Torn ACL - to repair or not?

MDMCG
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2/5/2018 6:59pm
RCMXracing wrote:
Get it fixed. The longer you wait the worse if there’s swelling. That can lead to arthritis and obv more injuries. If your Dr. is recommending...
Get it fixed. The longer you wait the worse if there’s swelling. That can lead to arthritis and obv more injuries.
If your Dr. is recommending a Patella graft he hasn’t progressed. That’s 90’s Tech. Hamstring autograft, OOOR....I have heard technologies have progressed with how a cadaver ligament is “cleaned”. Methods when I had my knee done (2010) to strip the bio footprint caused them to be weak.
The hamstring will grow back eventually, Patella will NEVER grow back. My knee with hamstring autograft is considerably more tight and stable than my stock knee...I did have a weaker hamstring that was noticeable with the tension of knee brace straps when putting foot back and forth from brake to peg. I was riding at the 4 month point BTW. I didn’t do anything special to strengthen hammy and it was a few years before it became a non-issue.
P.S. This might be the worst place to ask for advice next to ThumperTalk. Pinch
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital and send people to the OR daily. Cadaver grafts have about 75% strength. Patella is over 90% when compared vs native ligament. Get a good surg on and get the right graft,

Come to the Steadman Clinic if you want it done right.



gerg
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2/5/2018 7:07pm Edited Date/Time 2/5/2018 7:08pm
Tore my left in '96 after exiting a corner where is was kindof hard to sight the whole exit...surprise surprise they had drenched the exit with water to keep dust down from the lap before, rear just turned around but my left leg got stuck under the bike in the slide.
Didn't have surgery and had some stability issues for probably 6 months and my knee kindof popped out of place in my sleep on the odd occasion for about a year.

But yeah no issues as yet to this day and I've been bloody active with stuff like martial arts that obviously involves a lot of pivoting and twisting on one leg etc. It never bothers me to the point of never thinking about it...on occasion I wonder if it will come back to haunt me one day because a torn ACL is supposed to be serious business, but I didnt do anything except just allow time.

Doc at the time did give an option of an op if it continued to give issues so I guess it can have varying degrees of damage, but yeah an op never eventuated.
brimx153
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2/5/2018 7:16pm
i hav done my acl 4 time s . 3 left knee once right . got it fixed twice . i am now living with no acl left of right . i have no real problems . i ve have played rugby and all like this . the reason i didnt get them fixed is because i have arthritis ,and the doctor told me to do everything i could not to get another operation .

imo . its as easy as this, to weather you should or should nt get it fixed .
do you have good meniscus to begin with .if you dont ,getting your acl fixed could hurry up you needing a replacement knee down the road .

if you have good meniscus ,i would prob say to you you should get it done .but only if you can get it done right away . if you cant . id do a mad amount of physio on it and see what it is like in 6 months .you might be surprised how good you can get it . but you do have to put in a serious amount of muscle building around the knee. ie more work than even the normal rehab for an acl .

there are loads of factors you should look at.
but yes you can get really good stability without an acl it will take you 6 months though .
cause you are 40 id be making sure your meniscus is good before id get it,

VET74
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2/5/2018 7:22pm
Complete rupture, no repair, Asterisk knee braces...no problems. Had some friends that did a graft and a cadaver ligament, but still had some issues. I rode one time without my brace, and it only took one time not to make that mistake again. I'm 51 and still play a little football on Thanksgiving and outfield in softball so I can run, but really don't do anything that I have to cut.

The Shop

DirtBikeKid46
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2/5/2018 7:35pm
dylanv21 wrote:
Just had my right knee done before christmas. It was done with a cadaver, and doc fixed the meniscus while he was in there since the...
Just had my right knee done before christmas. It was done with a cadaver, and doc fixed the meniscus while he was in there since the inner part of it was torn.

Never really had much pain after surgery, more discomfort then anything. Did the knee machine and ice right out of surgery for 3 weeks and started PT after that at home just doing simple work outs getting the strength back in my leg. I was putting pressure on it in a brace a few days after surgery to get to the bathroom and what not. Doc then cleared me to walk with the brace at all times, one week after surgery.

