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Skiing after ACL reconstruction

post #1 of 35
Thread Starter 
I completely tore my ACL and meniscus, in early April last spring, when my binding didn't release. I had ACL reconstruction with a cadaver graft at the beginning of June with a little "cleaning-up"/trimming of my menisucs. I've been going to PT twice a week since then, and all summer have been swimming and biking a lot and am feeling strong.

This is my first serious injury, I'm only 23, and skied hard over 100 days last year in the Rockies and Cascades...Dec 2nd will be my 6 month mark. I'm waiting to talk with my surgeon/PT, but what has your experience been going back to skiing post-op/rehab? I know my knee won't be %100 for year or more, but should I get a brace? Just looking to hear other's experiences getting back into skiing after ACL reconstruction.
post #2 of 35
I am a little ahead of you, but almost twice your age.  I tore my ACL in January, and had my surgery the beginning of April.  I plan to ski with a brace this winter.  The doc said that I didn't need to use the brace, but I decided I would be more comfortable using the brace, especially since I have it already (used it to ski until my surgery).  I plan to be skiing by december.  Good luck.
post #3 of 35
Your ability to ski should be determined by your fitness as evaluated by your PT and your doc. Full range of mobility, equal strength in both legs, agility etc. One way I test myself on occasion

I have had 2 ACL reconstructions, both with patellar tendons. I used a brace after each surgery for a year or three. You will know when you feel confident enough to wear one. Depending on how 'tight' the ACL is, you may still experience some laxity in the joint. Physical strength can overcome a lot of deficiencies in the knee. You may also experience discomfort in your knee. You can experiment with utilizing the brace or not to see if it has an effect.

I highly recommend MSM, Glucosamine and Chondroitin. Many of my friends, as well as myself use it with good effects. Essentially, it can help the knee to not hurt.

Got to go. I'll contribute more later,

MR

MR
post #4 of 35
April of '08 I tore my acl and sprained my mcl.  Started skiing in early December with a brace.  Still no acl.  Tried to replace it the previous July but they couldn't due to arthrofibrosis.   In April of '09, the surgeon told me that there was no sense in having the surgery because he didn't think he could  make it any better than it was.  I plan on using the brace again this year.

The debate on to brace or not to brace is up there with whether or not to put the bar down on the chair lift.  The surgeon I had that gave me the prescription for a brace doesn't usually prescribe them but said because I didn't have an acl, it would be worth it.

A brace, when worn correctly, will not impact you.  If it slips down, it isn't on right.  To me it's just another piece of gear.

Most folks returning to skiing after acl surgery, spend the first few runs trying to get over the fear of falling and babying the injured knee.  If you search the archives, you can find that thread.  If your OS says you're ready, don't worry.  Be safe but don't hold back.

One of the instructors where I ski, doesn't use a brace and hasn't had an acl for over 9 years.  Just bring it up to muddy the waters.

For a point of reference, my daughter is older than you.
post #5 of 35
Quote:
Originally Posted by skiersjp View Post

I am a little ahead of you, but almost twice your age.  I tore my ACL in
Oct '08 and had surgery (double bundle cadavear with 20-25% meniscus trim) in November '08.  Rehab went well and I skied a few times gently the second half of March '09 and about once a week in April & May, mostly on piste.  Felt pretty good on the slopes by the end of the season and has continued to improve this summer, but still doesn't feel 100% "normal" at times.  Dr & PT both said things look good and Doc cleared me for most activities in April while PT seemed to vacilate between being surprised that I didn't go skiing right after my mid Feb check-up (when Doc said it looked good and that he doesn't like to say not to do anything, but recommended waiting a bit) to saying that he would wait a year before skiing.  

I had wanted to get a brace to ski in the Spring, but my Doc wasn't pushing me to and said that if I did want one, he would rather wait until my leg got a bit bigger before fitting it.  I skied a bit with a brace after an MCL tear when I was about your age and recall that it didn't bother me too much.  However, surgeon said it doesn't help with many causes of ACL injuries although it may protect some if you catch an edge and blow through the MCL on the way to the ACL.  My PT, who has had 2 blown ACLs and has much more laxity continues to wear a brace for skiing. 

Sorry not to give a more definitive answer, but there really seem to be lots of different protocols and schools of thought. 
post #6 of 35
More comments, as I didn't have the time before.

