My ACL Surgery! Video - Page 10

Quote:

Originally Posted by Finndog 

ACL recon and meniscus repair are not even remotely similar. the fact of how weak the graft is not open for debate. Most doctors are very conservative as there is no downside to protecting the graft.  after 6 weeks or so, the knee and surrounding leg muscles should be strong enough to support the knee well enough from moderate impact and twisting even though the graft is not fully stable. Can you do without the brace, absolutely. should you.......  What is to be gained?

 

Meniscus tears are different as the weight of the person can cause a lot of pain and swelling. but once it's repaired it should be stable. The vast majority of meniscus are repaired by clipping the tear so there is really no risk of causing more damage. the 1st time I had meniscus tear repair I was off of crutches in 2 days but walking around quite a bit but it really depends on how much and where the damage was. It also depends on the surgeon and that techniques they use. All surgeries are not alike.

This is true. However, mine were repaired with sutures, not resected. I believe that changes things.

Like we all keep saying, each surgery is different.

D, you're smart to play it safe, especially since you have the demands of new motherhood added to your recover.  That being said, it wouldn't be good to have a mishap with the new knee WHILE carrying BabySloan.  

Quote:

Originally Posted by Trekchick 

D, you're smart to play it safe, especially since you have the demands of new motherhood added to your recover.  That being said, it wouldn't be good to have a mishap with the new knee WHILE carrying BabySloan.  

This is probably my greatest fear. Which is what makes stairs a TON of fun.

The good news is the knee is feeling pretty good and swelling is pretty minimal. I feel like this is especially good considering I spent the weekend at my 10-year college reunion walking MUCH more than I had planned or really felt like. Despite that, the knee feels good today and is bending easily. Right now I am wishing I were allowed to go beyond 60* . . . next week.

Quote:

Originally Posted by Kneale Brownson 

Depends on the type of meniscus repair. When they try to stitch the meniscus back together, they want you to be really slow to apply weight.

Correct. However, I think both tears were on the edge of the menisci as opposed to on the weight-bearing sections. That made a pretty big difference . . . I'll count myself lucky!!

D, I think you are lucky.  You got to keep your meniscus, rather than getting it trimmed.  That means you will likely have more time before arthritis impinges joint function than those of us who had enough damage to the meniscus that it was trimmed.  Seems like a reasonable bargain to have to return a bit slower from surgery than the rest of us.

Mike

I was just reading over my surgical report. It appears I was VERY lucky. Both meniscal tears were on the posterior horn (one on the lateral meniscus and one on the medial). I tore each one at different times after the initial injury to my ACL and MCL (that's what happens when I have to wait 8 months to have surgery and am told to "take it easy" in the meantime). I know exactly when I did each one. What amazes me is that I tore both menisci in the same spot. Fortunately the posterior horn is a spot that allows for and is actually better off with weight bearing and walking because as the knee flexes weight is removed from the ph. So, good for me. Onward and upward!

Quote:

Originally Posted by Kneale Brownson 

Lack of stability in the knee led to the tears, I take it???
Weren't you using a brace while awaiting the delivery?

You're correct about the lack of stability leading to the tears. I wore a brace constantly . . . for about a month after the initial injury. Then just when I was doing anything active . . . then just while I was playing volleyball.

Quote:

Originally Posted by Finndog 

usually tears occur when the ACL blows, the femur slides forward on th tib and not only tears the meniscus but usually bruises the bones as well. If you don't support the knee afterwards and the knee is unstable, it will slide around especially under pressure.

In my case, the tears occurred later. One when I was about 8 months pregnant and coming down off of a step ladder. I was being really lazy and didn't feel like using each step on the ladder. I had been taking one big step down using my uninjured leg and there was no problem. Then I wasn't paying attention and I stepped down on the inured leg. The knee buckled/hyperextended laterally and down I went. The knee locked up and was swollen for a while after that. Tear #1. (No, I wasn't wearing my brace.) The second tear was about 6 weeks after delivery. I was playing volleyball with my brace on. Went after a ball and the knee buckled/hyperextended medially. Tear #2. My OS wasn't overly thrilled with me when he got inside the knee and was "surprised" by the two tears. The original MRI indicated no meniscal tearing. I did, however, have some impressive bone contusions.

By the way, Finn, do you mean to imply the knee was under some sort of pressure when I was 8 months pregnant thereby making it more prone to slide (think about your answer carefully)????

Quote:

Originally Posted by Finndog 

D' I wasn't speaking of you specifically but rather referring to the importance of taking necessary precautions to protect the knee when its not stable. A lot of people choose not to wear ACL specific (like a Defiance or CTI custom) braces after they injure an ACL after they feel the knee is stable however,from what I understand it's really not until 4 or so months of rehab & healing the knee approaches that level and that's just for "normal" daily activities.  the ACL specific Brace is supposed to be worn during any activity that involves cutting or high levels of stress.  Once you raise the level of stress & exertion on the knee, its hard to say what is the limit for that person given their daily activity levels, weight, height and strength.  For me, this was the problem with not repairing the ACL (specifically speaking) is that there's no true way to know at what point it can't support the forces on it. Interestingly, studies show that a properly rehabed knee can be very stable and don't really show that there is a true need to have ACL reconstruction. The problem of course is that you don't want to be in a bad situation where you exceed the limits and the knee collapses and I didnt want to always be wearing a brace when doing these activities. I am always concerned when they apply a base line of "normal" activity to any physical activity study or measurement. 

