[gcaz]

Hi all,

I'm set up for ACL reconstruction on the 20th of this month (April, 2005). Tore it skiing in February (first day of the trip, of course) . Doctor is recommending hamstring autograft.

I've been doing pre-op training to get the leg strong, and dang if I haven't had some great bike rides.

I've gone from crutches and a brace to just a brace to no brace and mountain biking. Now I'm thinking, why do I want to knock myself off a bike for many weeks if not months, and risk the complications of surgery if I'm getting stronger day by day?

My OS said, you know you'll be ready for the operation when you feel like you don't need it, but it's tough to go in for so much pain, immobility, and no riding when things are pretty fun right now.

Anyone out there have ACL recon? What's the time to getting back to riding? I'm 34 and thought I'd want the operation for all the future stuff I want to do -- anyone opt to *not* get operated on?

 

[arturo7]

You are doing the right thing by questioning the need for the surgery. I've had 2 ACL reconstructions and thought long and hard before the last one. Consider what activities you want to do now and in the future.

I have a couple pals, one girl one guy, who get by without it. The guy is inactive and thus not a good example. The girl, who is active, puts a lot of effort into keeping her leg muscles in top shape and seems to get along just fine.

For my part, I didn't get it done right away based on other circumstances. When I did do it my decision was based mainly on two factors: A) I don't like to spend time at the gym and B) on occasion I would twist my knee and it flippin' hurt.

If you can get by without the surgery that's great. Any time you're under general anesthesia there is a risk. Of course you know that you can put it off to see how the knee feels or wait until the end of riding season. With waiting however, I believe there is a higher risk of damaging the meniscus if there is an incident.

If you've got a good doctor he/she should help you with this decision. I'd be wary of any surgeon who takes it as a given that you must have the operation.

Just my opinion, hope it helps. Good luck with it.

Art

 

[JJK]

Hey Pal,

I've blown out both my knees years ago on seperate crahes on
my dirt bike. Blew them out again playing racquetball at different times.
Finally had an MRI done and found the right one had a torn ACL and a
medial meniscus tear. Left knee just a torn ACL. So i fixed the Rt one
with a cadavers part and left the other knee alone. This was back in 1998.

Since then they both are doing good, at least for a 45yr old.. LOL
But when it comes to riding my MTB or Road bike i have no problems to
speak of. I have always worked out in the gym and i don't ride dirt bikes
anymore. I have 2 CTi 2 knee braces that the doc fitted me for but i
only used them for dirt biking and 1 yr on the MTB.

Think about what you are going to do for the next 20-30 yrs and
don't tear the meniscus because then you will get arthritis which i have a
little in my rt knee.. No big problems yet...

Good Luck,

Johnny K

 

[kristian]

I had mine done 5 years ago

Anyone out there have ACL recon? What's the time to getting back to riding? I'm 34 and thought I'd want the operation for all the future stuff I want to do -- anyone opt to *not* get operated on?

I'm convinced it was the correct thing to do. I never have issues riding and I can ski all day with only a few Advil. I also tore my meniscus in a few places which the doctor didn't know until he got into my knee. The meniscus bothers me more than the ACL itself and I couldn't imagine worrying about spending my later years in arthretic pain because I didn't have surgery done when I was 25.

If you have been strength training in advance of the surgery and if you follow your PT religiously, you should be back on the bike in no time. My doc said 6 months before hitting dirt but I was riding pretty aggressivly again in 3 months (with the knowledge that a crash would be bad). I rigged a knee brace (cheapo neoprene with a hinge) to my leg armor to give myself a fair bit of protection, although I don't think I ever actually crashed on it.

Good luck!!!

 

[jl]

Hi all,
I'm set up for ACL reconstruction on the 20th of this month (April, 2005). Tore it skiing in February (first day of the trip, of course) . Doctor is recommending hamstring autograft.

Fixing your ACL will protect your meniscus in the future. What is a hamstring autograft? I've never heard of it before. If in doubt get some more "professional" opinions (like other doctors) ...

I would ask what are the differences between a patella tendon graft, and a hamstring graft in terms of rehab and resilience.

 

[SSINGA]

I didn't have the surgery the first time I tore mine, with the advice of the Dr., which ended up being the wrong decision. I was only 16 when I had the injury and was advised that since I was so young that I could rehab and get away with out the surgery. So I turned my legs into tree trunks and got by for years, including 4 years in the military, I thought. Every once in a while my knee would "wiggle" from the weakend and streached ACL, but since there was no pain I ignored it. 10 years after my first injury I noticed the "wiggle" was happening more and more and went to the Dr. to get it checked. A MRI revealed that my ACL had disinarated and nothing was left. Consequently, I had also torn the miniscus and caused injury to the MCL as well

Get a second and third opinion!!!!

 

[ibmkidIII]

I had one ACL recon back in 1998 with a Patella tendon and was the prospect to have ACL recon with a hamstring graft on my "good" knee this last summer. I did LOTS of research. A hamstring graft has much less harvest site morbibity (e.g. the area where the graft comes from heals well). A patela tendon graft CAN cause you to have serious knee issues down the road, e.g. things like squatting cause extreme pain. This wasn't the case for me--

One thing I suggest is to check out the type of hamstring graft he'll be using. The "newer" technique weaves a few strands of the hamstring together for a stronger graft with a similar stress failure rate of the pattella tendon graft.

My advice: Without an ACL your knee load won't be as balanced and you likely cause more wear over time on your medial meniscus (assuming you're even slightly bow-legged). An ACL also help protects you from future catastrophic injury. Having less or no meniscus because you didn't do the surgery will be a decision you WILL regret. I'm currently missing around 20% of my right medial meniscus and I really wish I wasn't....and I'm only 29...I can't imagine the pain I'll be in when I'm 45 and still trying to ride.

Personally I wouldn't rush the recovery...your ACL takes quite a bit of time to regain blood flow and it's optimum failure point, which really takes about 1.5 years...though you will be riding way before that. I'd listen to what your doctor and PT says about recovery time before riding. They will be on the conservative side of things...but you're young still...don't f0ck it up for yourself.

Do the surgery.

** I ain't a Dr. take this advice for what it's worth...

 

[rapwithtom]

hamstring graft here...

true that you don't need the surgery, but as others have said, if you don't have it, you risk increased meniscus wear and possible future tendonitis (unless you are a couch potatoe).

You must weigh that against 12 months of rehab. You won't do much fun stuff for 6 months after surgery; you won't feel "right" and trust your knee until 12 months after surgery; your knee won't be "stronger than new" until 18 months after surgery. It's a long time, and rehab all the while is lots of (good for you) work.

I think as people get older it makes less sense to do the surgery, but for younger people it makes good sense.

 

[ito]

Patellar replacement here. It's taken me about a year and a half to get fully rehabbed(even now I'm not as strong as I was), because I wasn't prepared for surgery(only time I could do it was about two weeks after I tore it and then insurance crapped out and I couldn't get PT). Anyhow, as others said you are right in questioning the idea of surgery.

I can't make the decision for you, but I would suggest getting the surgery rather than not. I'd rather be out for a while(and believe me it is painful and takes a while) than go through life with a not quite fully safe knee. Talk to your doctor about recovery times and alternative surgery methods. Know your choices and decide what is best for you. Also, find a doctor you trust, find someone who does these on atheletes. Talk to people who had him or her reconstruct, you don't want to have any slop in your knee and a good surgeon will make sure that there is minimal slop(my reconstructed knee's ACL is more solid then my undamaged ACL). Just like you wouldn't let a questionable mechanic near your bike, don't let anyone but the best touch you on a surgery table.

Good luck man, ACL's suck.

The Ito

 

[champagnejenkins]

I just had the surgery done Feb. 7th of this year..(long)

I just had the surgery in February. I tore my ACL three years ago and I put off the surgery until this year. I really wish I had the surgery done earlier, while I was in school...instead of taking time off work..In the three years since I tore my ACL, I had blown my knee out a bunch, and damaged my meniscus..

Basically, it's been about 2 months since my surgery. I'm walking totally fine. I've been in physical therapy once a week for the past 6 weeks. Since that time, I have regained full range of motion in my leg, regained tons of strength. More importantly, I've been riding for 2 weeks now.

At first I started riding short little xc loops just to regain some fitness and leg strength. Now I've started riding more and more, a little bit more aggressively each time. Granted, I'm not going full out yet.

