Knee Reconstruction

[DougMXer]

Well I washed out the front end of my new 2001 YZ 250 last year, and made the dumbest mistake of my life. I tried to save the poxy bike since I had never dropped it up till that point. The result of trying to save it was a severed acl, and torn medial meniscus and a part of the lateral meniscus. Anyway so rather than I few scratches I've got a ****ed knee. I go under the knife on Nov 19 for a patellar tendon reconstruction and meniscus trimming. What is the long term prognosis for a knee reconstruction in terms of pain and knee strength. Would like to hear from fellow riders who had knee recons say 10-15 years ago and how their knee has held up since. Why is it the smallest incident seem to result in the most damage eg Jimmy Buttons crash in practice in the whoops. Lifes a bitch!! I need to go riding

Cheers
D

 

[IrishEKU]

I have no idea on thr R&R with your knee but No bike is woth messing yourself up over.

 

[MikeT]

November 19th???? That is the soonest they can do it?? What's going on down there? That's like forever. How about August, maybe even September?? That is way too long to wait. Why so long?

 

[DougMXer]

I didn't have private health insurance at the time of the crash, so I took it out and have to wait 1 year before I can make a claim. So anytime after Nov13 is good, at any rate it gives my meniscus a little bit longer to heal before it gets chopped away
D

 

[haloboy]

doug,
I had acl reconstruction last year and after some rehab I`m back racing without a brace!!!! The knee feels ok and is geting beter every day.
The one thing to do before you go under the knife is work the leg musles and I mean build musel this will help with rocovery.
My physical therapist is a babe that helped!!!!!! good luck.

 

[Dennis Meyers]

Doug,
I'm 4+ months post-op from my ACL reconstruction, same deal too, severed ACL and bucket handle tear of the meniscus. My knee feels great and I'm back riding and mountain biking (with a brace). Same deal with the insurance too, I switched jobs and it happened before my new coverage started. I had to wait 11 months before I could get it done from that point. Anyway, why the Pateller Graft? Have you researched the options any? I've heard of people who have had pateller grafts a few years ago and still are not able to kneel on the knee. The new grafts are OK, but from what I've heard, the patella can get kind of screwy. I had a hamstring graft and my knee feels almost 100% now. Maybe some of the other DRN'ers with different grafts could let you know how theirs went, maybe someone has had good luck with the pateller graft. Either way, get the legs as strong as possible before surgery, it will cut your recovery time way down (I didn't spend 1 whole day on crutches). I was back to work only 6 days after surgery. Best of luck.
Dennis

 

[mark_england]

ive said this before but just incase no one saw it
you guys who are working the acl graft hard thro physio be VERY CAREFULL
there is a period (4-12 weeks) after the op where your acl will be extremely weak, this is natural and irrispective of the kind of graft you have had or the kind of physio you are doing. its gonna have a strength of about 20%-30% of you original healthy ACL.
i know you may of been walking on you knee the day after the opp
but ur ACL was stronger then, than after a month or two post opp.
after 40 - 50 weeks your acl will be at its maximum strength which at best is gonna be 70% of your healthy ACL
also it will have none of the sensory qualities your original ACL had, which means you wont get the feed back when your knee is in trouble.
,so just be carefull

as regards the bone-patella-bone graft, there is a risk of patella allignment issues at a later date.. though i think a lot of which kinda graft you get is down to who does the opp

 

[MikeT]

Lord, Please keep me from having this type of injury! I feel for you guys and pray that you all will recover fully.

 

[DougMXer]

Dennis, what did they do about your bucket-handle tear of the meniscus. Did they repair or remove it. I have a complex tear of the posterior horn of the medial meniscus and would rather get it repaired but the OS thinks it is only able to be removed, since it is a complex tear and extends into the avascular zone.

 

[Dennis Meyers]

Doug,
My OS had to remove it, it was too far gone. :( I use a Glucosamine/Chondroitin supplement daily now and it has helped a great deal. If I go without it for more than a week I really feel it in the knee! It is supposed to help rebuild cartilege, I know it makes my knee feel better.
Dennis

 

[MikeT]

Glucosamine/Chondroitin..... Is that stuff expensive?? How much do you take a day?

 

[Brett]

Im at 4 weeks to the day post-op of the pattelar graft ACL reconstruction. I went with the patellar because mainly thats what 2 OS's reccomended. It took about 6 -8 days to get off the crutches where as with the Hamstring graft I hear 1-2 days. Physical therapy has been alright with minimal pain. The one thing that bothers me the most is the fact that with the patellar tendon graft, you have to watch your kneecap. For if you fall on it with significant force, it will shatter because part of the patella (kneecap) has been cut out for use in the graft. Also heard from a guy who sells artificial limbs that for 10+ years that it will hurt to kneel on the knee and some pain when its "cold", not stretched out. Im only 17 yrs. old but the worst pain ive experienced in my life was the 2nd day/night after surgery. Even taking 2 Vicodin every 4 hrs. for the first 4 days. Not fun but glad its over. Hope this helps. By the way, go with the general anestetic (sp?) rather than an epidermal if you have the choice. Later on, Brett.

 

[IBWFO]

Listen to Brett about the general vs. the epidural. I did the left knee (ACL) in 92 and went with the patella graft. The reason my doc wanted the patella graft is because I have large muscular legs. Rehab was 9 months and the knee cap was not really sore but a little numb for about 3 years. You can work on this if you really rub your scar with your thumbs. I did my right knee in 97 and again did the patella graft. The second time my sister (a doctor) told me to go work out both of my legs at the gym, and gave me certain exercises to do. Rehab on the right knee took 6 months and I was in the best shape of my life when I went in for the surgery.
I can't impress on you that you will only be as GOOD as your rehab!
I am 42 now and still ride 2/3 times a week and race on the weekends. My right knee was sore after riding for about a year, but nothing a little ibuprofin didn't cure.
Check out a site called Bob's ACL Board. I wanted answers from some good atheletes about what I was in store for and what I could expect after surgery.
Good LucK!!

D

 

[DougMXer]

IBWFO
how much meniscus tissue did you have cut away when you had the acl reconstruction? How do the knees feel now 5 years after the fact as opposed to before the traumatic injury?

Cheers Doug

 

[Dennis Meyers]

Originally posted by MikeT
Glucosamine/Chondroitin..... Is that stuff expensive?? How much do you take a day?

MikeT,
I use the Spring Valley brand from Wal-Mart, it runs about $18 per bottle (120 double strength caplets). At 3 per day that averages out to $13.50 a month. Much cheaper than the name brands like Joint Rescue.
Dennis

 

[MikeT]

Dennis, How long after you started taking the Glucosamine/Condroitin did you notice a difference?

 

[Dennis Meyers]

About 4 to 6 weeks. It's gradual, in fact you almost don't notice anything until one day you realize that your knee doesn't feel 80 years older than the rest of you. MSM is also supposed to work well.

 

[MikeT]

What does MSM stand for?

 

[Dennis Meyers]

MSM = Methylsulfonylmethane
To the best of my knowledge it's a form of organic sulfur.

 

[WFO]

Tore my knee up long enough ago that it kept me out of Viet Nam. Finally totalled the ACL, lived with that for a couple of years, then finally went under the knife for a Patellar ACL re-construction about 5 years ago. My only regret is that I didn't do it sooner! Orthoscopic surgery (not available when I first hurt it) really deceases recovery time. My "new" knee feels much better than the one on the other side, but I ride with knee braces just to be safe.
I don't like to kneel either, but it's mostly from the stainless steel screw below the kneecap where they anchored the tendon graft. It hasn't really limited me except when I'm begging for a raise!
Pay attention to the advice above!!!!
1. Your muscles will atrophy at an incredible rate. Any improvement you do prior to surgery will aid your recovery time.
2. Don't be too quick to toss your crutches. It is important that you maintain a normal gait (IE-pattern of walking). Being macho is great, but you'll have a tendency to over-compensate for the bad leg and drag it.
3. Re-hab is critical!! A strong knee is a healthy knee. Whatever you do, don't let some physical therapist have you do leg extensions!! My surgeon (who repairs knees for the Houston Rockets) said extensions are harmful to a healthy knee; much more so to a damaged one.
4. Ask questions of the doctor! It's your dime. For instance, you'll wake up two days later and your entire leg (not just the knee) will be black, purple, and blue! Don't worry... it's normal....but they don't warn you and your first conclusion is that you are hemmoraging to death!
5. Don't expect mirracles! Pick-a-poo Street competed in the Olympic Downhill within 12 months of surgery. She was an idiot! Don't get me wrong...you can ride well before 12 months...but be advised that this is a long term fix and overdoing it early will negate all your hard work, to say nothing of the expense.
6. It really didn't hurt that bad. Waking up from anaesthetic sucks!!
Good Luck!!

 

[hebegebes]

I tore my ACL, MCL, and medial meniscus in a wreck in mid-February. Because the semester at college was still underway, I had ACL reconstruction on May 30. Against my doctor's recommendation, I had a cadaver donor tendon used instead of my own patella or hamstring graft. Everything has gone more smoothly than even the doctor or physical therapist could have predicted. I think that is partly because I waited until the MCL had repaired itself and I was actively using the knee before having the procedure performed. My doctor also believes strongly in prescribing VERY high doses of pain meds for the purpose of having his patients do as much to gain range of motion back during the first week as possible. He had me on oxycontin and percocet for the first ten days and told me to use them even if the pain was minimal. Then, when the meds were really kicking in, I would have someone move my leg to full flexion and full extension. I don't think that this would have been possible without the meds. Well, I gained full range of motion in just under one month and only went to the PT three times. I feel that I could ride right now, but I have been told that the graft is typically very weak at this stage so I am laying off.

Good luck in your recovery!

 

[DougMXer]

Why did you insist on a cadaver tendon as opposed to your own patellar tendon?

 

[hebegebes]

Doug - I insisted on the cadaver tendon because it just made more sense to me that if the surgeon didn't have to cut me open in another site to harvest a patella or hamstring graft I would heal up that much faster. Simply put - I figured that the less cutting, the better.

There are some possible side effects your doctor will inform you of that might scare you if you ask him about a cadaver graft. There are, of course, goods and bads to any of the procedures. I researched a lot on the internet before making my choice instead of just listening to my doctor - even though he is considered the best knee doc on the island. For me, the cadaver tendon just made the most sense.

Hope I've helped!