You make a good point about "normal" activity. Normal to some certainly isn't normal to others. Although I don't consider myself incredibly active or in great shape compared to a lot of the people with whom I interact (take many on Epic, for instance), it appears that I am quite active compared to others. For those people, walking around the house is considered normal daily "activity." For me, a normal day probably includes volleyball of some sort, maybe some running, and, on a great day, some cycling or skiing. So, I guess it is all relative. Like you, I don't want to be in a situation in which I really need my knee and have it give out. I want to be able to trust it as much as possible.

D and Finn I agree with the normal activity and the knee giving way when you don't want it to.  Also D with standing on it without the brace etc maybe because I didn't wear it much to start with it has been fine.  I had my 3 week follow up yesterday with the doc and he is happy for me to not use the brace at all anymore.

I was probably back to 'normal' activity levels about 4 months after the initial injury without surgery (it took about 6 months for the bone bruising to settle)    Months 4 - 6 I really stepped up the bike riding and got fitter than I had been before the injury and then at 6 months really stepped up the gym work.  By 10 months I was probably the fittest and strongest I have ever been and was road riding 150 - 200 miles a week and alternating core exercises and leg strengthening weights 3 days a week each. 

I skiied 11 months after injury and went straight back into skiing gates and race training and didn't have a single twinge for 2 months of skiing 6 days a week.  The knee felt very solid and that leg went from being my bad turn to my good turn!  But then whilst in a GS race I was turning with the l knee injury leg as the outer ski and then suddenly I was sliding down headfirst - definately not the time you want it to give way!  there was no warning at all.

I'm an instructor and had one day off before having to be at work for the school holidays.  I suspect I tore the lateral meniscus about a month after that initial giveway when a reasonabley large client skied into me from behind in the lift queue and knocked me over backwards and sideways.  I wore an ACL specific donjoy brace for skiing but nothing else during all of that rehab and although it didn't stop my knee giving way I think it helped stop LCL and MCL reinjury.  I did do some skiing without it as well with no probs.

I'm aiming to be back skiing gently in Novemeber in time to be able to work again come December.

Finndog you will I'm sure.  Its all about getting on a road bike for those hamstrings once you get the go ahead, be careful with it to start with though and keep the pedals spinning freely.  I found I had to build it all into daily routines else I didn't have time by the time I had worked all day - so the daily biking was 15 miles to work and then home again over some hills which was a couple hours but made it much easier to fit it all in.  And then a couple longer evening rides home and one longer one on the weekend.  Helps if you live somewhere nice and not in a city.  Can't wait to get back to it all...  an exercise bike'll do for starters though!

So how are all of us walking wounded doing? Haven't had to wear my brace for a couple of weeks now, enjoying not having the darn thing on. I do therapy twice a week with the follks who helped from the beginning, just there to use equipment rather than actual costly therapy. My co-pay was about fourty bucks a visit, (I think the actual cost sent to insurance was 300+ per visit) not bad just once but after about 15 visits with full PT it got expensive.

I am on my bike at home two times a week, about 15 miles, enough to keep me slightly in shape. Not much trail riding, although I am on gravel roads. I'm trying to not baby the bad leg, sort of a habit that I am breaking. Doesn't hurt any (or at least anymore than the other one does just through normal wear and tear) so obviously not over working it.

The worst part of my world right now is Bach is opening for 4th of July weekend, dangit. That's six months out from operation, and with allograft I really need nine months before I put on the brace and start skiing. If I am really lucky Hood will re-open at the end of September. They close Palmer and Mile for maintenance in September and re-open if there is still snow, and maybe I can get a drop in there.

Funny side note, several people I know have commented on how since I am "old" I should expect to break things and should slow down. Heck, an ACl is nothing and it is not about age as we see good young skiers go through the same experience. Heal time might be a bit extended but the actual tearing is just the fact that we get ourselves a bit over extended, usually from too much fun. As far as I know most of our top world class skiers have knee injuries for one reason or another.

Last thought here, is when the ACL rip happened. One of the other folks entering in this subject noted that when the ACL went they ended up sliding down hill head first. This is exactly what happend to me, and as I worked out exactly what happened I can see how one would end up head down hill and sliding. Your loaded up on the to be down hill ski when the knee pops and collapses, basically projecting you down hill with rotation of upper body so you land on your back head first.  In my case I had a bunch of rocks at the bottom of the chute we were on, I was lucky and managed not to slide into that mess. (Climbing deaths are usually from long slides that involve a finiish in rough terrain just had an experienced climber die on Hood from a slilding fall) So was this just a fluke that the two of us ended up this way or is this fairly common with other ACl rips?

Enough mindless babble, I wish everyone here a continued fast recovery, next season is fast approaching (the days are already getting shorter, winter is just around the corner).

I think DeAnn is on a family trip at a fish club, ........or did she say she was going to club some fish..........or she was going to drink wine while Mr Sloan went fishing? 

There was a club, a fish and wine involved in the plans.