The first two weeks after surgery were spent in bed strapped to a CPM machine that moved my leg through a range of motion passively. I was hooked up to this machine right when I came home from the hospital (i was sent home the same day). During the two weeks I went crazy. I was in the machine for 8 hours a day, watching dvd's and making my roommates bring me food.

Pain was minimal. In fact, I still have a bunch of pills left over.

I was mobile during the second week. Using crutches and a big knee imobilizer brace. Most of the pain during that time occured from the weight of the big knee brace.

I went back to work on the third week, and started physical therapy as well. I was on my cycle trainer even before physical therapy. My physical therapist said that my knee was already well on it's way to a fast recovery, which was encouraging, the next week I ditched the crutches, and then the brace shorty after..the past 6 weeks have flown by. I walk totally fine, and my knee feels solid!

While I don't feel pain, my knee gets sore after a full day. So ice helps. I've been riding about three times a week with varying mileage. So far so good!

So, about your surgery...you have a lot of options. I mean, if your knee feels solid even with the injury, and you still want to be able to enjoy your summer; then you might want to wait until winter to get the surgery done. I rode during my three years without my ACL and that was fine. It was everything else that hurt my knee. Any tennis or basketball like sports where you plant and move your legs and feet would blow my knee up. Or drunken nights at bars etc.

But if you don't mind recovering and rehabbing during the summer months then by all means do it now.

I'm so glad I got the surgery, and I'm even happier that I timed it so that by summer I'll be pretty much good to go..

 

[gcaz]

Thanks for all the great opinions. I'm much more positive today about the operation than yesterday. Just a bit of cold feet, I guess. My insurance should cover PT for as long as I need it. I'm more worried about time off work, in that regard.

I know I can't rush back. Most estimates are 6 months to any real tough athletic activities. Seems like at least I can get back on the bike for a bit of spinning pretty soon. I've got my road bike up on a trainer now. Might put the MTB with slicks and platform pedals on it post-op, at first, for its lower standover height and gearing.

I have a pre-op meeting with the OS next week, so I'll gather all my last minute questions to fire at him. One nice thing is that he's got a sports medicine background (orthopaedic surgery fellowship by the New York Giants and completed his training at the Hospital for Special Surgery in New York City, being chosen for a Sports/Shoulder fellowship).

Again, thanks for all the input -- and please let me know of any other tips or encouragement. I know that this is going to be a tough slog, especially at first.

 

[ibmkidIII]

The first few weeks post-op for me were real tough. Just know it WILL get better. Good luck.

 

[shiggy]

I had mine done in 1982. Better than new. Your rehab should be much shorter than mine. I had an open-knee repair and was is a hip-to-toe cast for eight weeks. Not the way it is done now.

 

[kristian]

Passive motion machine

I second the CPM. When I woke up in the hospital, I was already on it and my doc had one sent to my house for the next 4 days. I was on it 20 hours a day while it was in the house and I think it made a huge difference. I have talked to a lot of people who's docs did not use a CPM in their recovery and generally they seem to have more complaints about pain, stiffness, etc.

 

[knollybikes.com]

Had my right one done in 1999

Just tore my left one last fall and will have it rebuilt also.

I had a hamstring graft done for my right knee and it has been just OK. However, this is almost certainly due to previous knee injuries (which probably resulted in the torn ACL to begin with), not from the surgery itself. Eitherway, it doesn't bother me at all now.

One thing to think about is that you can pretty much live a normal sedentary life without having your ACL rebuilt. However, if you are active, then you will almost certainly want to have it repaired. I used a G2 brace for two seasons of riding (the summer after I tore it and the summer following the repair). The brace, while a bit of a pain in the ass, worked awesome and I actually did my hardest years of riding with my right knee blown out.

I'm now going to buy a brace for my left knee and am opting to have it fixed in the fall, so that I can keep the summer riding season.

As others have said, expect about 2 weeks of solid discomfort followed by about two months to get up and going fairly normally again. I was riding XC trails about 2-3 months after my surgery, but didn't hit any serious trails for about 3-4 months. Typically, it takes a good year to fully heal, so you will want to wear a brace if there is any chance of reinjuring it during the healing process.

This is the brace that I used:

http://www.g2orthotics.com/Products/Details/?target=02-EXTR

The G2 Extreme brace is great because it lacks an inner hinge, which would otherwise interfere with the seat when doing downhill technical riding. It is also fairly "svelte" and actually fits reasonably well underneath knee/shin armor.