ACL surgery, yes or no?
Asked by
Steve_A (
5130
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August 6th, 2010
I did some reading here
http://www.sportsinjurybulletin.com/archive/acl-reconstruction-surgery.html
and from what my doctor said after I had the MRI, my ACL was basically “mushy” with a lot of scar tissue, also had meniscus damage and a black spot he showed me that I guess that would be shaved down. There was a lengthy medical term he had for it but I can not remember.
He told me like this you could go on and not have surgery if the knee feels fine, just stay away from sports with a lot of quick cuts,stops etc…That alone sucks and I now have a fear if I attempt to do anything too rigorous and even doing some trail running which is what I like the most my knee will out ( which it has locked up before since my injury)
Anyways I have 2 weeks before I see him again with a decision. The more I think about it overall it seems obvious to do the surgery.
I’d still like a second opinion from y’all personal experiences or input…Anything would be great, because this is stressing me out haha….
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23 Answers
ACL replacement surgery is quite a routine operation, and in my experience rarely has complications. I think it would be best for you to have it done, simply because your quality of life would be restricted without it. Obviously it is wise to avoid surgery where possible, but when such significant benefits are on offer from such simple surgery there isn’t really a reason not to have it done.
I am not familiar with knee surgery, but, I had a ligament destroyed shoulder that needed to be pinned years ago from several dislocation injuries. They shaved a piece of my collarbone off, pinned the shoulder and it has never bothered me since. Some rotation fatigue but no pain, great mobility, full range of motion, and strength retention. I’d go for it, you could continue to re-injure it and perhaps complicate your condition even more.
Best wishes!
@Coloma Good point the next time could be really bad….
@Steve_A: This advice here is all well and good, but you might want a third opinion, from another orthopedic surgeon.
@Steve_A
Yes, and be sure to do your physical therapy exercises for the best outcome.:-)
@gailcalled Certainly. It is impossible to say over the internet whether or not he is a candidate, especially when we cannot see his images.
@gailcalled Hm that’s true I think I will before I see my doctor again, thanks.
@FireMadeFlesh If I had the CD of it I’d upload the same image my doctor showed of my ACL, and as he said it was indeed “mushy” from what I seen or blurred and not a nice black thick line like my PCL.
Another way that might help with your decision is to talk with others who has had the same surgery and see what their outcome was like. Your doctor might be able to set up a meeting with them.
AS long as there’s no, or very little, downside risk, I’d say go ahead and have the surgery.
@Rarebear That’s shocking…Of course, that study could only be done in Europe and not the US. I’m sure there are quite a few orthopods moaning and groaning right now…
I’d say that surgery is not a bad idea. My Dad ruined his ACL and after surgery and about three months later, he was able to run a good mile pace and even went on to run several half marathons which he’d still be doing if he didn’t mess up his back…
It is possible to wait too long.
I tore my ACL and meniscus in high school. My folks weren’t in to doctors at the time (or couldn’t afford them), and I had a couple of arthroscopic surgeries through college to clean up bits of meniscus that would continue to tear. I chickened out of having the ACL repaired until in my early 30’s, when it was giving me a lot of trouble, but by then, there was too much remodeling of the joint. Mine can’t be repaired at this point, and my orthopedic specialist said I’d probably need a total joint replacement.
@shilolo Actually, I’m not surprised. Back when I did just primary care I saw a lot of sports medicine and worked with a family physician who was also a sports medicine specialist. He was a big advocate of rehab and thought surgeries were way over done.
I would put the orthopods barely in front of the undertaker on my list of choices. At the top of are the PT’s.
I did some pretty severe damage to my knee a decade ago (15 sheets of sheetrock bent it backwards) and I never got any surgery. I spent a few months in a leg brace that initially locked it at 20 degrees and eventually moved the stops until I had a nearly-normal range of motion.
A year later I took a job that involved a lot of twisting, but I had to quit a year later. Considering the physical demands of that job even on a healthy person though, that was not surprising.
However, something less demanding like mountain biking poses no problems other than the fact that I got a little out of shape after not doing it for a while. Personally, my only real weakness is twisting, so I have to be careful when I lift stuff and cannot do rapid direction changes like one would have to do in football or basketball. Running in a straight line shouldn’t pose any issues even if you don’t get the surgery. I can run as well as I could before the accident.
Be warned that you will feel it for the rest of your life though. I can tell when it’s going to rain by how my knee feels. It may not limit you much (mine doesn’t) but you’ll always know that that knee was messed up once; it won’t let you forget.
There is also the risk that surgery will leave more scars and cause more problems than natural healing, which is why I elected to not get surgery. It will never be 100% ever again whether you get surgery or not.
@jerv ACL reconstructions are done laparoscopically, so there are usually only three scars about 2–3cm long.
@FireMadeFlesh On the outside, yes.
I was referring to on the inside, and sometimes you can do more damage trying to fix something than whatever damage was there in the first place.
@FireMadeFlesh Quibble: It’s not laparascopically, but arthroscopically. And @jerv‘s last comment is correct. Also, see the New England Journal article I linked to above.
@jerv Thanks for the clarification. If something is damaged to a point where the body cannot heal itself though, isn’t it worth the risk to get that quality of life back?
@Rarebear True, but the word slipped my mind so I chose one that was close enough.
@FireMadeFlesh Mine wasn’t injured badly enough to require surgery. Though I couldn’t climb stairs or stand for more than a few minutes unaided, I had enough ligaments left that I could limp painfully for short distances on level ground without a brace or cane; it wasn’t totally destroyed.
If your ACL is mangled more than mine was, then yes. However, when you consider that I can still do just about everything I did before even though I didn’t have the surgery, I have to say that it’s something that really has to be taken on a case-by-case basis. It’s not like I am a professional athlete that lost millions of dollars for not being able to play next season.
As for sports that involve “quick cuts”, even without a trauma like I had, that will eventually kill your knees anyways.
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