OT: ACL Tear Question

[huskyrider390]

Has anyone out here torn the ACL in their knee? It's a complete tear and would like to get opinions on surgery or just phisical therapy from those who have gone through it. If you had surgery, can you pass on some of the things you went through? What I've been told, they don't usually do ACL surgery on people over 40-45 ish, I guess for not to active of a person.
I should have added I'm 59 and after a few weeks of therapy, the leg kicked out a few times and seems not to stable. I also understand it can cause more damage if it keeps kicking out.

thanks

[dennis foley]

i had a complete tear in 01 at 41. had reconstruction. the rehab was about three months. i race all summer and am on the ski patrol so i am on skis all winter. no problem, i would do it again. give me a call if you want, i can go into more detail.607-844-9819 after 5pm est.

[tofriedel]

First, make sure you get to a Great (not just Good) Ortho knee guy.  My son has had he ACL torn twice and neither time was physical therapy an option.  As best I know, it has to be repaired and surgery is the only option.

Rehab depends on the individual, some longer some shorter.  Work hard at it and it can be shorter, 3 months sounds about right.

Good Luck and heal quick.

Tony

[AndyL]

Here is my two cents:

I have no ACL in either knee.  One was donated to college football, the other to the dirt bike gods when I was 43.

The ortho's here in KC did give me the choice, but were pretty confident that as long as I stayed active, the muscles around the knee, and the other two (PCL, MCL) can compensate for it.

If it caused problems, they said that the surgery could be done at any time down the road.

I quit playing City League basketball at 40, but I still jog 4 miles at least 5 times per week out on the sidewalk and across parks.  The ortho's said that the uneven terrain, while tricky, helps the muscles compesate. Something to do with the balance required as opposed to the treadmill.

So far so good.  I now have three items that I won't get on a dirt bike without: Helmet, left knee brace, right knee brace (Asterisk Cell's).


Andy
#14u MOVMX and AHRMA
75 Jackpiner
70 Steeltanker
92 KTM 300

[bentrims]

Husky Dude,

I had ACL in 2001 and highly recommend it. My alternative was to continue having the knee slip out of joint unexpectedely at the worst time, then swell to elephant proportions. Easy decision!

I now consider it a teenaged knee compare to the 48 year old counterpart.

Be aware that you will have what I call electrical shots of pain as the area begins to link up as they say in the computer world.
Tom B

[maicobuddy]

Huskyrider390,
I had a 50%+ tear in my Left ACL in 1977 and didn't get it fixed(on the advice of a #@*% Othropedic Doctor:(..he said you can cast it for 2 months and rehab it with physical therapy and with no health insurance I went that route..BIG mistake..I have had nothing but problems since and it's gotten awhole worst in my late 40's..I have had acouple of orthoscopes done to clean it up, but still must wear a knee(also Asterisk Cell) for any activity..my last trip to the Sports Doctor left me somewhat upset as I was told the only thing he could do for my knee was for me to have knee replacement surgery..not yet I'm going to put it off as long as possible..I will say this he said the Doctor that told me to cast it & rehab it was a NUT and that was terrible advice..what you gone a do 28 years later..anyway Good Luck..Buddy

[pketchum]

About 20 years ago I tore my ACL 90% while racing at Saddleback Park and opted for arthroscopic knee surgery.  For me this was a good decision but it took a full year before I was able to comfortably sit down fully on my heels.  I still race MX and enduro's while wearing a PAIR of Asterisk Cell's.  I felt my "good" knee give while racing and though, "Oh no, we're not going to go through that again are we?"  Therefore, I upgraded from my single surgical brace to my current pair of Asterisk's.  Only once has my left knee given me problems while racing and it swoll up a bit which had me worried but I was fine a week later.  I don't play basketball, go snowskiing, or play tennis anymore (too risky in my opinion) but if I did it would be with my Asterisk Cell's on.  They've allowed me to continue to be very active and still enjoy many of the sports that I enjoy.


Phil

[rpage11]

I tore my acl in the early 70's.  I think it was about the same time doctors stopped believing in bleeding as a way to heal.  At the same time I tore two cartilages in my right and left knees.  The doctors in Montana at the time believed that torn cartilage should be removed and acls should be left.  I have had to stop playing court games like basketball and handball because your foot stops and your knee keeps moving thus hyper-extension.  As far as everything else, I have not had any problems because of an acl tear.  I lift free weights 3 times a week and think the same as Andy, condition all the muscles around and get the best balance with stronger muscles in you legs and you won't have a problem.   I can ski any run on just about any mountain in the US or Europe and never give my acl a second thought.  

