Please educate me.
I did not stick the landing a week ago when I made an ill-advised jump.
A horrible series of crackling noises issued from my leg as it collapsed under me upon landing. I have since seen an ortho, who believes I’ve completely torn my ACL in one knee. I’ve had the MRI, and go to discuss results/options on Friday with him.
If I understand correctly thus far, I have 2 options.
1) correct with reconstructive surgery.
2) attempt to rehab and modify my lifestyle to accommodate this new defect.
I am walking far more comfortably than I was initially (+1 week out), and I suspect the swelling will eventually go down in my knee and ankle, if I just stay off the leg more.

I’m not a super athlete by any means, and the surgery sounds painful (drilling through bones to reattach something they take from somewhere else on me or from a cadaver). OTOH, I’m accustomed to being unlimited in my physical activity, the surgery is a day procedure, and 6 weeks healing. I’m not a spring chicken, but not old yet, either.

Any advice from folks who’ve been at this crossroads?

Thanks for any insights.

I tore my ACL around 1991 but, being a 21 year old, I didn't know what had happened. Yeah, it was the most intense pain I've had for 15 minutes but then I was able to get up and walk fine...sure, pretty sore still but could walk. No problem. For the next year or so every time I made a lateral move my knee would buckle and I get the pain again. Sitting on the edge of a desk swinging my legs and the knee would pop out. I wasn't an athlete...just kind of trying to function.

It wasn't until almost 2 years later I talked to another guy who showed me the huge (18") scar on his knee and he told me, "Oh yeah, you tore your ACL". I got the surgery, rehab was annoying, but I laugh at how small the scars are today and how quickly you can rehab.

Get the surgery if you can afford it monetarily and with your schedule.

i am sorry to hear that Irr. I am a sports fan and ACL tears are very common. Andrew McCutchen a coupled of days ago.

Surgery is always the fix and these guys and gals always come back great. So surgery it is as far as I can tell. Do the rehab after the surgery. You will be pretty much as good as new. Don't sweat it. Pretty common these days.

I'm currently dealing with a grade-I near II MCL sprain. I initially feared it was a ACL tear as the damage was in that area of the knee; luckily no surgery necessary. Just a lot of RICE = Rest, Ice, Compression, Elevate.

I'd get the surgery, modern medicine has evolved to the point where Sports Medicine is it's own sub-category. Without surgery, you'll suffer from instability and occasional buckling, if you're active and mobile, such incidents will get very tiresome. The techniques and rehab methods for knee repair are far advanced these days, there's been a lot of advances over the last 30-years. I would recommend getting a Incrediwear compression sleeve, the one I've worn for my previous major knee injuries have helped recovery and support much better than anything else I've tried.

You need to get it fixed, no amount of strengthening or rehab is going to keep the knee as stable as it should be unless you get it fixed.

With the torn ACL, you are at a high risk for damaging your meniscus (if you haven’t already) once that’s gone it’s bone on bone.

It will take ~ 1 year to get back to where you were before surgery, getting muscle built up, flexibility, mobility, confidence but you aren’t going to be able to do any of that until you actually get it fixed.

Getting injuries like that is a tough pill to swallow but there’s no shortcut, I shattered my ankle ~ 19 months ago and was asking for advice here on sigforum while waiting for the med evac. It’s a bitch but you need to get it fixed.

Tore mine in high school football back in the early 70s. Played 3 more games with the torn ACL and the torn meniscus along with it.
The meniscus was cut out (this was the 70s after all) and the ACL was ignored.
The fix was a grafted ACL about 15 years later.

I’ve heard that the best outcomes are with folks that have a “pussy” level pain threshold. (hearsay from friends and partly my experience)
I pushed mine so hard that the doc almost crapped himself seeing me do a one leg drop and push up with the repaired knee. This was at the first post-op visit where he was going to tell me to start using *one* crutch...I had stopped using any a week prior. He was NOT happy.

Ask what they want you to do and follow their directions.
They know a LOT more more now than ‘way back when’ and you should have a good outcome.

Thanks, you guys. I really appreciate your input.

The doc I’m seeing tore his own ACL and never had it repaired- and he skies. So I hadn’t even realized there might be a chance without surgery.

As with most folks, I’m sure, I hate being dependent, I hate to take pain meds, I hate surgery, and have managed to avoid most of that thus far in my life. Pisses me off that something as simple as a poorly landed jump fucked up my knee so badly.

The tear isn't anything, wait til you wake up from surgery. The tear you can live with, but you won't function right. Get the surgery. They screwed mine up somehow. Had to go back a get it drained three times with the largest needle I've ever seen. I still have nerve damage and pain 5+ years out (not typical).

On the bright side, I now have a new definition of '10' when the doc asks on a scale of 1-10 how much does it hurt. So Happ my wife is so awesome, she got me through it.

PS I'm pretty sure all of the rehab ladies get pleasure out of torturing their customers.

quote:

...
1) correct with reconstructive surgery.
2) attempt to rehab and modify my lifestyle to accommodate this new defect. ...

I was in a similar boat in my late teens and 20's...

1) YES & YES. They would take a ligament and create a new ACL. You won't tear up your joint, cartilage, etc. up any further than the original injury.

2) Found via arthroscopy that I had a tear, not complete, in my ACL. Told to stop playing soccer for a few months, etc. Did exactly what they told me. Many months later was playing soccer again and something felt "funny" in my knee. Did not think much of it because it did not knock me down like the first time nor did it hurt.

Advance about 7 years and found a bump sticking out from my knee that locked the joint. Via arthroscopy found my ACL was totally gone, had completely atrophied, rebuild was not possible, so they cleaned up the joint from loose cartilage.

So for the next 25+ years I lived with "bone on bone" in that knee. It finally reached the point wherein I needed an artificial knee.

Long story short, have it rebuilt RIGHT NOW while you can.

Do the repair surgery
Get a Breg Kodiak ice pump (amazing)
Do the PT

Don't look back
8 years later, it is my best knee

Take a look at this study (link below). They did a study to compare immediate surgery with rehab vs immediate rehab then surgery if indicated. Gist of the study was that the ones who did rehab initially followed by surgery when indicated did a little better with respect to associated meniscal tears.

https://www.nejm.org/doi/full/10.1056/NEJMoa0907797

There's another study somewhere that was published in the same journal, compared young fit people who got rehab only to less fit couch potato or older types who got the surgery. Do not recall all the details, but the summary was that rehab in the young folks did as well as surgery in the others. Sorry, no linky on that one.

Get it fixed...plain and simple.

Been there, done that ... might as well get it fixed now as your aggregate pain and misery will only increase if you put it off. Ask me how I know...

Good luck, it's not a quick or easy rehab.

My son injured a knee playing college football sophomore year. His ACL, PCL, and I can't remember if the third was the MCL or LCL were torn. The surgeon used most of his patella tendon to replace his ACL because it would be stronger than a cadaver's ligament. He did rehab and had a very painful recovery. If he hadn't have had the surgery, he would have been severely limited in his physical activity.

The beginning of his senior year, as he was running down the field and tried to change direction, he felt pain and knew he tore the same ACL as before. This was while wearing a prescribed brace. He had surgery a second time and had to hang up football. He is still active but doesn't participate in sports anymore.

The long and short of it is, once it's injured it will be much easier to re-injure it no matter what you choose to do. The severity of the tear and your lifestyle will determine the best course for you and what you will be able to do afterward.

Wishing you the best outcome possible.

[quote]The long and short of it is, once it's injured it will be much easier to re-injure it no matter what you choose to do.

i disagree. It depends of a lot of factors. Many have surgery and never have issues again doing the same level of activities as before. Just cannot make a blanket and throw over everyone.

Tore mine in 2010 skiing. @mos later had the sx, used my own hammy tendon. I have a 3in scar on the from of my lower leg belt the knee where they took the tendon. The 4 1/4in scars where they used the arthroscopic tools. I was in pt grinding away at it 2weeks post op.
Here's my tip, get in the best shape before you have it done, it'll make pt faster and less painful. Find a great pt. Someone said pay for the ice machine, yes. And move around as much as you can, and then more. The knee likes to move, even when it has screws in it.
I never took a high powered pain med, just ibus.

I was golfing 3mos out and skied no problems the next year.

Its a nothing burger, get it done.

I've torn both of my ACLs, one in 92 and one in 08. In 08 I also tore the meniscus and smashed the femur. I had both repaired. Used my own tissue instead of a cadaver. The first week post op sucks. After that, it's up to you. If you work hard and do the rehab, you will most likely get good results.

My mobility is not as good as it was, but I can still run a half marathon and generally do what ever I want. I notice cold weather hurts more than it once did.

I've never regretted having the surgeries. Only thing I can't do is ski.

If I was to distill my many years of knee injuries on an ACL I would get it repaired, without question. Some other parts do well on their own (I think MCL was mentioned above), but not your ACL.
Since in my own case they couldn't assure me the cadaver part was from an NFL player and not a 90yo I used my own. But that you should reason out for yourself as its a double edged sword...
But get it fixed.

Surgery is always scary however in this case, just get it done and repaired. Do the PT, get better and move on in your life and be careful. God Bless

quote:

Its a nothing burger, get it done.

Not for me. Six years out and I still hurt, have nerve damage/numbness/tingling. I used a very highly regarded surgeon too. