JJmxr

Member
Nov 14, 1999
122
0
Well tomorrow is the day. My 15yo dabbed his foot when he shouldn't have and completely tore his ACL, and some meniscus too. I have researched it alot and feel pretty good about full recovery, but would like to hear from those of you who have been through it. He is going to have the patella tendon autograph, which I think is the the right choice for him. I know what all the doctors say about recovery milestones, but I would like to hear what the real world says. When did normal walking start? When did it become pain free? How bad was the post surgery pain? Could you really ride a Bicycle, and swim at six weeks? Is racing again at 4 months braced realistic? Is 6 months good as new? Thanks so much for your replies, they will help a nervous parent alot
 

seth5051

Member
Jul 31, 2003
11
0
I had the same exact surgery Nov 5th, which was a Wednesday. I went home the same day and felt great. I received a shot of novocaine in my hip that numbed my leg for about 48 hours, so pain post op was not bad. In total I have taken 3 pain pills. By Sunday I was able to walk with out crutches. Started P/T the Monday after, returned to work Tuesday, a week after surgery had >90 degrees range of motion. About a week and a half later normal walking, with slight pain.

Its going to be sore and go through different pains, at least mine has. I would say that biking and swimming at 6 weeks is possible.

Fastest recovery I've heard of was 3 1/2 months.
 

TM-Frank

Member
Dec 15, 2000
325
0
I had a left knee injury on the 2nd of August in which I broke a little piece off the tibia head, tore both mensicus and the ACL.
Surgery with a new ACL was in mid august. Into hospital on wednesday, out of hospital friday afternoon.

Don't worry about pain. Right after surgery they will give you pain killers (I had a cool fully-automatic electronic pump attached to my upper tigh which constantly delivered the stuff into my venes). When I left hospital they supplied me with pain killer pills, which I didn't need anymore after three or four days and before that only during night time.

The doctor told me to walk on crutches for 14 days and to wear a brace (limting movement to 0°/90°) for six weeks. He said I should put only little weight on the left leg and support mywalking with the crutches.
After 8 days I put the crutches away and after 3 weeks I stopped wearing the brace.

A very slow walk, without limping, was possible after 14 days or so, and constantly getting better. Very light jogging after 4 or 5 weeks.

Right after leaving the hospital I started visiting a physio-therapist three times a week for the duration of six or seven weeks. There I went on Step-Machine, Training-Bicycle, Massages, gymnastics, electro-shocks - all the torture stuff. These training-sessions were the only occasion on which real pain occured.

After 2 months I had nearly complete movability again. I forced myself to wait another month and then went riding again yesterday. All fine so far.
 

James

Lifetime Sponsor
LIFETIME SPONSOR
Dec 26, 2001
1,839
0
I had mine done on Monday.

Very little pain and it only hurts when I let it get stiff or if I move way past my current range of comfortable movement. I got the nerve block and only took pain pills the first three days because they told me that would help with the swelling.

I currently have full extension and well over 90 degrees bend. I think the swelling is most of what keeps me from moving it better than I do. Swelling isn't terrible but it is a little puffy. I can walk without crutches and it almost appears like I am walking normal after my leg is exercised and stretched a bit. Those first few steps are tough after I have been sitting for a while though. I can also drive my truck (work the clutch - left knee) if I wanted to.

I started the recumbant bike at PT on Friday and I can see bike riding and swimming at 6 weeks.

From what I understand...it is NEVER good as new. I think you end up with about 90% of new. I have heard of people riding after 1 month braced but I am not going to be that ambitious about it. SUPPOSEDLY, the graft goes through a vunerable period in months 4-6, otherwise the only concern would be that the bone doesn't fill around the graft completely until about 6-8 weeks (2 months). Other than those two things, its just about getting the swelling down and getting your muscles to work again.
 