A properly fit brace will not interfere with your skiing. It will provide some 'comfort' as you will realize it is there and it does provide some support.

I would recommend going with a brace, at least for a while. You are probalby still on the same deductible year, so the price for a custom vs. an off the shelf unit likely won't matter. Custom is nice, off the shelf will work well, too. I've had both.

If your leg is strong and you don't feel and strange movements in your knee while you are using the brace and you don't have any discomfort in the joint after skiing hard, try skiing without the brace on a short ski day. If you don't have any more discomfort or strange movements in your knee, you may want to consider retiring the brace. On the other hand, if you have discomfort without the brace and none with the brace, stick with the brace.

By 'strange movements' in your knee, I am referring to the dangling by a thread feeling that you can get if your ACL and/or your muscles arent' able to keep the knee joint from separating. You may already know this feeling just from walking.

One way I test myself is to jump off a low wall or object (2 to 3 feet). If I can land without favoring one leg over the other, than I am confident that my knee is strong. If I've tweaked a knee recently and do the test and favor one leg over the other, then I get out a brace.

FWIW, My first ACL tear (left knee) occured 25 years ago and I didn't repair it until I was getting chronic pain, just from walking. I was completely ACL deficient for 15 years. I was moving out to CO so I had Dr. Steadman replace my ACL in March 01. The next winter I skied with a brace, mostly telemark. The next season I started alpine racing after a 25 year hiatus (stopped racing at 19 when I broke my back). I had been using the brace since the operation and continued to use it for the beginning of the race season. I was winning in class and not feeling any pain despite skiing quite hard. After the 9th race, I tore my other ACL training GS. I had that one repaired as well and used a brace on the right leg without utilizing the brace on the left leg. Both legs felt fine. I have subsequently ceased using a brace on either leg.

Occaisionally, I get the 'strange movement' in my right knee, never my left. I did have a strain on the right ACL subsequent to the repair, so it may have a bit more laxity. The key thing is that I always ski strong, I dont' just 'idle' down the slope; that is when accidents are more likely to happen. Deliberate skiing insures that I am always aware and that my muscular-skeletal system is always 'loaded' and in action, ready to deal with anything that comes.

BTW, the meniscus is more likely to be an issue than the ACL; it is generally a victim in any ACL injury. Tears and cleaning up will take a toll on this essential material that separates your thight bone from your tibial plateau. With it you have lubrication and cushioning. Without it (or with it damaged) you have less lubrication and cushioning. Smooth skiing is better than rough skiing, soft snow better than ice, staying on the ground is better than jumping when considering maintaining your meniscus.

MSM, Glucosamine and Chondroitin are your friend and will help your meniscus, not your ACL. Try them. They don't give immediate results, but over time and with continuous use, they generally provide good results. Try using less than the recommended dosage once you notice there beneficial effect. You can save $ that way.

Welcome to the ACL club, too! Unfortunately this is a big club. Fortunately ACL repairs have come a long way over the years.

Best of luck with your 'new' ACL. Take things a step at a time, don't over do it and before long you will know just what your limits, if any, are. It is quite possible that you'll be able to rip on the hill just like before. Just remember that ripping in the present may affect your ability to rip in the future.

Doug
post #7 of 35

Once you get the go-ahead from your doc/pt, the good news is you're then more likely to blow the other knee than the one you had reconstructed.  The first few falls, if you ski aggressively, are key to getting past the fear about the knee imo.  That assumes that you hear the knee is good to go, as opposed to working around any continuing stability issues, and that you've built the muscles back up enough.    

It's true for cross-training in general, but in particular for rehab I've found selecting biking/etc. activities that closely mimic skiing to be very beneficial for rebuilding proprioception in addition to the general conditioning benefit.  I've seen some people get to the end of "official" rehab and get hooked on spinning on the stationary bike, etc. and not go out and do a real motion sport.  You've got to re-engage your different balance systems and get used to dynamic movement again in addition to being "in-shape."  For biking I personally prefer platforms to clipless in terms of less knee stress, but I also don't spin well and know people with knee issues who prefer clipless.

