acl-meniscus tear

[holeshot01]

hi,
alright i'm going in for surgery soon, acl reconstruction, lateral meniscus,and medial meniscus repair. any ideas on which way to go with the acl? cadavor, patella tendon etc? recovery time? realistic? i am trying to be ready for the spring..any ideas or helpful sites would be appreciated.

 

[KiwiBird]

Dead dude leftovers seems to be a really good fix from the reports I've seen. Recovery time varies from person to person but intense PT is the best way to recover the fastest.

knee1.com

Bob's knee board

Google search results

 

[hebegebes]

holeshot,
i had a cadaver tendon used for acl reconstruction on may 31. it seems to have worked very well for me. the doctor advised me that if it were his knee he would have had the patella graft. it just made more sense to me that if you don't have to harvest something from your own body, you have less healing to do. the doc said he just wouldn't feel comfortable having someone else's tissue in him if it wasn't absolutely necessary. he said the screening processes are very advanced but they can only screen for what they know exists. his rationale was that if there is some new disease (mad cow, etc.) that they don't screen for yet, you could get infected. i guess that was one chance i was willing to take. by the way, i feel fine.

as for recovery... i went to PT three times and then stopped. i just felt they were taking things WAY too cautiously. i was doing some moderate hiking after four weeks, bodysurfing with fins after two months, and riding (slowly) after three months. it still gets a little stiff after some hard abuse, but i'm very pleased with how the ordeal went and glad i had it done.

couple of suggestions... work on getting your range of movement back as quickly as possible. my doc has a great philosophy - he give his patients a TON of pain meds and orders them to take them even if the pain is bearable. then, while high on oxycontin and percocet, have someone push and pull that lower leg to the ranges it would normally hurt to go to. it sucks to be drugged up that much, but through this method i had FULL range of motion back after only three and a half weeks. even the doc was amazed at this. just remember, even though it hurts to push that leg while gaining back range of motion, you will not do any damage.

hebegebes

 

[MXN4FUN]

You have to watch it though when you are are pushing the rehab. While the old addage is 'No pain No gain' Trying to push too hard can cause setbacks like swelling and fluid buildup causing stiffness and reduction in motion. The more you force the more it swells. You can always do what I did, head done to the Farm and Fleet for your own syringe to aspirate your knee...Man was I young and dumb. Hey it was for a good cause I had to be ready for the next season. It payed off I still have the jacket they awarded me and the limp to remind me how stupid I was. Take it easy you have the rest of your life to limp around or run it's up to you. :thumb:

 

[JC Soto]

I did the patella tendon graph almost 4 months ago. The "mechanical" features of my knee are great, but I developed tendonitis on my patella from using it to hard to soon. I injured it downhill mt biking and I can't ride because of the tendonitis, although I do ride my Katoom. It seems that is the best workout for me, but I am going back into weight lifting now that the tendonitis is mellowing out.

Like previously mentioned, get your range of motion as soon as you can. Motion is more important at first than strength. I met some guys at the rehab center that were on their second graph, and this time they did the donor approach. They mentioned that their recovery was a tad slower than the patella or ham string graph. They both felt that they were about 1 or 2 months behind, but they had no other second effects (maybe a feeling that their graph was a bit weaker).

 

[WFO]

I went the patella tendon approach (mainly because I was never even told there was an option).
LESSON #1-Don't let your doctor out the door without asking him about everything you're hearing on this page. For what you'll be paying, he can hang around and answer questions.

I've had great luck with my ACL re-construction. No pain what-so-ever after 20 some odd years of off and on aching (and #@$%# pain near the end). Physical therapy is essential, but physical therapists are a joke.
LESSON #2-An extremely expensive joke!! Find out what you basically need to do, then join a gym and do it for a fraction of the cost. You don't really need somebody to say "...one more time..." for $100 an hour.

LESSON#3- As noted above, strive for full motion, but make sure it's NORMAL motion. This is a major operation and you're not gonna be up in 3 days. I never experienced that much pain (more like discomfort) so I'm not a big fan of doping up on pain killers for a better work-out. Pain tells you when you've gone too far. Don't mask it with dope and screw it up permanently. If you're serious about recovery, you'll work hard enough on your own.
LESSON#4- Passive motion machines. MUCH worse than enemas and last infinitely longer. No way around them. Forget you read this part.
LESSON#5- Use your crutches! Be a big man (like me) and walk too early without them. You'll end up favoring the leg and walking in an awkward motion to compensate. Gives you back problems AND slower recovery.
LESSON#6- Just before they put you under anesthetic on the operating table, ask everyone there if they know what procedure you're in there for. It never hurtsd to be carefull!

In all seriousness, this needs to last you the rest of your life. Overdoing it too early now to get a trophy isn't going to be worth it unless you can use that trophy as a crutch for the next 50 years. Use your head.
Good Luck!

 

[mark_england]

hebegebes,,,,,,
''as for recovery... i went to PT three times and then stopped. i just felt they were taking things WAY too cautiously. i was doing some moderate hiking after four weeks, bodysurfing with fins after two months, and riding (slowly) after three months. it still gets a little stiff after some hard abuse, but i'm very pleased with how the ordeal went and glad i had it done.

couple of suggestions... work on getting your range of movement back as quickly as possible. my doc has a great philosophy - he give his patients a TON of pain meds and orders them to take them even if the pain is bearable. then, while high on oxycontin and percocet, have someone push and pull that lower leg to the ranges it would normally hurt to go to. it sucks to be drugged up that much, but through this method i had FULL range of motion back after only three and a half weeks. even the doc was amazed at this. just remember, even though it hurts to push that leg while gaining back range of motion, you will not do any damage. ''


,,, no offence but thats just about the dumbest advice ive ever heard.