At home, I am not using the brace as I try to stay still and not do too much. But if I am out and about running to stores or whatever I will wear it just to be save. Supposed to get my functional brace within a week or so and that I will have to wear for a few months basically at all times Doc said.
Glad to hear it went well, very reassuring that it wasn't that painful either! How old are you?
DirtBikeKid46
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2/5/2018 7:40pm
RCMXracing wrote:
Get it fixed. The longer you wait the worse if there’s swelling. That can lead to arthritis and obv more injuries. If your Dr. is recommending...
Get it fixed. The longer you wait the worse if there’s swelling. That can lead to arthritis and obv more injuries.
If your Dr. is recommending a Patella graft he hasn’t progressed. That’s 90’s Tech. Hamstring autograft, OOOR....I have heard technologies have progressed with how a cadaver ligament is “cleaned”. Methods when I had my knee done (2010) to strip the bio footprint caused them to be weak.
The hamstring will grow back eventually, Patella will NEVER grow back. My knee with hamstring autograft is considerably more tight and stable than my stock knee...I did have a weaker hamstring that was noticeable with the tension of knee brace straps when putting foot back and forth from brake to peg. I was riding at the 4 month point BTW. I didn’t do anything special to strengthen hammy and it was a few years before it became a non-issue.
P.S. This might be the worst place to ask for advice next to ThumperTalk. Pinch
MDMCG wrote:
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital...
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital and send people to the OR daily. Cadaver grafts have about 75% strength. Patella is over 90% when compared vs native ligament. Get a good surg on and get the right graft,

Come to the Steadman Clinic if you want it done right.



I'm not sure I'm defined as an "athlete" and need the strongest graft, but I could be wrong. I take my health and fitness seriously, ride dirt bikes, ski every so often and enjoy mountain bikes. Lots of home and yardwork...think cadaver could work well for me?

Like the idea of not having a graft harvested from me but then again, don't like the idea I could get some sort of disease ('s), cancer etc from a cadaver. Even though the odds are low....
brimx153
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2/5/2018 7:47pm
everyone saying not getting an acl fixed will lead to arthritis . have to remember that getting it fixed will also prob lead to getting arthritis .doctors are very spilt at the moment on this .years ago every doctor would tell you to get it fixed .now alot of doctors will talk you out of getting it fixed . ie .i was lucky to get mine fixed by a one of the most well know doctors in the world for fixing acls .he does not have an acl in his right knee the last 10 year s .its not as easy as saying just get it fixed ! depends on the person and the knee.


i remember the nurse telling me , the doctor was kind of famous for fixing all the top soccer stars in europe . and how he got so good was because he worked in Belfast in the 80 s .when the IRA were knee caping loads of people . so he had to come up with new techniques for fixing knees
RCMXracing
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2/5/2018 9:26pm
MDMCG wrote:
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital...
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital and send people to the OR daily. Cadaver grafts have about 75% strength. Patella is over 90% when compared vs native ligament. Get a good surg on and get the right graft,

Come to the Steadman Clinic if you want it done right.



What exactly is not true? I’m taking about Hamstring vs. Patella. Agree the cadaver isn’t the best option. If they take a slice of your Patella it will never regain its full strength, does NOT grow back. It’s taken out of the center. The Hamstring Is a slice and it grows back. The quote from my knee surgeon, who by the way has done 1,000’s:
”I quit doing Patella grafts in the 90’s, I respect the Patella tendon too much to weaken it, and I could pay for my house, cars, and send my kids to college for all
The Cadaver re-do’s I’ve done”. So I ask about why so many do the Patella graft...”Because that’s what they know.”
ando
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2/5/2018 10:46pm Edited Date/Time 2/5/2018 10:46pm
I had a hamstring graft. The way it was explained to me at the time was that over the long term the hamstring graft will be better (can't recall exactly what "better" meant - maybe stronger or fewer side effects?) and for most people more convenient as you still have one good knee during rehab, but professional athletes tend toward the patella graft for speed of recovery.