 

post #8 of 35
 Not much left to say here other than my quick story. Had my ACL replaced in June of 8, cleared to ski in December and used a brace for most of the season. I did forget it one weekend and skied anyway without issue. I'll probably forgo the brace this season.
post #9 of 35
I've had both ACLs reconstructed, one at age 19, the other at age 29.  Now 36.  Like others, I wore a brace on each knee for a year or two afterward but no longer do.  I think the advantages of the brace were mostly psychological. Of course, rehab is crucial.

Just one thing to add: My second surgery was at the NYC Hospital for Special Surgery.  I don't remember the doc's name but he used a hamstring graft, which was then a new and less-proven procedure (had a patellar graft the first time).  My result on that hamstring-grafted knee has been much better -- faster recovery, less pain from the graft site (it felt like a mild hamstring pull), etc.  And today it honestly feels as good as new, which was never quite the case with the other one.

I don't know what the state of the art is these days, but I would be interested to hear from anyone who has gone through it recently.  I can track down the surgeon's name if anyone needs it.
post #10 of 35
State of the art is a matter of opinion and preference in terms of hamstring vs patellar vs cadaver.  Most people still feel hamstring is more likely to lossen over time; some people are spooked by cadaver tissue. 
post #11 of 35
Quote:
Originally Posted by CTKook View Post

  Most people still feel hamstring is more likely to lossen over time

Based on research data, or what?
post #12 of 35
Thread Starter 
I had a cadaver graft. Yeah a little creepy - but it should heal more quickly and I won't have to deal with a weak or potentially weak patellar. Sounds like it is mostly opinion, my surgeon was also more comfortable working with a cadaver graft.
post #13 of 35

well said

post #14 of 35

I had the Unholy Triad of knee injuries in October 2011 (ACL, MCL, meniscus tears) and then surgery.

 

I rehabbed very diligently for the first 6 months, then my wife and I had a baby and my rehab/exercise efforts dropped to 2x a week.   I started rehabbing hard 2-3x a week again after Thanksgiving and just returned from a 4-day ski trip in Utah.  Skiied hard.

 

Knee felt great.  My biggest worry was if I missed a turn or got off balance and reflexively tried to recover.  My legs felt much stronger than ever before due to the 14 months of leg workouts.

 

I did wear a nice custom brace used by the US ski team.  It was very comfortable and not at all restrictive.  Despite the fact you see all the offensive linemen wearing them, I think there is very little medical research supporting the efficacy of knee braces EXCEPT for a study of ski instructors in Colorado, in which braces lowered the risk of ACL reinjury substantially, cutting it more than in half. 

 

I won't go into all the various ACL exercises, but I thought squats on the bosu ball were great and I think any kid of 1-legged exercise requiring balance was also very important.  One-legged hops, walking down a lot of stairs, and hopping up onto a bench one-legged and then back down were all very valuable. 

 

So get a nice brace.  And wish me luck on my next ski trip!

post #15 of 35

Hi - seeking advice on skiing 7 months post ACL surgery. I no longer do resorts..... only backcountry which can have pretty variable conditions. I've gone out 2x both times skiing ~25degrees - the second time was about 1000ft and I did fall. :mad There was about 500 vert ft of powder but the exit was super icy. My knee was a little sore - so was my hamstring. More then anything I'm really freaked out about falling!!

 

Any backcountry skiers have advice?

post #16 of 35

I agree with that. The meniscus is the big issue.

I tore my acl and both meniscus and going for knee reco this week. I am 43 and I am extremely worry about the meniscus tear. The ACL can be fix and give you very good outcome in the long run that is why I am interested to hear from people in their 50 - 60 who to their meniscus and acl around 40s and how they are going now. I believe the meniscus trim multiple by 10 your risk of OA whereas a knee reco with no meniscus damage just increase your chances by 3. 

post #17 of 35


Good luck. How old were you when you had your knee reco ? What did they trim in your meniscus ? I am having this operation next week and I am 43. First time. I am scared

post #18 of 35
Quote:
Originally Posted by skiersjp View Post

I am a little ahead of you, but almost twice your age.  I tore my ACL in January, and had my surgery the beginning of April.  I plan to ski with a brace this winter.  The doc said that I didn't need to use the brace, but I decided I would be more comfortable using the brace, especially since I have it already (used it to ski until my surgery).  I plan to be skiing by december.  Good luck.

Hi SKiersjp,

 

I am probably the same age as you at 43. I am going for knee reco and meniscus repair this week.