JJmxr

Member
Nov 14, 1999
122
0
Thanks or the replies. The nerve block/novicane seems like a good idea. Since he doesn't have to work or anything like that I think he should be pretty comfortable. I am encouraged that your experiances seem to all say that moving around normally is coming at a pretty fast pace. Its funny that yesterday while watching the discovery channel they did an ACL surgery right on TV. It was pretty gnarly how they did it, and it was an Allograft which is a bit less dramatic then the Autograft from what I hear. Its going to be a tough road to recovery for a antsy teenager. Even though I know it will never be the exact same I do have an expectation of 100% pre-surgery performance. The Dr. said that because he is young his recovery will be very good, and with poor diligence toward PT he would still get to 90%. He thinks with a diligent PT program he will get to at least 98%, and believe me I will be pushing his PT to the limit.
 

James

Lifetime Sponsor
LIFETIME SPONSOR
Dec 26, 2001
1,839
0
To clarify, the strength of the actual ACL graft is never better than 90% of what your body grows on its own from what I have been told. Now your leg muslces, flexibility, strength, endurance, etc etc can all be 100% or better than previous depending on your workout routine and the quality of the surgeon's work. So my interpretation is that is will take a bit less of an impact to the ACL graft to re-tear it than it would to tear the orginal...all other things being equal.

I must have misunderstood your "6 months good as new?" question....sorry. :thumb:

Good luck!!! Let us know how the recovery goes.
 
Last edited:

carnage

Member
Mar 16, 2001
73
0
I tore my MCL and severed the ACL back on July 6th. I had acl reconstructive surgery on 8/11. I was back on my bike for the first time this weekend 11/22 with the help of a CTI2 brace. The recovery period has been up and down to be honest. I was in PT the day after surgery, by day two was off of pain meds but kept taking the advil for swelling. Within a week I was walking with the aid of crutches and without at about the two week mark. For the first six weeks my recovery was fast and I gained most all my flex and alot of strength back.

I was walking around fine without any kind of post-op brace at the five week mark. I started having problems with the patella at around week 7 or 8 and that set me back awhile. The problem was resolved and I'm now at 15 weeks and recovering strong.

Like I said, I went riding this past weekend and meant to take it easy. Well, that didn't happen and I put the knee through a test and it survived just fine. No major swelling of any kind and only a little sore the next day. Mainly meniscus issues. I don't feel I'm ready to go racing again at this point or play sports yet. But, I should be good to go at the 6 to 9 month mark. Keep in mind I'm a bit older than your son to. He should do just fine. Just don't let him slack on the PT.
 

JJmxr

Member
Nov 14, 1999
122
0
Thanks for the replies! The surgery went well for the most part, and by that I mean the Dr. had hoped that the meniscus would have healed on its own (which I guess is very possible for kids, but not for us adults) and it did partially, but he still needed to use a few sutures on it. He also put an extra screw in the tibia which he wrapped the ACL sutures to as an additional anchor. I am a little fuzzy on why and how of this, but he did say it was not something he would do to a normal Recon. but he felt that it would give a little more safety factor to someone like us MXers.

I am glad I posted this because I did not know about the vulnerable stage of the graft that you guys described, and it made for interesting comments. I did know that there are quite a few grafts that fail within 5 years, but I didn't know that 15% of the people whose grafts hold past 5 years will have the surgery again. This is kind of depressing, but I guess there is no use sweating it.

Another thing that he said was that surprised me was that he felt that the partially torn meniscus was of more concern to him than the ACL itself. He said the long term effects of it had in his opinion greater consequences. I guess you can actually live a pretty normal (non-sports) life with a torn ACL, but a damaged meniscus is a different story.

He has the straight leg brace plus crutches this week, looses the crutches next week, and should return to an ACL brace the week after. He doesn't want him in PT until after he sees him again on Monday because he wants to make absolutely sure that everything is as it should be before he starts messing with it. He is at this point ok with riding braced at 3 months, but I will probley make him wait until 5 to be sure. My son is a pretty fast "B" rider, but not fast enough to where I think it is worth the risk. He did tell him to enjoy this week because the PT he is going to put him through is going to be grueling.

James- I also misunderstood what you were saying, and I agree 100% that the graft itself will always be a bit weaker.

Carnage- I am interested about the Patella issues you had, please do tell.