Also I think it depends somewhat on what the particular surgeon specialises in or has a preference for.
RCMXracing
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2/6/2018 6:55am
I'm not sure I'm defined as an "athlete" and need the strongest graft, but I could be wrong. I take my health and fitness seriously, ride...
I'm not sure I'm defined as an "athlete" and need the strongest graft, but I could be wrong. I take my health and fitness seriously, ride dirt bikes, ski every so often and enjoy mountain bikes. Lots of home and yardwork...think cadaver could work well for me?

Like the idea of not having a graft harvested from me but then again, don't like the idea I could get some sort of disease ('s), cancer etc from a cadaver. Even though the odds are low....
You make a good point, you’re not cutting lines at 100mph on a giant slalom course or carrying a football in the NFL, BUT Moto is gnarly. Watch that old slow mo of Tomac wheeling through the whoops at Daytona on his Honda...watch the forces on his knees. Yeah, least invasive, quickest recovery would be the Cadaver. Hey, and if it snaps, just go get another one! Always a donor.
cjmx
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2/6/2018 7:30am Edited Date/Time 2/7/2018 6:04am
RCMXracing wrote:
Get it fixed. The longer you wait the worse if there’s swelling. That can lead to arthritis and obv more injuries. If your Dr. is recommending...
Get it fixed. The longer you wait the worse if there’s swelling. That can lead to arthritis and obv more injuries.
If your Dr. is recommending a Patella graft he hasn’t progressed. That’s 90’s Tech. Hamstring autograft, OOOR....I have heard technologies have progressed with how a cadaver ligament is “cleaned”. Methods when I had my knee done (2010) to strip the bio footprint caused them to be weak.
The hamstring will grow back eventually, Patella will NEVER grow back. My knee with hamstring autograft is considerably more tight and stable than my stock knee...I did have a weaker hamstring that was noticeable with the tension of knee brace straps when putting foot back and forth from brake to peg. I was riding at the 4 month point BTW. I didn’t do anything special to strengthen hammy and it was a few years before it became a non-issue.
P.S. This might be the worst place to ask for advice next to ThumperTalk. Pinch
MDMCG wrote:
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital...
This is not true. Patellla grafts are the standard for all athletes. NFL, Soccer, US ski team, etc. I work at a world renowned ortho hospital and send people to the OR daily. Cadaver grafts have about 75% strength. Patella is over 90% when compared vs native ligament. Get a good surg on and get the right graft,

Come to the Steadman Clinic if you want it done right.



The Hamstring tendon may or may not regenerate.

MDMCG please support your reference of an allograft only having 75% of the strength? I'm curious of current research supporting that statement. I remember reading several articles stating after the first few months the allograft tensile strength is actually as strong as an autograft.

Wasn't Steadman himself mainly using cadaver grafts for ACL repairs before he retired? I thought that's what my wife stated when she did her residency there.

My left knee was done 3 years ago with a cadaver graft. My right knee 15 years ago with the hamstring graft. My hamstring is weaker on my right knee where the graft was taken from. Not an issue but it is noticeable when lifting weights. Other than that I have no issues with the hamstring graft acl repair. At the time I choose the hamstring graft because of research regarding arthritis with the patella graft.

The left knee with the cadaver graft has no issues. Yes, the sterilization procedures have gotten a lot better resulting in less failures. This was a big decision in choosing a cadaver. Also, my age played a huge factor in deciding...I was 40 at the time of surgery.

