My latest update is here in this post:
Quick background on my injury: Female, mid-40s. Besides skiing, no other high risk sports. Pop, no pain and minimal swelling with injury. MRI = high grade tear. I'm almost 2 months post-injury. 5 weeks of physical therapy. Feel great most of the time and ankle has probably held me back more than knee with rehab. About 2.5 instances of instability/buckling. Have full extension and just short a little in flexion. Poor balance/proprioception (was bad after previous ankle surgery and now worse.) My physical therapist worked on mobility with my ankle and it's the best it's been in 10 years.
Appointment with orthopedic surgeon yesterday:
- Two options: 1) Continue with PT for another couple months and re-assess, or 2) Schedule surgery
- Knee feels very loose to him.
- Indicated that allograft was best choice and said there was only minimal differences in failure rates with autograft. Said he's only had a couple of failures of each type.
- I asked if rehab was longer with allograft and he said no. Then asked whether ligamentization takes longer with allograft and he said no.
- He had ACL-R a couple of years ago and was going to do allograft and then decided 2 days before to go with autograft (can't remember if he did hamstring or patella). Went skiing 7 months after with kids.
- Asked what kind of things might come up unexpectedly during surgery and he indicated that other ligaments, meniscus, and cartilage were good on MRI. Didn't see bone or cartilage bruising on x-ray, so wouldn't expect to see it during surgery. If something showed up, I'd end up being non-weight-bearing longer.
- Four-five days to return to work (I have a job where I sometimes can work from home.) Formal PT at about 10 days.
- He's a knee and shoulder guy, but when I asked how many ACL he does a week the response was a lot.
He's a really nice guy and caught himself rushing through and then sat back down and said, I see you have written down questions--ask me more. I told him that I had a 2nd opinion scheduled. He said it was a good idea and was curious what the other doctor would recommend.
I know there are no "right" answers to the questions I asked, but I guess I was looking to see the rationale behind making a choice. The answers to the autograft/allograft questions did surprise me. I heard him dictating right after wards and an hour or so later I got the updated notes via email. I know doctors are busy and there is no way they can remember the details on everyone, but for my 2 follow-up visits I felt like a new patient again. Then I read the notes and it states that he ordered x-rays (I have not had any x-rays there at all and the order was for the wrong knee). I thought maybe there was a clerical error that someone else's notes got "into" my chart, but the DOI and type (skiing) were the same and stated I was getting a 2nd opinion. Other things like "in a lot of pain" were not accurate. I heard him dictate hamstring allograft, but nothing in notes about it. I left message with office first thing today and didn't hear anything back. I'm not impressed by the office staff, but my mom had a great experience with them.
Kind of frustrated and confused at this point and trying to put it out of my mind for now. Just trying to "look forward" to the appointment on Monday and stay optimistic about it.
It's weird to think that it seemed "easier" messing up my ankle and seeing it deformed and just getting the surgeon that was available when I got to the ER. But I know that didn't work out the best since I had repeat surgery.
I kept my physical therapist appointment for that afternoon so we can talk about it.
I apologize for any typos or disjointed thoughts--I'm tired but needed to try to organize my thoughts and figured it might help to get it down on paper.