On another note, cartilage is a different beast.  I had two removed and today doctors sew or do partial removal.  No cartilage for 35 years has been basically bone on bone and now I have bone spurs that are about as painful as you can image once any activity begins.

Get the best doctor your insurance will pay for.  Plan on doing physical therapy for at least 3 months and if you want to play court games, I'd do therapy for another 3 or don't waste your time and money.  Be extremely careful of how they handle any cartilage damage and have that addressed before you are under the knife.


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Tucson, AZ

[Lloyd Boland]

There is still differing opinions even among the experts.  A complete ACL tear causes the tibial to move forward under the femur.  Make sure it is a "COMPLETE" tear before surgery.  Even MRIs have a cerrtain number of "false" positives when doing MRIs of the knee.  Clinically, it must be unstable to consider surgery.  I have seen "complete" tears on the MRI but when examined, there is no or only minimal joint instability.  These are no complete tears, only an inclomplete image on the MRI that does not show the entire ACL.

Performing a rigorous rehab program to the knee muscles will provide extra joint stability and in many people eliminates the necessity of the surgery.  The greater the tear and the weaker the surrounding musculature, the more instability.  Various factors come into affect in deciding the medical necessity of a ACL repair:

Co-morbidity factors; age, weight,local circulation for healing (affected by smoking, drinking, etc.), other local pathology, etc.
Over-all general health.
Future anticipated activity level.
Patient's anticipated compliance to treatment recommendations.

There are also various types of surgeries:
cadaver donor tissue
self donor
and various types of actual surgical procedures

There are always risks associated with surgery, even death.

I beleive there is a greater risk for arthritic changes without surgery.

There is no right answer.

There is greater stability with surgery but with potential greater risks.  Making an educated decision that bests fits your needs is what needs to be done.  Keep talking with a variety of people.  I would agree that you need to find a knee orthopedist that specialized in knee ACL repairs that has a long hstory of success.  Don't be afraid to ask.

Lloyd Boland

[bentrims]

Lloyd,
Fantastic reply. The info on this site is unbelievable. I looks like this Pogger has a REAL AMA card...medical that is.

[Dwight Rudder]

I have no ACL in my right knee. I lost it on Day 3 of the 1982 Czecho ISDE.  Crazy Richard Myers did cleanup aurthroscopic surgery on it a month later.  I still have some problems but not enough to warrent surgery.  
I lost my ACL in my left knee in 1993.  They did a Alagraph ( ? sic ) with a donor ligament.  It was extremely unstable before and after 3 years of it slipping out of place I had to have something done. The cartiage was completely eat up.  ( unlike my right knee ). It is much better but still not perfect.  I guess it depends on how unstable the knee is, on whether to have surgery or not.  Either way exercise will help greatly.
Best of luck,
Dwight

Dwight Rudder
7 time ISDT / E medalist
8 time National Enduro Class Champion.

[huskyrider390]

Well, thank you all for your opinions and stories. I guess I will have to see what the doctor has to say. In any event, I don't like the knee kicking out, I don't like the pain after it kicks out and I know I won't like the surgery or rehab after, but what you going to do?

thanks again guys,
geo

[hankthecrank]

Hi.
 I am not familiar with ACL problems as I always manage to break the lower leg bones at the top[in the knee]. The doc's say good braces are in order. My question is, what about the Asterisk cells? I have seen them mentioned and I know if the guys in the group use them, they work. Any info will be greatly appreciated. Thanks.

Hank Rinehart

[Lloyd Boland]

Chiropractor by day, partime rider on weekends.

Astericks work well.  I use them.  (prior history of multiple leg, ankle and knee fractures)  There are a variety of knee braces on the market.  The upper end ones give you more support than the less expensive ones.  CTI braces are probably the best because of the custom fit but much more expensive, unless you have a documented "medical condition" and can get your insurance to cover them.  The high end off-the-shelf braces work very good, just get ones that fit well and are comfortable.

The down side to knee braces are that they do protect the knee, but if the trauma is great enough, the brace may protect the knee but the energy is transfered up and down the brace to the top and bottom edges and may cause fracture of the leg or thigh.  That type of trauma would probably have done considerable damage to the knee joint resulting in probable knee surgery anyway.  I think they save more knee injuries than they cause leg/thigh fractures.  Only my opinion though, no know research yet.  I feel naked if I ride without my braces now.