Dirtbikekid, using a autograft is creating a NEW injury to fix an existing one. Discuss with your DR and decide with them what your best option is. Most DR's have their go to graft and will recommend that one. If you're not comfortable or they're not taking the time to answer all your questions, get a second opinion.

jbrass715
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2/6/2018 8:06am
I just tore my ACL completely on 10/19/17. Had surgery 12/28/17 with using my Quad tenden because dr said it was the larger tenden to replace with. Minus the first couple days after surgery, really haven't had much pain. Was told recovery time in the 6 month range, already feel like i can ride again, just waiting on dr to release me. They have came a long ways on surgery procedure and rehab over the last decade. I would rec having a joint specialist do the surgery, I believe that is the biggest plug side to my surgery experience.
DirtBikeKid46
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2/6/2018 9:46am
I'm not sure I'm defined as an "athlete" and need the strongest graft, but I could be wrong. I take my health and fitness seriously, ride...
I'm not sure I'm defined as an "athlete" and need the strongest graft, but I could be wrong. I take my health and fitness seriously, ride dirt bikes, ski every so often and enjoy mountain bikes. Lots of home and yardwork...think cadaver could work well for me?

Like the idea of not having a graft harvested from me but then again, don't like the idea I could get some sort of disease ('s), cancer etc from a cadaver. Even though the odds are low....
RCMXracing wrote:
You make a good point, you’re not cutting lines at 100mph on a giant slalom course or carrying a football in the NFL, BUT Moto is...
You make a good point, you’re not cutting lines at 100mph on a giant slalom course or carrying a football in the NFL, BUT Moto is gnarly. Watch that old slow mo of Tomac wheeling through the whoops at Daytona on his Honda...watch the forces on his knees. Yeah, least invasive, quickest recovery would be the Cadaver. Hey, and if it snaps, just go get another one! Always a donor.
I love that slomo vid of Tomac, so smooth! Yea, it is gnarly on your whole body. Funny thing is, while researching I wrote off the cadaver quickly but now it's starting to make me take another look. lol, hopefully I won't need another but next up is looking into braces. I've seen several (some here on this post) where the braces did nothing for their ACL injury...
DirtBikeKid46
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2/6/2018 9:49am
cjmx wrote:
The Hamstring tendon may or may not regenerate. MDMCG please support your reference of an allograft only having 75% of the strength? I'm curious of current...
The Hamstring tendon may or may not regenerate.

MDMCG please support your reference of an allograft only having 75% of the strength? I'm curious of current research supporting that statement. I remember reading several articles stating after the first few months the allograft tensile strength is actually as strong as an autograft.

Wasn't Steadman himself mainly using cadaver grafts for ACL repairs before he retired? I thought that's what my wife stated when she did her residency there.

My left knee was done 3 years ago with a cadaver graft. My right knee 15 years ago with the hamstring graft. My hamstring is weaker on my right knee where the graft was taken from. Not an issue but it is noticeable when lifting weights. Other than that I have no issues with the hamstring graft acl repair. At the time I choose the hamstring graft because of research regarding arthritis with the patella graft.

The left knee with the cadaver graft has no issues. Yes, the sterilization procedures have gotten a lot better resulting in less failures. This was a big decision in choosing a cadaver. Also, my age played a huge factor in deciding...I was 40 at the time of surgery.

Dirtbikekid, using a autograft is creating a NEW injury to fix an existing one. Discuss with your DR and decide with them what your best option is. Most DR's have their go to graft and will recommend that one. If you're not comfortable or they're not taking the time to answer all your questions, get a second opinion.

Have you heard much about the new sterilization procedures with cadavers & transmission of diseaeses? That's one thing that scares me and obviously the tear rate. I'll do some more current research on that.

CJMX, do you recall how much more pain and rehab was needed between your two knees using the different grafts?
DirtBikeKid46
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2/6/2018 9:51am
jbrass715 wrote:
I just tore my ACL completely on 10/19/17. Had surgery 12/28/17 with using my Quad tenden because dr said it was the larger tenden to replace...
I just tore my ACL completely on 10/19/17. Had surgery 12/28/17 with using my Quad tenden because dr said it was the larger tenden to replace with. Minus the first couple days after surgery, really haven't had much pain. Was told recovery time in the 6 month range, already feel like i can ride again, just waiting on dr to release me. They have came a long ways on surgery procedure and rehab over the last decade. I would rec having a joint specialist do the surgery, I believe that is the biggest plug side to my surgery experience.
I heard the quad was a very viable option and quite strong. Good to hear yours went so well! How old are you jbrass715?
cjmx
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2/6/2018 10:36am
Have you heard much about the new sterilization procedures with cadavers & transmission of diseaeses? That's one thing that scares me and obviously the tear rate...
Have you heard much about the new sterilization procedures with cadavers & transmission of diseaeses? That's one thing that scares me and obviously the tear rate. I'll do some more current research on that.

CJMX, do you recall how much more pain and rehab was needed between your two knees using the different grafts?
I forget the exact numbers, but HIV was around 1 in a million. Hepatitis was half that. The numbers may be better now. Great questions for your DR.

Allografts use to be sterilized with ethyl oxide, which weakened the graft. This is no longer used. Now they use gamma radiation.

The only difference in pain was after the surgery. The allograft surgery they used a nerve block which was great. You don't feel anything for 12 hours or so. Definitely request it! Rehab was simpler with the cadaver knee because I knew what to expect and my knee was a lot better going into the surgery. I waited a while for surgery, strengthening the knee and getting back full range of motion. It was a lot easier for me to get the range of motion back before surgery than after.

jbrass715
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2/6/2018 10:44am
I heard the quad was a very viable option and quite strong. Good to hear yours went so well! How old are you jbrass715?
28 and over weight lol. Doc said the tendon strand can be up to 10mm thick and it what the strongest for repair. I also believe therapy has went very well with it
12/2/2018 1:45pm
Lots of experience here! It sounds like a lot of the knee injuries are from planting your foot. I race woods, but I'd be interested to hear some of your opinions on these questions:

1. Obviously, wearing a brace is important but does anyone have any recommendations on how to avoid knee injuries while riding?
2. Do you think the Asterisk brace with the tether (attaching the boot to the brace) adds significant protection from rotational injuries over other braces? What's you favorite brace?
3. What percentage of amateur racers do you think get these types of knee injuries we're talking about?
Marty1028
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12/2/2018 6:33pm
brimx153 wrote:
everyone saying not getting an acl fixed will lead to arthritis . have to remember that getting it fixed will also prob lead to getting arthritis...
everyone saying not getting an acl fixed will lead to arthritis . have to remember that getting it fixed will also prob lead to getting arthritis .doctors are very spilt at the moment on this .years ago every doctor would tell you to get it fixed .now alot of doctors will talk you out of getting it fixed . ie .i was lucky to get mine fixed by a one of the most well know doctors in the world for fixing acls .he does not have an acl in his right knee the last 10 year s .its not as easy as saying just get it fixed ! depends on the person and the knee.


i remember the nurse telling me , the doctor was kind of famous for fixing all the top soccer stars in europe . and how he got so good was because he worked in Belfast in the 80 s .when the IRA were knee caping loads of people . so he had to come up with new techniques for fixing knees
It does lead to arthritis. Tore mine in my left knee back in may of this year. Immeadiately after i tore it i was limping for a day then i walked, worked, and continued to ride on it for 6 months. The only reason i decided to get it fixed was that it popped out and i would fall on my ass at random. Also was sore 24/7, still kinda is actually. Had it repaired in september and now i just got cleared for golf and full weight room participation. After the op the knee hurt worse than when i broke my femur in my right leg. Even with a nerve block (even though i dont think it worked) and pain killers. And also keep in mind with the arthitis part im only 16.
tk2stroke
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12/2/2018 7:15pm
Man you guys are awesome, great to hear your stories and the way you got it repaired. Hey, the way I look at it is I...
Man you guys are awesome, great to hear your stories and the way you got it repaired. Hey, the way I look at it is I research the hell out of aftermarket parts for my bike...damn right I'll do it for my body!

Had my first day of physical therapy tonight, cute girl stretched me all out. My insurance for PT blows and costs $80 a session so can't imagine I'll be going too much and need to work my ass off at home.

I'm restricted to a certain mile radius with my insurance so I need to stay with a doc around the Philadelphia area.