Finally I really hate to go here as its been beat to death on this site, but I had to ask if a brace would have prevented the injury. He said it MAY have prevented the ACL damage, but not the meniscus injury. He sited a recent study of a thousand athleats (no MX), half braced, half not, and there was no difference in injury rate. He did admit though that we are subject to greater forces than other sports, and as long as we trained without the brace so the knee could strengthen, he felt they couldn't hurt. He said the bottom line was that odds are, even braced he would have still been in the same place. That really helped out a parent who has been beating himself to death about being too cheap to drop the 500 on braces. I will be buying them now though!
 

oldguy

Always Broken
Dec 26, 1999
9,419
0
Glad to hear the surgery was a success. I had the ACL, MCL and lat replaced as well as screws in the femur and tibia head last year in November and concur with the above posts. Mine was done with a piece of hamstring as the replacements. I had a set back during mine as I was allergic to the screws used and this delayed the calcium replacement. I had a second surgery to remove the screws 1 1/2 months after the first. From this point on recovery went fast. I still had trouble kneeling on the patella until about 7 months after the first surgery ( remember I was 48 yrs old at time of surgery). I did experience some depression that the healing was not progressing at the rate I expected but Firecracker confirmed I was close to hers which made me feel better.
Pain after surgery was nothing compared to before it and I really think the motion machine helped immensely. PT especially on a recumbant bike also was vital in recovery.
Good luck and keep a close eye on him to make sure he is doing all the PT and also not adding his own program without checking it out first.
 

carnage

Member
Mar 16, 2001
73
0
As far as my patella goes, I developed an inflamation right under the center of it. This was a result of my patella not tracking properly. What we later found out was that the quads were not firing properly so my patella wasn't being pulled evenly for lack of better words. After a couple of painful deep tissue massages of the quad right above the patella to break up the scar tissue everything started working normally again and I haven't had a problem since.

As far as a brace goes you'll get many different view points. Personaly, I'll wear mine when I ride until my knee is fully healed. I might even stretch that out to a full year post-op. After wearing it all day last Saturday I'll say that it gives plenty of support for hyper-extension and side impacts. However, would it have prevented my injury in the first place, doubt it. My foot had gotten stuck and the knee twisted pretty violently about 180 degrees. If, and I do stress the if, it would have prevented the knee from going then something else would of had to have given. If that other injury is a simple break then that would be worth it. A complicated spiral fracture or even a femur break and I'd start second guessing the brace. I think the brace will prevent minor force twists of the knee and the side impacts and hyper-extensions. Any major twisting force to the knee area and I'm not so sure it would have helped. Just my opinion.. others vary.
 

James

Lifetime Sponsor
LIFETIME SPONSOR
Dec 26, 2001
1,839
0
I agree with carnage about the brace. I wasn't wearing one when I injured my leg. About two weeks after injury, I could walk and ride about like normal except for the occassional over extension that caused considerable pain. I bought the braces and had no more problems while riding. Obviously does something.

I also think they provide additional protection to the ligaments by preventing the side to side and hyperextension and my assumption is that you will avoid injuries up to the point of failure of the brace or your leg bones. I further rationalized that I'd rather avoid many ligament/knee injuries from smaller hits as opposed to leaving my knees vulnerable to prevent a femur break in case I had a big hit.

I think a major twist with or without the brace is going to do damage.
 
Last edited:

Natester55

Member
Jun 13, 2002
25
0
I tore my MCL earlier this year and started wearing Asterisks. I've hear it said that they weaken the knee, etc, but that's rubbish. I've caught my foot several times in a rut and felt the brace torque on my leg--thank goodness I had them on!!! It takes only a little while to get used to wearing them, and once you do you'll feel naked without 'em. I'm not saying they will prevent all injuries, but hey--you can still have a head injury while wearing a helmet, too.
 

JJmxr

Member
Nov 14, 1999
122
0
I think we all agree that braces can help, but they like all other safety equipment has its limits.

Well now that we are a few days post-op the pain is really starting to appear. The Dr. gave him a stronger pain medication because the original one was not cutting it. I just hope the pain decreases soon like is expected. I know that ice is good for the swelling but man he has him frozen like a popsicle. The Dr. wants him iced pretty much constantly for the next week.

