How long before riding? -ACL surgery next month

How many months were you guys out for after ACL surgery. I have a torn ACL and meniscus, having the patellar tendon graft on the 23rd. How was your first ride? Do you always wear your brace?
Sharon

I was release back to activity ( with brace to be worn for a total of 18mos only) 6mos post op.
But I had a Cadaver Patella tendon graft, which is not as painful as the autograft.
I went back to work within 10 days. My job has me standing on my feet for 8+ hrs at times.
Can't answer the queston about 1st ride, haven't had time to try. But I haven't had any issues with rollerblading or using the indo board if that's any help.

6 mos is about right, assuming you only have ACL/meniscus repair plus you don't have any major complications during rehab. My first patellar graft about 5 years ago I had a slight bump in the road with tendenitis, but quickly recovered. My 2nd was this past Oct and it's been much more rocky. It's up to the surgeon whether you should use a brace for a while or not, but in my experience it's helpful for the mental aspect. Your knee probably won't need it.

Good luck!

My father tore both of his ACLs in a skiing accident a while back. He had a procedure done known as healing response. His recovery was quick(less than 2 months) and he has had no issues in approximately 6 years. Here is an article about Bode Miller's experience with the same surgery( http://www.steadman-hawkins.com/athleteUpdate.cfm ). As far as I know Dr. Steadman is the only surgeon doing this procedure.

I know you are committed to another procedure, and I don't know if this is even applicable to your case. Just thought you might be interested.

-Philip

Intriguing read. It'll be interesting to see if that technique catches on.

Wow, that's a pretty amazing deal. I'd be inclined to look into that if I ever had knee problems. Really cool to see medical advancements like that.

Here's the abstract on Steadman's study:

A minimally invasive technique ("healing response") to treat proximal ACL injuries in skeletally immature athletes.
J Knee Surg. 2006; 19(1):8-13 (ISSN: 1538-8506)

Steadman JR ; Cameron-Donaldson ML ; Briggs KK ; Rodkey WG
Steadman Hawkins Research Foundation, Dept of Clinical Research, Vail, CO 81657, USA.

This study documents outcomes of athletically active, skeletally immature patients with proximal anterior cruciate ligament (ACL) tears treated with a non-reconstructive technique to promote healing ("healing response"). Between 1992 and 1998, 13 skeletally immature athletes with proximal ACL tears underwent a healing response procedure. Patients with previous ACL injury, other concurrent ligament pathology, and/or complete mid-substance ACL tears were excluded. Average preoperative KT-1000 arthrometer manual maximum difference for all patients was 5 mm (range: 3-10 mm). Preoperatively, all patients had a 1+ or 2+ pivot shift, and all patients reported knee function as abnormal or severely abnormal. Patients were followed prospectively with clinical examinations, KT-1000 testing, and subjective questionnaires. Three (23%) patients had a re-injury 30 to 55 months after the healing response and underwent subsequent ACL reconstruction. Subjective follow-up on the remaining 10 patients at an average of 69 months (range: 26-113 months) postoperatively indicated no patients experienced pain or giving way, and all considered their knee function normal. Average Lysholm score was 96, Tegner score was 8.5 (range: 7-10), and patient satisfaction at follow-up was 9.9 (1=very dissatisfied and 10=very satisfied). Clinical examination at least one year postoperatively was performed on 7 of 10 patients at 35 months (range: 12-63 months). Five patients had a negative pivot shift and 2 had a 1+ pivot shift. KT-1000 measurements improved to 2 mm (range: 0-3 mm). In the athletically active, skeletally immature patient, the healing response procedure can restore stability and knee function, with proper patient selection. In this study group, patients were very satisfied with the procedure and returned to a high level of sports and activities.

* PreMedline Identifier: 16468488

Sharon, depending on which form of surgery you have and which doctor you have perform the procedure, you will get varying advice on when you can return to impact sports. One thing is for sure though, the more rehab/physio work you do the faster you will be able to go riding (safely) again.

I had exactly the same operation (patellar tendon graft) in October last year. My biggest issue is the loss of muscle in my leg. I had my first day of snowboarding last weekend (very carefully), but will not be able to do any form high impact riding for another 3 months minimum. I will also use my CTi brace for a long time to come (12 – 18 months).

My doctor has told me it can take up to 9 months until the implant will come back to life, until then you are at risk of tearing/popping it - which will mean another operation and another 6 - 9 months of waiting while all your mates are sessioning all the powder/glass.