Hardest decision at this point is which graft to get. Are any of you Patella guys experiencing any pain on your knees when kneeling down?
I'm 18 weeks post op on my ACL right now and I went with the cadaver graft. While the patella graft may be the gold standard and best for young bucks, My doc and all the research I did showed the cadaver is just as succesful for 40+ year olds. Then when taking into consideration that the rehab for a cadaver is the easiest and least painful, the choice was pretty easy.

Dean Wilson had his 3rd ACL surgery earlier this summer and he chose the cadaver graft for his latest surgery and he was back on the bike in 4-5 months.

While you have the trifecta, in my case I had a very slight torn meniscus and ruptured ACL. The surgery itself was fast and actually painless. I had a nerve block during surgery and went back the next day for another 24 hour block. After 48 hours and the nerve block wearing off I still encountered a pain level of zero and only took the meds for the first 72 hours.

Regarding recovery: The hardest part of recovery is not being able to do your normal hobbies for such a long duration of 6 months. Overall the surgery and recovery was much easier and painless than expected.

- On the 3 day I was already applying pressure while hobbling around as encouraged by the doctor.
- 7-10 days walking around with a good limp
- 4 weeks: Walking mostly normal
- 6-8 weeks fully normal walk (Fully normal household activities return)
- 12 weeks: Able to jog lightly but not with any grace
-16-18 weeks: My normal jogging stride has returned and I can go 2-3 miles. Running is not an option yet.
- +18 weeks: We'll see

I can't stress enough how how critical rehab and leg weight training is. As a hyper active person, early on I assumed that my knee would return to full strength through my normal daily routine as most injuries have heeled for me in the past. It became very clear after 10-14 weeks how weak my knee was compared to my good leg and that I would have to get much more serious and committed. It's not the ACL that feels weak, it's all the muscles around the knee from surgery that require committed rehab. Since the 12ish week mark I started rehabbing my knee every day at home, in the gym or at PT. Since then the improvement is significant and I can see very measurable increases in leg strength, but it's also obvious that I will have to continue to rehab hard every day in order to get back on the bike at 6 months, and even then I highly doubt it will be anywhere near 100% strong.

Good luck, it's not that bad and IMO necessary if you want to live an active lifestyle
1
Timo_2824
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12/2/2018 8:29pm
I'm not trying to scare anyone, but another thing to keep in mind is that no surgery is minor. My sister in-law had her ACL repaired and meniscus cleaned up in the middle of October. On thanksgiving day she past away from a blood clot that had broken free and caused a pulmonary embolism. If you start getting any of the classic signs of a heart attack within a couple months of surgery, you need to go to the ER. She was having signs for 3 days before finally going to one of those neighborhood clinics because she didn't want to pay for a ambulance or ER trip. They wasted 3 hours before figuring out what was going on, she died before they got her in the van to transport to the actual hospital. She was on hormonal birth control which may have been part of the clot, but I've just found out that my brother in-law had an uncle who also died of a pulmonary embolism after an ACL surgery. It happens more often then I thought.
tk2stroke
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12/2/2018 9:08pm
Timo_2824 wrote:
I'm not trying to scare anyone, but another thing to keep in mind is that no surgery is minor. My sister in-law had her ACL repaired...
I'm not trying to scare anyone, but another thing to keep in mind is that no surgery is minor. My sister in-law had her ACL repaired and meniscus cleaned up in the middle of October. On thanksgiving day she past away from a blood clot that had broken free and caused a pulmonary embolism. If you start getting any of the classic signs of a heart attack within a couple months of surgery, you need to go to the ER. She was having signs for 3 days before finally going to one of those neighborhood clinics because she didn't want to pay for a ambulance or ER trip. They wasted 3 hours before figuring out what was going on, she died before they got her in the van to transport to the actual hospital. She was on hormonal birth control which may have been part of the clot, but I've just found out that my brother in-law had an uncle who also died of a pulmonary embolism after an ACL surgery. It happens more often then I thought.
Very good point and this alone was my biggest fear. Wearing the compression stockings is a must to help prevent clots.
milamcreek
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12/2/2018 9:31pm
There is a lot of good advice from several members. I as well as many others have experienced this same injury the terrible triad.
Before you make your final decision take note.
I have torn my acl in my left knee 4 times.
3 surgeries. First surgery in Frisco tx patella, rehab etc.
Injured again shortly after 2nd surgery hamstring, rehab began riding.
Reinjured 8 months later.
3rd surgery combination right leg patella along with right hamstring wound together tight. Limited problems for 7 years and 3 weeks ago destroyed again. Surgery is a quick fix, will not ever be right physically and mentally. If you are turning pro fix it. If not rehab and strengthen it, will work fine. If I had it all to do over again would not have fixed the first time and would have just rehabed it.
That is my course of action now.