You guys have encouraging recovery stories he had all but given up on making it to a local Loretta qualifier, but it looks like we will make one. The one we would like to make it to is about 16 weeks post-op, but if he is not ready we can always travel a bit. Thank you all for the info you provided.
 

zero_it

~SPONSOR~
May 20, 2000
287
0
I wasted my ACL and tore the medial meniscus back in '94. They did the hamstring tendon for my ACL and sewed up the meniscus. Since there is very littel blood supply to the meniscus, it takes a long time to heal. With that procedure I wasn't to full weight bearing for two months. I was able to ride a bicycle about 3 months post-op and was back on my motorcycle in 5 1/2 months wearing a brand new CTi2 knee brace. It was a long haul, but I'm really glad they didn't carve any of the meniscus out, I'll be really thankful the older I get! Shortly after getting back on the bike I opted to buy a CTi2 for my other knee because I want to cut the chance of that ever happening to me again. They are expensive knee braces, but worth it. The only problem is getting MX pants & boots that fit properly over them and then dealing with your pants tearing out at the knee where the braces rub. It's still cheaper than surgery.

Good luck with the kid's recovery! Do all the prescribed physical therapy and then some.
 

BigSchafft

Member
Apr 20, 2000
84
0
Zero It: YOu say your glad they did not carve out any of your meniscus, why do you say that? trying to find out what I can be hopeful for...

Im at 6 weeks post op on an ACL debreadment (cleaning up a partially torn ACL, about 25% remains) and partial torn lateral and medial meniscus where Dr. shaved about a grand total of 5% between the lateral and medial. I can stretch to -5 degress extension (shoulod be +5 degree) and about 115 degrees flexion so range of motion is decent, but still improving.

My pain is in the meniscus area when i am squatting or doing a lunge as well as the fact that the Knee POPS. I am hoping continued PT can keep improving the situation but was wondering what kind of complications and/or limitations you (as well as anyone else) may suffer from with your knee injury.
 

zero_it

~SPONSOR~
May 20, 2000
287
0
Since meniscus keeps bones from grinding together and in proper alignment, the more you have the better. I'm happy to have all of mine in tack after 30 years on dirt bikes. I'll have plenty of other aches & pains to deal with later in life, I don't need that complication!

I'm 9 years out on an ACL replacement and meniscus repair and have very little problem with that knee. Nearly two years after the surgery I started having swelling around the small screw in my tibia (where they connected the "new ligament") nearly every time I rode. In a quick in & out surgery they spun it out and made my life a bunch better. Approx 3 years ago the knee started bothering me again and swelling in the joint and under the kneecap after playing soccer. I started taking glucosamine (500 mg) with MSM (300 mg) daily and now enjoy pain free living, including dirt biking and soccer every week and a fair amount of mountain biking. About the only limitation I have today is I can't bend the knee back as far as the other, lacking about 5 degrees or so. The new ligament is really tight, so I don't get any popping.

Everybody's experience is different and I know they handle the post-op therapy quite a bit differently today than even just 9 years ago. They seem to be a bit more aggressive with getting motion and weight bearing back.
 

CrRacer125

Member
Sep 23, 2003
3
0
My dad tore his ACL and Maniscus(sp) cartilage about 2 years ago. The doctor didnt give him the surgery until a year later, and during the time between, he walked on it normally with pain and the occasional time when it would pop out of socket or whatever. He had the surgery, and now a year after, it feels the same as before, still bad pain and all, just no popping out...
 

firecracker22

Sponsoring Member
Oct 23, 2000
3,217
0
I'm working on rehabbing ACL number 2 right now. I tore my left ACL in a race 2.5 years ago, had recon surgery w/the hamstring graft on Halloween 2001. I was done with crutches in about 3-4 weeks or so, rode for the first time at 3 months, and went running for the first time at 8 months (VERY painful at first). The only thing that really hurt it was dancing when my friends and I go out to the clubs, or if I don't lift/ride/bicycle for a while, then it gets stiff. However both my new doc and my therapist noticed that my first ACL repair is really loose--not torn again, but there is more movement in what they call a "Lachmann shift" than is really acceptable, so I will probably be looking at another surgery down the road. Right now, ACL wise, my new knee is actually stronger than my "good" knee. Also there was a lot of cartilage damage so I have a lot of early arthritis in that knee. I have been wearing Asterisks since that first recovery--both for snowboarding and dirt riding.