Good luck with everything!

Paul

Thanks for the replies everyone, I definately don't want to rush it...
Joe H. did you tear the same knee or the other one?
Paul, I have a home gym so I will spend the summer getting my leg strong, and watching my neighbors riding in front of my house this summer
Guess it's time to take up fishing.
Sharon

My son Larry had his ACL replaced and his minicus repaired,
on Sept 23rd 05 and was doing some light riding on Dec 24th, and is know riding full strenght. Knee is great and doctor said it looks good at check up last week, does wear a brace when he rides for the fist year,he doesnt think he needs the brace but at 15 he still does what I tell him I think.

Gordie - that's encouraging. I just had my knee done, with the allograft on the 15th of this month.

Thane, I read that how is it going? When do you start P/T, do they have you on a CPM machine? Lot of ice,and walking on it a little.
Sorry about the Hijack.

I go for my post op on the Friday, the 24th. Start PT after that. No CPM machine right now. Been icing as much as I can, and been walking fully since Saturday. I have a brace the only gives me 70 degrees of movement. 20-90.

I had my acl replaced last march 30th and was riding by july 1 with a brace... took it very easy till my muscles got used to it again, but was riding pretty hard in the fall and went snowboarding over the winter... PT is an absolute must to rebuild strength, you need the muscles in your leg to compensate/assist your acl!

i cant stress building your quad muscles up to as strong as possible before surgery, it will make everything so much easier.

im about 3 months out of surgery right now, my quad strentgh is horrid and my knee is still aching and popping.

I am 20 days post-op now. I had an isolated ACL tear (no meniscal or other damage). I opted for the hamstring harvest/graft. About 90% of the Ortho surgeons in our department generally recommend the hamstring graft, and about 10% recommend allograft (cadaver anterior tibial tendon graft). Rarely do they recommend the patellar tendon graft because of the rather high incidence (about 20%) of chronic post-op anterior knee pain. Certainly there are lots of factors to consider and the patellar tendon graft may be the best choice for your circumstances, so I'm not trying to tell you which type of reconstruction to do. I know that the rehab from a hamstring procedure is more painful and time consuming in the first few weeks as compared to an allograft procedure. I left the hospital and was weight-bearing immediately with my brace locked in extension. I stayed on the couch with my knee iced for 2 days, then started PT on post-op day 3. I feel I have progressed quite well. I went back to work after 6 days and I am now walking around quite comfortably. Strength is definitely slow to come back, but I see improvement every day. I was off crutches completely after about 9 days. I feel very comfortable walking without my brace now, but I am still supposed to wear it for at least 6 weeks fo safety/protection. I have had full extension the entire time, and about 120 degress of flexion now. I was told not to resume full activity for 6 months. Apparently the 2-4 month post-op period is the time of greatest vulnerability, as we generally feel good enough to resume activity and try to get back to it. Unfortunately, the graft has not had time to fully revascularize and heal solidly and is prone to tearing out. Good luck!

well in my case i pulled my ACL from the bone and bone came with it..so they re-atached the acl..no reconstruction..but i had allot of muscle and damage behind the knee ..anyways 4 months after i was back to running and now run the same speed as before...aboout 7-9mph on the treadmill for 10 min ..but still have some weirdness in my knee and its been 9 months...this weekend im going to try wakeboarding (with 2 new knee braces)and see how that goes

Suprarider;

There are several ways to fix it as you already know. But for someone to tell you how soon till your back on the water is impossible. I had the Patella Graft done Jan 19th and really don't know what to think. I actually am a little scared and depressed that my recovery is not going well. I curently have to wear a Dynasplint to assist me in getting my leg straight. I was in PT 5 days post opt and been working hard at it every day. I believe that recovery from a bone to bone patella graft is the longest recovery for this type of surgery. But on a positve note the best repair for the injury. The most pain I have is the daily ache of stretching out my tendons and muscles to allow my leg to get range back. I have a great site for explaining all the steps in the various surgeries on my other computer if your interested. But good luck and I wish you nothing but a speedy recovery along with everyone else currently in the recovery process.

Sharon...you may want to get a second opinion from a MD who uses the hamstring tendon for a graft. In order to harvest the patella tendon, they have to saw part of the patella with the tendon to get the graft. I have never had it done but I have scrubbed on a lot of them. The hamstring tendon graft also works great and you don't go through the bone pain that you do with the patellar graft. It's just a different technique. Both ways give you a functioning new ACL and all surgeons have the technique they are comfortable using. Perhaps your MD is just used to the patellar tendon technique. There are also different ways to use the tendon to graft it into a new ACL. And everyone heals at a different rate. If it was me I would look into it a little more. Either way, you WILL be just watching this summer!! Good luck!!!