WFO
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Terrell, TX US
12/4/2018 10:50am
Had both my knees done. Left was completely blown out and folded back over the bars and toe hit me in the goggles. Probably the most painful thing i've ever felt. Made several people sick that were there. Tried to come back with no surgery and was playing hoops with friends and it did the same thing. Made people sick again. Had that repaired using my Patella (uncommon now) also did epidural. Took me 3 days just to feel below my waist. Almost a year re-hab. Other knee snapped the acl when I thought my name was McGrath and came down on the leg before the tires hit the ground. Another Patella graph and did general. Much better on recovery and out of hospital same day. Re-hab was 6 months (I pushed it) and knee took over a year to feel right as opposed to the longer re-hab. At 59 I ride at least 2x a week but only off-road. No more moto. Knees are fine. Worry more about my brain, You're only as good as your re-hab, and you can write that down!
bb252
Posts
56
Joined
2/12/2017
Location
Bartelso, IL US
12/6/2018 9:52pm
I've done 3 acls, two right one left. First was patella second hamstring, third was the left and I tried to go without fixing it. Made it about a year before tearing meniscus. Then got the surgery with the replacement from the quad. This knee was damaged the worst I was the oldest but it has healed the fastest and I am most confident in it.
That being said knees are definitely a case by case thing everybody's body heals differently. Good luck! It's a shitty surgery...
12/9/2018 11:36pm Edited Date/Time 12/10/2018 1:05am
If a building is designed for a column to take 30% of its load, and that column fails, what happens to the load? It goes elsewhere and overloads other parts of the structure. The same with your knee. They can repair a torn ACL very reliably. They can not repair meniscus damage reliably at all. Once you get to that point, it is too late.

There are always stories of the lucky few, who's knees were so naturally strong that they could function and ride without an ACL. They are the lucky ones. 90% of people who do not get it repaired go on to regret it. Don't be in the 90% because you think you might be in the 10%.
2
12/10/2018 12:58am Edited Date/Time 12/10/2018 1:11am
Man you guys are awesome, great to hear your stories and the way you got it repaired. Hey, the way I look at it is I...
Man you guys are awesome, great to hear your stories and the way you got it repaired. Hey, the way I look at it is I research the hell out of aftermarket parts for my bike...damn right I'll do it for my body!

Had my first day of physical therapy tonight, cute girl stretched me all out. My insurance for PT blows and costs $80 a session so can't imagine I'll be going too much and need to work my ass off at home.

I'm restricted to a certain mile radius with my insurance so I need to stay with a doc around the Philadelphia area.

Hardest decision at this point is which graft to get. Are any of you Patella guys experiencing any pain on your knees when kneeling down?
tk2stroke wrote:
I'm 18 weeks post op on my ACL right now and I went with the cadaver graft. While the patella graft may be the gold standard...
I'm 18 weeks post op on my ACL right now and I went with the cadaver graft. While the patella graft may be the gold standard and best for young bucks, My doc and all the research I did showed the cadaver is just as succesful for 40+ year olds. Then when taking into consideration that the rehab for a cadaver is the easiest and least painful, the choice was pretty easy.

Dean Wilson had his 3rd ACL surgery earlier this summer and he chose the cadaver graft for his latest surgery and he was back on the bike in 4-5 months.