I tore my right ACL in September, not even riding (which I would have been wearing the braces anyway). I had my second surgery on 10/17/03, this time with the patellar graft. The post-op pain was MUCH better! Lots and lots less swelling too. I was done with crutches after about the same time, 4 weeks or so, and now I only wear a brace around if I'm out and about--just in case I slip on some ice, or get bumped into at the store. At home and work I don't worry. I've had a much easier time rehabbing it EXCEPT I've had a hell of a time getting it straightened out. I don't know why--the first time I had it all the way straight before I could bend it 120 degrees. Now, at about 6 weeks post op, I can bend it to 140 degrees (lacking about 10 degrees of full motion) but am still about 2 degrees away from being able to straighten it. It's really frustrating b/c it inhibits me from walking without a limp, and once you develop bad walking habits they are really hard to stop. However as far as strength and weight bearing go I am feeling REALLY good.

As far as doing stuff, what all my doctors have told me is that while you may have the muscles back up to par at 3 months or less, your body still takes time to establish blood flow and accept the graft as new tissue. So you can walk etc and feel fine, but it wouldn't take much at all to pop that new ligament again. Basically you are asking a what was formerly a tendon to become a ligament, and there are differences in density and elasticity. So at 3 months I would definitely say riding is possible, but racing would be a bad idea. In fact my new doctor just chewed on his lip and said "hmm. We'll see." when I told him I plan on riding at Reno (4 months post op). He thinks it was a very bad idea that I started riding at 3 months last time. I don't know about actual bicycles but he might be riding a stationary in PT at on week post op--whenever he can complete a full rotation. You can start with the seat up high so he's not bending the knee as much, then lower the seat bit by bit as he regains mobility. Stationary bikes are one of the best forms of therapy as you work on range of motion, strength and endurance.

He needs to practice normal walking as SOON as he starts weight bearing. Whenever he has the muscle control back in his quadricep, he should start putting his foot down and "walking" with the crutches--that way he can work on regaining a normal stride with the support of the brace and crutches. He might try going down to just one crutch (use it on the good side, it seems backwards but works the best) for a few days to a week before he ditches the crutches entirely. But no matter how slow he is, he needs to use a full stride as soon as he starts walking otherwise he will develop bad habits which can stress all of the tendons and ligaments. It's really hard--you have to think about each element of taking a step. Heel down first, leg straight, step through, push off with the toe.

So those are just MY thoughts and experiences. Every doc and every therapist will tell you something different. I plan to start REALLY hitting the weights and bicycle to speed up this recovery and prevent the next one. I was just starting to ride my mountain bike more when I tore my right knee, so I'm a little disappointed at such a big setback but we've all been there so I have nothing to bitch about in this thread. A lot of you have had it worse than I.

Good luck everyone, and let's all keep each other posted on our recoveries. I have to ask though--did anyone else have this much problem with straightening the knee? I didn't the first time so this is really unexpected. It hurts so bad, and not in the graft area either--it's underneath and on the outside of my leg where I really feel it pull when I lay with it propped up and weights and ice draped over it.
 

carnage

Member
Mar 16, 2001
73
0
Ouch! Sorry to hear about the second ACL going. Even more sorry to hear the first one has gotten loose. That's what scares me the most to be honest. I'm doing fine now at the 17 week mark and I've ridden a couple of times now. I won't try racing again until next spring though.

That's a good point about the graft not being fully accepted by your body at the 3 month mark. I know my therapist wanted to wait until the 3.5 to 4 month mark before doing any running or pounding type excercises like jumping jacks.

As far as straightening goes, I was able to get mine fully straight right from the get go. I must have gotten lucky. I know my friend Anne had a hell of a time with that as well.
 