Here is a pretty good site discribing the diffrent techniques and the steps taken to do them.http://www.orthoassociates.com/ACL_grafts.htm

Well I had my ACL Patellar graft done on 9/15/05. I had it done on a thursday and was back to work on Weds the next week. Of course my job is at a computer all day. Right now I'm at almost 6 months and am going in for a check up on monday to hopefully get cleared to board again. It feels great and the strength is as strong as it was before the surgery.

FWIW I'd reccomend the patellar graft because bone to bone always heals better than tendon to bone, either cadaver or your own is up to you. I used my own because I just felt more comfortable doing it that way. Do the research and talk to your doctor. Re-hab is most important, once you get range of motion back the next step is to work hard on getting strength back. The atrophy the muscles go through is amazing. It only takes weeks to lose the strength but months to get it back.

edit: Oh and I recently got my CTI2 brace. I plan on wearing it for about a year. Probably till the end of snow season next year.

(Message edited by detonate69 on February 22, 2006)

Gary, many thanks for posting the link. I have been looking for information regarding the differences of both techniques and it’s all listed on that site.

Interesting to note that there seems to be little difference in the overall outcome of both methods; however, the Patellar Tendon Graft may cause more pain, which results in a longer recovery time (exactly what I am going through right now).

SoCal M.O.B did you notice that they use the middle 3rd of the patella and tibial insertion for the graft?
I had a friend have the Hamstring graft ACL repair done 6wks prior to me having my Cadaver Patella tendon ACL repair.
My friend is still having problems with her Hamstring repair and she's close to being 1 yr out.
Her biggest complaints are: lack of full extension,Pain along the lateral aspect of the thigh(the proximal attachment site of graft), lower extremity numbness and lack of hamstring stength.
She's taken enough pain meds to kill a kidney and has started back on PT.
Literature on hamstring grafts do state that the hamstrings do not comeback to 100% strength.
(I've posted the articles in past ACL threads)

Phantom...absolutely!!! But it is still tough to recover from. There are pro's and cons to EVERYTHING. You are fortunate you had a cadaver graft....that is the ultimate way to go. But not all MD's like to use the bone from the patella for insertion. There are several options depending on MD's preference. You can use the patella part of the graft with a bone screw to secure the final graft. Also, you can use the semi tendinosis over a bar inserted into the side of the femur similar to a "pully". Finally, you can use an endo button similar to a molly screw that is drilled through the femur and "catches" on the outside of the femur. There are so many different graft sites and ways to use the graft. The majority of all of these surgeries don't come back 100%. The only thing that is 100% is not having had an injury in the first place. Which is the best? Probably all of them. After all...anything is better than having a torn ACL!!

i can say im about 95% back and its been 9 months..id say in a year ill feel like it never happend...i hope

good job, Ryan...you must have worked hard in PT

check this link:

http://www.break.com/index/mcgahee.html

And he's playing in the NFL now. Amazing.

*not for the faint of heart

i never spent a second in physical training, and my brother is a physical therapist..i just forced myself after 3 months after surgery to jog and in a week a slow jog..in 2 weeks running around 6-7mph and now 9mph for 10 min on the treadmill, leg extensions for 1/2 hour increasing the weights, leg lifts increasing the weights.. 4 days a week..and lots and lots of gloucosamine/chondrotin from the day i damaged my knee..i also used a few low dose muscle building supplements which shot my muscle into overdrive repair!

Oh, my 2nd tear was the other leg so I now have matching scars.

Today is the big day? Let us know how it goes!

i had surgery sept 7th on torn acl, medial and lateral maniscus, still out for 2 more months, doing mad conditioning and pretty much have my muscles to normal, but still cant do anything. Also have some patella tendenitis but its not too bad. I would definetly recommend a cadaver, much faster recovery if you only have acl but yeah i wold recommend staying off for about 6 months. As per previous post i also did not go in to physical therapy just did my own exercises, add to that lots and lots of bike everyday

this past weekend was my first Wakeboardin since my injury..9 months exactly and my leg felt the same as it was before the surgery..i got right up and started jumpin the wake..carefully little hops..feels strong..its a good start..nest time i think ill go big