While you have the trifecta, in my case I had a very slight torn meniscus and ruptured ACL. The surgery itself was fast and actually painless. I had a nerve block during surgery and went back the next day for another 24 hour block. After 48 hours and the nerve block wearing off I still encountered a pain level of zero and only took the meds for the first 72 hours.

Regarding recovery: The hardest part of recovery is not being able to do your normal hobbies for such a long duration of 6 months. Overall the surgery and recovery was much easier and painless than expected.

- On the 3 day I was already applying pressure while hobbling around as encouraged by the doctor.
- 7-10 days walking around with a good limp
- 4 weeks: Walking mostly normal
- 6-8 weeks fully normal walk (Fully normal household activities return)
- 12 weeks: Able to jog lightly but not with any grace
-16-18 weeks: My normal jogging stride has returned and I can go 2-3 miles. Running is not an option yet.
- +18 weeks: We'll see

I can't stress enough how how critical rehab and leg weight training is. As a hyper active person, early on I assumed that my knee would return to full strength through my normal daily routine as most injuries have heeled for me in the past. It became very clear after 10-14 weeks how weak my knee was compared to my good leg and that I would have to get much more serious and committed. It's not the ACL that feels weak, it's all the muscles around the knee from surgery that require committed rehab. Since the 12ish week mark I started rehabbing my knee every day at home, in the gym or at PT. Since then the improvement is significant and I can see very measurable increases in leg strength, but it's also obvious that I will have to continue to rehab hard every day in order to get back on the bike at 6 months, and even then I highly doubt it will be anywhere near 100% strong.

Good luck, it's not that bad and IMO necessary if you want to live an active lifestyle
Stop listening to sales pitches and read the studies yourself:

https://www.dropbox.com/s/2a7j2tz6u3aikpq/Graft-Selection-in-ACL-Surger…

If you have a straightforward ACL tear, your repair options are pretty straightforward (PTG, Hamstring, Cadaver), and the pluses and minuses are easy to evaluate. Unless you are an idiot, you really do not need a Doc to determine what is best for you. Read the studies, learn the lingo, determine what is best for you. THEN go find the doc that is the best available to your at doing THAT procedure. This is backwards from what most people do.

Most people do not realize that when they select a Doc, they are selecting a procedure...they just do not know it at that time. The Doc you choose already has his way of doing things, and he is going to talk you into his way. That is the way it works.

If you are OK with Cadaver...get a Doc who does those a LOT. If you want to go PTG...get a guy who does a LOT of PTGs. This is absolutely critical with PTGs, as they take more skill and experience due to the mechanics of bone plug seating and graft length in the tunnel.

Personally, the downsides of a PTG were not downsides to me (more pain...eh...who cares. Kneeling pain...eh...I do not lay tile or roofing... Tough rehab....eh....I can do it.) but the plusses were a huge deal. To me...the choice was obvious...B2B PTG. You may have different priorities.

Once I determined I wanted a PTG BTB graft, all that was left was to find a doc that had done a LOT of them (at the time I had my knee done...he had performed over 3000 BTB PT Autografts...) and he was damned good at them. I also had the donor material taken from the opposite side, which really helps with re-hab by spreading our the surgical trauma.
1
12/10/2018 5:06pm
I snapped my right ACL in a high side MX crash off a jump back in 1986 - aged 20 racing in Icey conditions was a mistake

I never had it fixed, It has caused me a few problems over the years with stability particularly if I plant my foot & twist my knee it can partially come out of joint & be painful.

You have to alter your ways of doing things, stance, twisting etc, however on the bike was pretty good once my muscles built up, I raced motocross for years after only stopped doing Vets in 2010 wearing Pod knee braces & when correctly fitted they worked wonders, Thankfully I still have no pain in my knee or arthritis symptom's aged 52 now.

Ime not going to have it fixed any time soon unless I have to.
RCMXracing
Posts
847
Joined
8/10/2011
Location
N., TX US
12/10/2018 8:16pm
This is a regen thread started back in Feb 2018.

So @dirtbikekid46 what did you end up doing? How is the knee?

Post a reply to: Torn ACL - to repair or not?

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