JJmxr

Member
Nov 14, 1999
122
0
Our Doc was most concerned about the straightning of the leg from the very beginning. He says that it is the hardest part of full recovery. He has us working on it very hard at home and at therapy. He said that normally if you don't get full extention by 6 weeks then you probley never will. We are now 4 weeks post-op and he still makes him wear the full leg brace in the locked straight position when he sleeps. He thinks that this is a key step in getting full extention. Yesterday at therapy he was only one degree away. At home they have him lay on his stomach with his leg hanging off the bed below the knee with a 2.5lb weight on his ankle for ten minutes at a time. It is slightly painful at times but it is working well.

So at four weeks post-op he has been without crutches for almost a week now. He walks around the house without a brace, but must wear one when he leaves the front door. He is working hard on the heel to toe thing to try and get to a normal walk. The only pain now is post PT. He gets his custom brace (an EBI) in about a week. He can pedal stationary bike fairly easily and can bend to 110 degrees on his own. The Doc is keeping him away from assisted therapy of bending the knee for a while to protect the graft. Again the major focus of his PT is extention, he says the flextion will come without worry.

Overall he is doing very well, and we expect to get full extention in a week or so. I must say though that the whole PT thing has strained our relationship. Sometimes I have to push him more than he likes, and we argue quite a bit. He hates that straight leg brace he has to wear to sleep and I pretty much have to force him to wear it every night. Being 15 he likes to put his own spin on the doctors words, and I always find myself having to set him straight. I have the next two weeks off so if he thinks I have been pushing him now just wait.

I think we are going to wait until the 5 month mark to ride again, and probley won't consider racing or intense practice until next September.
 

seth5051

Member
Jul 31, 2003
11
0
follow up to my earlier post in this thread:

My right knee has been feeling great, I have 98% Range of Motion and very good strength. This Wednesday (01/07) made 9 weeks post-op. That day my PT advised that I begin working out at a gym and "check-in" with him every 3 or 4 weeks. The next day was a check up with my surgeon, he agrees to this and says that everything looks great. He added jogging to my workout, which i didn't think I would be able to do for another 4 weeks.

So at this point my schedule is,
workout at gym 2 or 3 times a week, focus on quads and hamstrings
try to jog or cycle for 30 minutes daily

In 4 weeks I will have an isokinetic test done to measure the strengh of my quads and hamstrings. At that time if my right leg is at least 80% of the left I will begin the last phase of PT, agility. That is expected to last for 4 weeks.
 

firecracker22

Sponsoring Member
Oct 23, 2000
3,217
0
Wow, you have a much more aggressive PT schedule than mine. I'm not to jog for a LONG time. Which makes it clear to me that it's OK to push myself even though my PT says not to . . .
 

SpectraSVT

Member
Apr 17, 2002
720
0
Glad to hear everythings going well. i didn't have such a good exp. with the ACL reconstruction. I lost all muscle in my entire leg. I had nothing left. I couldn't walk unassisted until after 1 month. I got swelling when ever I worked out for an entire year. I limped when I ran for another 6 months. Total recover time to 95% was a year and half.

I returned to college basketball after a year and was able to do everything 7 days a week just like everyone else but just had that annoying limp. I lost muscle in my foot which I have never regained back. So now one foot is slightly slimmer than the other (sure makes finding shoes interesting!). Everything is fine now but definitely not an experience I wanna go thru again.
 

JJmxr

Member
Nov 14, 1999
122
0
Update

Things keep getting better for the most part. The DR. says that at this point (9weeks) he couldn't be doing better. Still doing PT 3x a week, but the new thing now is the Hydrotherapy. They have a tank with a treadmill submerged and he runs on it for 20 minutes. He is free to start jogging as soon as he wants. Mobility is great, and the limp is almost gone. I can already tell that having his bike in pieces is a good thing trhough, he thinks he is going to try the Loretta Qual. at Budds in mid March, but I am not going to let that happen. The Dr. actually is very optimistic about riding after 4 months. He actually said he would be ok with him riding after 3 months if my son would take it easy (15yo take it easy, right..). I think we are looking at no riding until late April.
 

firecracker22

Sponsoring Member
Oct 23, 2000
3,217
0
I'm at 4 months and getting ready to ride at the Reno trip (against my doc's better judgement, but I'll be wearing braces and riding with the beginners). I feel so much better than I did a month ago. Good luck to your son and keep us updated.
 
Top Bottom