Quote:
Originally Posted by MastersRacer View Post

More comments, as I didn't have the time before.

A properly fit brace will not interfere with your skiing. It will provide some 'comfort' as you will realize it is there and it does provide some support.

I would recommend going with a brace, at least for a while. You are probalby still on the same deductible year, so the price for a custom vs. an off the shelf unit likely won't matter. Custom is nice, off the shelf will work well, too. I've had both.

If your leg is strong and you don't feel and strange movements in your knee while you are using the brace and you don't have any discomfort in the joint after skiing hard, try skiing without the brace on a short ski day. If you don't have any more discomfort or strange movements in your knee, you may want to consider retiring the brace. On the other hand, if you have discomfort without the brace and none with the brace, stick with the brace.

By 'strange movements' in your knee, I am referring to the dangling by a thread feeling that you can get if your ACL and/or your muscles arent' able to keep the knee joint from separating. You may already know this feeling just from walking.

One way I test myself is to jump off a low wall or object (2 to 3 feet). If I can land without favoring one leg over the other, than I am confident that my knee is strong. If I've tweaked a knee recently and do the test and favor one leg over the other, then I get out a brace.

FWIW, My first ACL tear (left knee) occured 25 years ago and I didn't repair it until I was getting chronic pain, just from walking. I was completely ACL deficient for 15 years. I was moving out to CO so I had Dr. Steadman replace my ACL in March 01. The next winter I skied with a brace, mostly telemark. The next season I started alpine racing after a 25 year hiatus (stopped racing at 19 when I broke my back). I had been using the brace since the operation and continued to use it for the beginning of the race season. I was winning in class and not feeling any pain despite skiing quite hard. After the 9th race, I tore my other ACL training GS. I had that one repaired as well and used a brace on the right leg without utilizing the brace on the left leg. Both legs felt fine. I have subsequently ceased using a brace on either leg.

Occaisionally, I get the 'strange movement' in my right knee, never my left. I did have a strain on the right ACL subsequent to the repair, so it may have a bit more laxity. The key thing is that I always ski strong, I dont' just 'idle' down the slope; that is when accidents are more likely to happen. Deliberate skiing insures that I am always aware and that my muscular-skeletal system is always 'loaded' and in action, ready to deal with anything that comes.

BTW, the meniscus is more likely to be an issue than the ACL; it is generally a victim in any ACL injury. Tears and cleaning up will take a toll on this essential material that separates your thight bone from your tibial plateau. With it you have lubrication and cushioning. Without it (or with it damaged) you have less lubrication and cushioning. Smooth skiing is better than rough skiing, soft snow better than ice, staying on the ground is better than jumping when considering maintaining your meniscus.

MSM, Glucosamine and Chondroitin are your friend and will help your meniscus, not your ACL. Try them. They don't give immediate results, but over time and with continuous use, they generally provide good results. Try using less than the recommended dosage once you notice there beneficial effect. You can save $ that way.

Welcome to the ACL club, too! Unfortunately this is a big club. Fortunately ACL repairs have come a long way over the years.

Best of luck with your 'new' ACL. Take things a step at a time, don't over do it and before long you will know just what your limits, if any, are. It is quite possible that you'll be able to rip on the hill just like before. Just remember that ripping in the present may affect your ability to rip in the future.

Doug
 

Doug,

 

I agree with the meniscus being essential for longer term prospect of your knee. have you had any meniscus damage and when ? Unfortunatelly I had a knee reco and had 2 small lateral tear and one larger tear of the posterior horn of the medial meniscus (1.2 cm) all left in situ as none symptomatic or mildly in case of the medial meniscus. I am wondering what are ,meniscus tear impact on the knee vs partial menisectomy for longer term health. We know partial and total menisectomy lead to OA but what about meniscus tear left in situ ?

 

Cheers

post #19 of 35
Quote:
Originally Posted by MastersRacer View Post

More comments, as I didn't have the time before.

A properly fit brace will not interfere with your skiing. It will provide some 'comfort' as you will realize it is there and it does provide some support.

I would recommend going with a brace, at least for a while. You are probalby still on the same deductible year, so the price for a custom vs. an off the shelf unit likely won't matter. Custom is nice, off the shelf will work well, too. I've had both.

