot of school and it's also my senior year in high school and a cheer comp. I was so bumbed. I had my surgery a month ago and they took it from my hamstring. and i'm up and walking alot better than i was at least. You'll want to get up and starting moving in a few weeks.

MAYBE!! knee braces should be a standard piece of equipment for wakeboarders ..as a life vest is

Well, I had my surgery on Oct 6th. So far the rumors are true, the first week is indeed sucking! The night I got back I had so much drainage from the knee that it soaked right through all the bandages and onto my couch! I was a little freaked but after that it was all good. Today is the first day off the meds and I feel pretty decent. My back is whats really killing me. I might just take the Norco for that reason alone! I have pretty much full extension right now but it takes a few seconds to coas my leg into doing it. I was also prescribed a CPM machine which has been really helpful in getting my leg to bend to 90 and beyond. its alot easier for the machine to get me to bend to 90. Its a bit different when I try to bend my knee on my own. I am able to put some weight on it and can hobble around from kitchen to living room. Stairs are a bit tricky, but only coming down, going up I can use my bad leg for some help. I couldnt do the whole sponge bath thing, I still felt scummy. So, last night I wrapped a gallon freezer bag around my knee and duct tapped it into place. I kept the shower away as much as I could and when I pulled the bag off at the end my knee was dry as a bone. I start PT next week and Im not sure if Im excited or scared. Ive been told that it can hurt quite a bit.

For all those getting ready to undergo this surgery, just stick through it and keep it excersized. A week goes by pretty fast when you are on meds and you have netflix and a XBOX ;) Getting it extended is supposed to be the most important thing for you to do so keep at it.

I hope all the new reconstructed people here are doing well.

Nick

I'll be 4 weeks out of surgery on thursday and so far so good. I was walking without crutches 2 weeks out of surgery (although I didn't push at all I probably could have been walking sooner) and now have almost full motion. The Atrophy that happens to your quad is crazy. All my strength is gone. Re-hab hasn't hurt for me at all. They didn't have to bend it at all I had more than 90 degree bend 2 weeks out which is what they want. If you don't have enough range of motion then they start working, bending it and trying to straighten it; I heard thats what hurts. Basically my rehab is consisting of things to strengthen the muscles around the knee to help stabilize it. I'm walking normal and have been walking up and down stairs normally for a week now. IMO the surgery isn't that bad. It's the rehab that takes commitment to get back to strength. Just last week I had an X-Ray of my knee. It's pretty cool to see the 2 screws in it. They put 2 10mm Titanium screws in there.

(Message edited by detonate69 on October 11, 2005)

Nick and David,

It's glad to see you guys are doing so well. This Friday will be the four week point for me. I really couldn't be happier. I am able to do pretty much everything my hamstring will allow. There is definitely still a fair amount of swelling, and the back of my leg stil has this ugly yellow-green bruise, but other than that, things are great.

I start my formal PT on the 20th and then go back to the doc on the 25th to get a brace prescription. Think I'm going to go with a CTI.

I completely agree that the first week was AWFUL. Thankfully, since then it's been all good.

Take care,
jesi

My wife just blew her acl 2 weeks ago. It was increadibly painfull at the time and continues to be. Shes on crutches.

surgery in 3 weeks or so. probably cadaver, not sure yet. Thanks for all the great info in this thread tho. lots to think about.

By the way,

I decided, with the strong recommendation from my surgeon to go with the cadaver Achilles tendon. I am 6'2" 218 and the surgeon receommended the Achilles because of its size and relative strength for a big guy like myself. I play paintball (used to play tournament) frequently and the increased risk of knee pain associated with a patellar autograft was not worth it. In paintball you are frequently kneeling and I didnt want to have to contend with extra knee pain.

My son Larry had his sugery 3 weeks ago, doing
great walking fine no limp only used his cructhes when he left the hospital, no pain ever.
Started P/T yesterday will be going 3 times a week for the next month. Was out driving the boat for his buddies the other day, the problem with him is he say's he's bored everyday, As long as he follows directions should be better than ever
but it's hard for a 15 year old to do sometimes.