6-12 weeks post opratively your knee graft is EXTREMELY WEAK,, you need to be very carefull on your rehab,,,,, as the physio recomends

 

[oldguy]

I popped the ACL and ripped both the MCL and Lat at DW so I am into the recovery now.

My surgeon wants me to get the rips healed and strengthen the whole knee before he looks at surgery. For reconstruction he prefers taking a piece of hamstring to form the ACL. I am not sure if this is a newer procedure or if I misunderstood him (?) but I will ask further on Wed when I see him. He was the highest recommended in the area and is responsible for 3 Pro athletic teams in Milwaukee so I trust him to be up to date.

Also in PT don't mask the pain- I agree that pain is a part of recovery but its purpose is also self preservation to prevent ytou from going way to far. Yes I work to the pain threshold I have established and rest at that point.

 

[AnneBrooks]

I went with the cadaver parts....ACL & PCL (both severed) My doc thought that was the best way to go and really didn't offer the other options.

Also, remember that PT is very important, even if they are trying to see how much pain they can inflict! :p

Good luck and keep us informed about your progress!

 

[yz250-effer]

I still don't have an acl on the left after a severe injury a couple years ago and am riding on it ( with a brace, of course ) for a year and a half now. I am going the get the acl reconstructed tho, in the next year or so and have done a bit of research on it tho. The cadaver tendon is very popular these days. And it does require the down time from work ( depends on your work ), rehab, and just waiting for the tendon to turn from mush to something that actually stabilizes the knee. 6 months is what the Dr. says for that.
BTW, I loved the passive motion machines so I guess that shows you how sick I am. I had to go through alot of rehab ( severed patellar, acl, and broken femur condials ) , so I know alot about that stuff. Pain pills are an effective tool, IMO, if you know you are in for hard session - but only one pill. The PT's don't care what your "normal" pain threshold is and most will go beyond it. Stretching through that scar tissue and immobility is going to be painful, but there is a difinite limit as to how much pain should be endured to get gains. Too forceful of a contraction is bound to do alot more damage to a freshly operated on knee than a forced stretch, but all of this is my humble opinion. Good luck ;)

 

[firecracker22]

You will find that each surgeon does it differently. Mine did not feel that passive motion machines were helpful so I did not have one. Instead I started PT on day 5 (she wanted to do it on day 3 but I stayed at my mom's for the first few days).

I had a torn ACL, MCL and meniscus. The MCL will heal and I don't think she did anything to fix that. It was actually about 6 weeks older than the ACL tear. She cut off a piece of my torn meniscus; the good news was that it was a fairly small piece; the bad news was that is was in a high wear area, thus ensuring arthritis in about 5-10 years. She used my hamstring as donor tissue because a.) it is a larger tendon from which to take a piece and b.) she felt the long term effects were less than with patellar grafts, like the tendonitis mentioned above.

I agree on the PT being fairly worthless; for all I'd heard about slave drivers, I didn't feel they pushed very hard. I went to the gym on alternating days to work out further and I ended up cutting my recovery in half. I was on one crutch after 2 weeks (too early but I didn't know any better--DON'T ditch the crutches too soon!) and off them completely after 5-6 weeks I think. I got rid of most of my limp unless I was tired or carrying something after 2 months and riding again (carefully, and with a brace) at 3 months. The original prognosis was 6-8 months to ride again but at my 3rd post-op check-in she said I looked great and to go ahead and ride if I was careful. I think physical therapists are just trying to get "normal" (non-athletic) people back to their couch-to-fridge shuffle.

The initial range of motion was the most difficult and the most painful. Do as much of it as you can stand but as mentioned above, don't go too hard; swelling inhibits healing and motion. Take your anti-inflammatory regularly and supplement (ask your doc but most recommend it) with glucosamine. Once you can move it regularly, start building strength back up and DON'T STOP. It is very, very hard not to let it slack off once you're back to normal. I did and STILL don't have 100% of my strength back, and lots of bad riding habits from weighting my good leg to compensate.

I had my surgery on Halloween 01 and am very happy with the results. I still have some soreness after a lot of riding (like several days in a row) or a lot of walking around or standing, but nothing a little Aleve (or generic naproxen) won't take care of. I have full motion back which I thought I would never get but I can finally kneel down and sit back all the way on my heels. That took about 6-8 months to accomplish. My only other complaint is that it crackles and pops when I pivot on it or kneel down, but there is no pain when that happens, and my surgeon said it's normal, it probably won't go away, and unless it starts hurting it's ok. Oh and you might also end up with weird numb spots--where they make the incision they often have to cut through a nerve, and every person has a different reaction to it. Some get better, some don't. I have lots of pins and needles and basically the whole front of my shin is numb. Small price to pay, really, and it doesn't hurt when I bark my shin on things.

I would write down all your questions--I kept forgetting all of mine by the time I got to the doctor's office. Many surgeons have crappy bedside manners but that doesn't really matter as long as the do a good job. Don't let him/her leave until you're satisfied though, getting cut open is no minor matter. The good thing about ACL repair is it is common, it's been done a million times, and most docs are pretty good at it. Relax and know they will take care of you. And enjoy the pain pills. ;)