If your leg is strong and you don't feel and strange movements in your knee while you are using the brace and you don't have any discomfort in the joint after skiing hard, try skiing without the brace on a short ski day. If you don't have any more discomfort or strange movements in your knee, you may want to consider retiring the brace. On the other hand, if you have discomfort without the brace and none with the brace, stick with the brace.

By 'strange movements' in your knee, I am referring to the dangling by a thread feeling that you can get if your ACL and/or your muscles arent' able to keep the knee joint from separating. You may already know this feeling just from walking.

One way I test myself is to jump off a low wall or object (2 to 3 feet). If I can land without favoring one leg over the other, than I am confident that my knee is strong. If I've tweaked a knee recently and do the test and favor one leg over the other, then I get out a brace.

FWIW, My first ACL tear (left knee) occured 25 years ago and I didn't repair it until I was getting chronic pain, just from walking. I was completely ACL deficient for 15 years. I was moving out to CO so I had Dr. Steadman replace my ACL in March 01. The next winter I skied with a brace, mostly telemark. The next season I started alpine racing after a 25 year hiatus (stopped racing at 19 when I broke my back). I had been using the brace since the operation and continued to use it for the beginning of the race season. I was winning in class and not feeling any pain despite skiing quite hard. After the 9th race, I tore my other ACL training GS. I had that one repaired as well and used a brace on the right leg without utilizing the brace on the left leg. Both legs felt fine. I have subsequently ceased using a brace on either leg.

Occaisionally, I get the 'strange movement' in my right knee, never my left. I did have a strain on the right ACL subsequent to the repair, so it may have a bit more laxity. The key thing is that I always ski strong, I dont' just 'idle' down the slope; that is when accidents are more likely to happen. Deliberate skiing insures that I am always aware and that my muscular-skeletal system is always 'loaded' and in action, ready to deal with anything that comes.

BTW, the meniscus is more likely to be an issue than the ACL; it is generally a victim in any ACL injury. Tears and cleaning up will take a toll on this essential material that separates your thight bone from your tibial plateau. With it you have lubrication and cushioning. Without it (or with it damaged) you have less lubrication and cushioning. Smooth skiing is better than rough skiing, soft snow better than ice, staying on the ground is better than jumping when considering maintaining your meniscus.

MSM, Glucosamine and Chondroitin are your friend and will help your meniscus, not your ACL. Try them. They don't give immediate results, but over time and with continuous use, they generally provide good results. Try using less than the recommended dosage once you notice there beneficial effect. You can save $ that way.

Welcome to the ACL club, too! Unfortunately this is a big club. Fortunately ACL repairs have come a long way over the years.

Best of luck with your 'new' ACL. Take things a step at a time, don't over do it and before long you will know just what your limits, if any, are. It is quite possible that you'll be able to rip on the hill just like before. Just remember that ripping in the present may affect your ability to rip in the future.

Doug
 


 BTW, the meniscus is more likely to be an issue than the ACL; it is generally a victim in any ACL injury. Tears and cleaning up will take a toll on this essential material that separates your thight bone from your tibial plateau. With it you have lubrication and cushioning. Without it (or with it damaged) you have less lubrication and cushioning. Smooth skiing is better than rough skiing, soft snow better than ice, staying on the ground is better than jumping when considering maintaining your meniscus.

 

I have 3 meniscus tears in my knee

Quote:
Originally Posted by wa-loaf View Post

 Not much left to say here other than my quick story. Had my ACL replaced in June of 8, cleared to ski in December and used a brace for most of the season. I did forget it one weekend and skied anyway without issue. I'll probably forgo the brace this season.

 

I am 5 months into rehab from knee reconstruction and my injured knee is still painful and I have still got inbalance in my body. How long does it take until it feels normal ? Does it ever feel normal again ?

post #20 of 35
Quote:
Originally Posted by fabienzan View Post
 

I am 5 months into rehab from knee reconstruction and my injured knee is still painful and I have still got inbalance in my body. How long does it take until it feels normal ? Does it ever feel normal again ?

 

So it's been 6 years now ... my repaired knee feels stronger than my "good" knee. It took over a year to fully get to that point however.

post #21 of 35
Quote:
Originally Posted by wa-loaf View Post
 

 

So it's been 6 years now ... my repaired knee feels stronger than my "good" knee. It took over a year to fully get to that point however.

