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Re injured ACL during rehab?

post #1 of 8
Thread Starter 

I tore my ACL skiing back in January.  I had the ACL hamstring reconstruction surgery in mid March.  Rehab was going really well.  Then one day, I was using a machine where you sit down and your legs start bent near your chest and you push outward.  Sorry, I dont know the name of the machine.  Anyway, my PT told me it was ok to use this machine.  One day (about 3 weeks ago) I tried to increase the weight because I was still under the max weight the doctor said to put on it.  Then I felt a pop, similar to when I originally tore it, but there wasn't really much direct pain from the pop.  However, since that day, my progress has gone down and now doing exercises that used to not hurt are causing more pain.  I am worried that I tore it again.  I told the PT and the doctor.  The doctor checked it with his hands and said it feels fine and said theres no need for an MRI, but I have a suspicion that I injured it again.  Do you think I need to worry?  Perhaps I injured it slightly but it will get better?  I really hope I wont need another operation...

 

any thoughts would be greatly appreciated.  Thank you!

post #2 of 8

I have not had experience with ACL injury (knock on wood) but I've been around lots of people who have.  Hope you find your answer and heal well.  

frown.gif

post #3 of 8

No experience either but I'd talk to the surgeon and your own physician about a review, if needed an MRI or such.  Of course, if you really feel the need, a second opinion but I think you express your concern to your primary, they'd insist on a thorough exam.

post #4 of 8

Despite what your physician said, if you are worried, take a MRI scan.

post #5 of 8

If there is no instability and the knee is not "giving out" while walking and turning corners etc then my guess is that the "ACL" is still OK. I had the same surgery and I've been told that the hammy repair is stronger than the original ACL was plus it's screwed in top and bottom so it's mechanically sound from the get go. Since your Physio and Doctor both say It's OK chances are that it is. The pop that you felt in the knee is concerning though, you might have done something else. If you have "new" pain then that's another red flag. A MRI and a second opinion will at best put your mind at rest and at worst stop you from doing more damage if the unthinkable has happened. Good  luck, I'm certain that you will have a positive outcome!

post #6 of 8

1- not necessarily true. I had a grade3 tear and my NJ ortho thought my knee was fine because it felt stable. many people have complete tears and don't have an issue with the knee giving out under normal conditions.

2- totally untrue! your ACL graft will deteriorate after a couple of weeks and your own tissues will regrow around it. this can take several weeks to become stable again.

Quote:
Originally Posted by Speeder View Post

1- If there is no instability and the knee is not "giving out" while walking and turning corners etc then my guess is that the "ACL" is still OK. I had the same surgery and I've been told that the hammy repair is stronger than the original ACL was plus it's screwed in top and bottom 2-so it's mechanically sound from the get go. Since your Physio and Doctor both say It's OK chances are that it is. The pop that you felt in the knee is concerning though, you might have done something else. If you have "new" pain then that's another red flag. A MRI and a second opinion will at best put your mind at rest and at worst stop you from doing more damage if the unthinkable has happened. Good  luck, I'm certain that you will have a positive outcome!

post #7 of 8

Thank you Finndog, can I have another? I guess my guess would have been wrong in your case, just like the guess of your own NJ Physio,  my guess may still be valid for the OP, plus their Physio and Doctor may be more insightful than yours was (though I'm sure your medical  staff were eminently qualified and I don't doubt the quality of their opinions but too bad they missed your injury). I don't understand what you mean by "your ACL graft will deteriorate after a couple of weeks" I hope mine didn't deteriorate in any substantive way, I'll agree that tissue will replace the dissolving screws after a while. I was told by my Surgeon that the hammy replacement is stronger than the original ACL and that the screws make it mechanically sound from the get go. I don't have any insight or interpretation beyond what my Doctor told me but I wish you had been there to dispute the point with him. By "mechanically sound" I didn't mean to infer that you could go out and ski on it on day 2 but I did mean that the two ends are securely fastened to the bones and unlikely to tear free during properly supervised rehab. Again the only information I have is what I was told about my own ACL tear and repair by my Surgeon and Physio. I'm not a Doctor nor have I done any research into the intricacies of knee surgery, I'm speaking from my own experience with having great and happy success with an ACL replacement using a hamstring tendon and subsequent long but fruitful rehab and a return to sport. There are as many stories as there are people and all are somewhat different. Your NJ Physio misdiagnosed yours mine was a happier story and I hope it works out well for elvenshadow. Thanks for thoughtfully correcting any factual errors I may have made. Would you please give us more detail about the fixture and subsequent stages of healing of an  ACL replacement graft using hamstring tendon? 

post #8 of 8

go to page 2 great reading. very interesting stuff.   I can look more when I have more time, this search took me less than 5 minutes.  the issue of stability is not the anchor-point rather the graft itself. Please note the reason why I pointed out my NJ ortho was that I had my surgery done in CO. the point was that even doctors get this wrong. 

 

http://www.pitt.edu/~mechbio/publications/graft.pdf

 

you can also go to the Steadman clinic site for more info.

 

bottom line is this was an old post and that its always better to seek the professional advice on a matter of this gravity. More than likely he had no issues but we don't know that.

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