That is great to know. How old were you when you had the knee reconstruction ? Did you have any meniscus or other dammage ? Have you got any OA or pain in your knee ?

What did you do during rehab that help you the most ? I do a lot of leg press and I am finding this is very useful ? I have to say I am still finding that there is this sense of inbalance in me where my good knee is being used a bit more (surely this is because of a lack of strength in the other knee). Also I have small menisci tears in both meniscus which can't be a good thing even though my surgeon said they were not a big deal . I am 43 and fit.

post #22 of 35

I was 40 when it happened. Also, had torn meniscus, stained mcl and bone bruising. I did all the prescribed physical therapy, most of which focused more on balance than strength. By winter I wasn't doing more than skiing. Started running the next summer. Every person is different, and even though I had all that damage my knee was pretty "tight" and required an MRI to confirm the injuries. So your results may vary. But I would definitely focus on balance work in getting rehabbed.

post #23 of 35
"Hi
I just had an ACL tear repair and lat. meniscus trim in 1/14, was back on slopes in winter 14/15 in brace. Then in April 15 torn my other acl. Had it repaired in May and rehabbing now.
I read that ladies and recreational skiers have higher rates of injury. And higher rates of acl tear in contralateral leg then in repaired leg. I am skiing only 1-3 times per year. I am worried if I even should be back on slopes. Both times I had this tame, phantom foot type of fall.

But I really want to go back.
Are there any clinics or groups of skiers for injured people that specifically address the "learning" of falls? And fear of skiing.
It is also said that only sport specific drills get you ready for slopes. And only practicing sport itself.
Should I start back with the instructor?

By the way glucosamine increases the risk of bleeding, I took it after surgery and had a hemorrhagic fluid taken out of my knee.
May be useful for some. But would stop taking it if you have a knee injury and wait 6 weeks.

Do you have any advice what was the most helpful strategy to protect yourself from reinjury ?
post #24 of 35

This post has been going on a while now, but I would like to ask the group a few questions as well as comment.  Also, if any of you are reading through this you'll see that there are questions that went unanswered.  I, as others would like to hear any answers to those questions that some of you may have.

 

Life long athlete and Colorado skier.  38 now.  Indoor soccer a year ago blew the ACL, strained the MCL and shredded my lateral meniscus.  Quickly after, had the ACL replaced (patellar) and 80% of lateral meniscus entirely removed, but MCL inoperable.  PT for 3 mo. hard.  3 times a week in gym, but mostly cardio and legs, no real building.

 

Issue:  1 year post op, been playing soccer again for a couple of months and  just go back from ski trip.  Sore.  Not whiney sore, but really sore.  I skied hard, but no spills.  Only a few quick mogul runs, but mostly took it easy.  Wore the big brace the first time back.  Not worried about the repaired ACL at all.  MCL is loose, but that is not as concerning as how the lack of meniscus may be affecting me, although the pain is more in the medial meniscus/MCL area than the lateral.  Odd.

 

Questions:  Doc/PT have been awful about discussing what to expect.  I purposely sought out an ortho that treats athletes and he does all the local pro team work so hopefully I would be treated as active as I am.  Nope.  No real expectations, no advice, no nothing, and I've tried to get answers.  I am looking for answers on loose MCL's and the serious lack of meniscus.  Is the lack of meniscus causing additional MCL looseness? Or is the MCL looseness causing irritation of the meniscusless area?  Any of you have the same issues? 

 

I am still trying to build back my lost muscle mass, but thought I was pretty close.  Will more mass tighten what I'm feeling as loose?  Why don't I feel anything in the lateral area where I am missing all of the padding?

 

I will check this and respond for a few weeks.

 

FYI: 

 

No, I have no real idea why he didn't want to do the MCL.  It was a grade 2 tear, so most athletes would replace, but I guess I am on the cusp of oldish?

 

Not doing glucosamine chondroitin.  Unfortunately it makes me nauseous.

 

Was not made aware of how bad the lateral meniscus was damaged therefore he just removed it during op without giving me the option of meniscal transplant or other newer treatments.  He even makes reference to it in the op video saying, "oh, here goes most of your lateral meniscus being sucked out. Looks like your days of sprinting and jumping are over."  Jerk. 

post #25 of 35

Wow!  I'm so sorry you had that happen.

 

I  had a similar orthopod for my first surgery.  

 

I had to have a second surgery elsewhere as a result.

 

I ski with a hinged brace, not the huge prescription one.  I had about 6 years of post-surgical skiing until OA set in (meniscus removal).  I use SAM-E, anti-inflammatories, ice.  Compression tights.  

 

I ski conservatively.  Slow down.  Forget bumps.  At least I'm still skiing.

post #26 of 35
Quote:
Originally Posted by n2dxtrem View Post

This post has been going on a while now, but I would like to ask the group a few questions as well as comment.  Also, if any of you are reading through this you'll see that there are questions that went unanswered.  I, as others would like to hear any answers to those questions that some of you may have.

Life long athlete and Colorado skier.  38 now.  Indoor soccer a year ago blew the ACL, strained the MCL and shredded my lateral meniscus.  Quickly after, had the ACL replaced (patellar) and 80% of lateral meniscus entirely removed, but MCL inoperable.  PT for 3 mo. hard.  3 times a week in gym, but mostly cardio and legs, no real building.

Issue:  1 year post op, been playing soccer again for a couple of months and  just go back from ski trip.  Sore.  Not whiney sore, but really sore.  I skied hard, but no spills.  Only a few quick mogul runs, but mostly took it easy.  Wore the big brace the first time back.  Not worried about the repaired ACL at all.  MCL is loose, but that is not as concerning as how the lack of meniscus may be affecting me, although the pain is more in the medial meniscus/MCL area than the lateral.  Odd.

Questions:  Doc/PT have been awful about discussing what to expect.  I purposely sought out an ortho that treats athletes and he does all the local pro team work so hopefully I would be treated as active as I am.  Nope.  No real expectations, no advice, no nothing, and I've tried to get answers.  I am looking for answers on loose MCL's and the serious lack of meniscus.  Is the lack of meniscus causing additional MCL looseness? Or is the MCL looseness causing irritation of the meniscusless area?  Any of you have the same issues? 

I am still trying to build back my lost muscle mass, but thought I was pretty close.  Will more mass tighten what I'm feeling as loose?  Why don't I feel anything in the lateral area where I am missing all of the padding?

I will check this and respond for a few weeks.

FYI: 

No, I have no real idea why he didn't want to do the MCL.  It was a grade 2 tear, so most athletes would replace, but I guess I am on the cusp of oldish?

Not doing glucosamine chondroitin.  Unfortunately it makes me nauseous.

Was not made aware of how bad the lateral meniscus was damaged therefore he just removed it during op without giving me the option of meniscal transplant or other newer treatments.  He even makes reference to it in the op video saying, "oh, here goes most of your lateral meniscus being sucked out. Looks like your days of sprinting and jumping are over."  Jerk. 

I can't offer any feedback on the ACL, but three years ago, I completely tore my MCL and fractured my tibial plateau. I was lucky that the fracture didn't displace and didn't require surgery.

I discussed options for the MCL with my surgeon, and she strongly recommended no surgery. The MCL (and especially the area in which mine tore) receives high blood flow, and while the ligament doesn't repair itself, it scars up and effectively reattaches itself either to the other part of the ligament, or to surrounding tissue.

The rehab was long and hard, and rebuilding the muscle around the injury took maybe two years. Three years in though, I'm at 100%. I don't notice it at all (even forget which leg was injured sometimes) and at 45, I ski harder than ever.
post #27 of 35

Terrific thread, for skiers and non-skiers alike - great job to all the posters.

 

I'm a 40-year-old male with a partial tear of my ACL diagnosed a couple of days ago by MRI (also two fractures to two separate bones in the knee). Unfortunate accident where I fell over while moving away on skis from a ski-lift. Someone else's skis rode over mine and I fell backwards and to the right, my bindings not opening. There was a loud crack as my knee couldn't release in the twisting motion. I know now that was the bones cracking...still kind of coming to terms with it. I'm more or less a beginner (have skied on 3 separate occasions), but of course this one was just a 'freak accident'. I was managing my effort as a newbie and learning slowly and steadily, so I'm all the more p***ed off by the whole thing. (End of rant :-)

 

The partial tear and extent of it are still to be confirmed by specialist physio, who is my consulting doctor as it were. He hasn't seen the images yet, but will do in a few days. 

I have an existing small tear on one of the meniscus, not related to this event. It's unchanged, according to the MRI, and has never given me any real issues. 

 

 

My thoughts at this point, and I'd really appreciate any feedback: 

 

1) Diagnosis

How did you guys have your tears diagnosed fully to everyone's satisfaction? I'm reading that partial tears are difficult to diagnose from MRIs (done) and/or from surgical exploration (not yet)...is this your experience? I'd obviously like a full and accurate diagnosis before going under the knife. 

 

2) Graft choice

I've read the cadaver grafts (allografts) are less favoured nowadays, as they seem to be showing more re-injury...although comments here seem to suggest favourable outcomes + the added advantage of not harvesting from your patella, hamstring, etc. Have seen patella autograft described as the 'gold standard'. What's the latest word on this? 

 

3) Meniscus tear

Does the small tear on the meniscus have any bearing on the outcome / decision-making here? 

 

4) Outlook

I don't feel like giving up on football (my lifetime sport) or skiing for that matter (which is new thing, but I've caught the bug!) despite this injury. But, all things considered, is it not advisable to just drop them and be safe? I'm a little tired of the achilles tendonitis I've had on and off for a few years and now this disaster...I've been sporting active all my life, but maybe I need to make a tough decision? 

 

Best to you all, 

 

Tob 

post #28 of 35

who was the doc that did that? 

 

It's been difficult getting timelines and expectations for post-op rehab and when to return to skiing.  

post #29 of 35
Quote:
Originally Posted by tobba007 View Post
 

Terrific thread, for skiers and non-skiers alike - great job to all the posters.

 

I'm a 40-year-old male with a partial tear of my ACL diagnosed a couple of days ago by MRI (also two fractures to two separate bones in the knee). Unfortunate accident where I fell over while moving away on skis from a ski-lift. Someone else's skis rode over mine and I fell backwards and to the right, my bindings not opening. There was a loud crack as my knee couldn't release in the twisting motion. I know now that was the bones cracking...still kind of coming to terms with it. I'm more or less a beginner (have skied on 3 separate occasions), but of course this one was just a 'freak accident'. I was managing my effort as a newbie and learning slowly and steadily, so I'm all the more p***ed off by the whole thing. (End of rant :-)

 

The partial tear and extent of it are still to be confirmed by specialist physio, who is my consulting doctor as it were. He hasn't seen the images yet, but will do in a few days. 

I have an existing small tear on one of the meniscus, not related to this event. It's unchanged, according to the MRI, and has never given me any real issues. 

 

 

My thoughts at this point, and I'd really appreciate any feedback: 

 

1) Diagnosis

How did you guys have your tears diagnosed fully to everyone's satisfaction? I'm reading that partial tears are difficult to diagnose from MRIs (done) and/or from surgical exploration (not yet)...is this your experience? I'd obviously like a full and accurate diagnosis before going under the knife. 

 

2) Graft choice

I've read the cadaver grafts (allografts) are less favoured nowadays, as they seem to be showing more re-injury...although comments here seem to suggest favourable outcomes + the added advantage of not harvesting from your patella, hamstring, etc. Have seen patella autograft described as the 'gold standard'. What's the latest word on this? 

 

3) Meniscus tear

Does the small tear on the meniscus have any bearing on the outcome / decision-making here? 

 

4) Outlook

I don't feel like giving up on football (my lifetime sport) or skiing for that matter (which is new thing, but I've caught the bug!) despite this injury. But, all things considered, is it not advisable to just drop them and be safe? I'm a little tired of the achilles tendonitis I've had on and off for a few years and now this disaster...I've been sporting active all my life, but maybe I need to make a tough decision? 

 

Best to you all, 

 

Tob 

 

Oof, sorry about your accident.

 

No comment about football (soccer or American football?), but there are plenty of skiers at all ability levels who completely rehab and got back on the slopes.  Key is to do plenty of physical therapy exercises both before and after surgery.  Once you are ready to ski again, it's probably a good idea to invest in some lessons.

 

Have you found Knee Guru?

http://www.kneeguru.co.uk

post #30 of 35

I also had the cadaver graft 4 years ago & will be skiing in Montreal, QC next weekend. Had an achilles tendon graft & it ironically feels stronger than my natural knee. How haver you felt skiing after surgery?:)

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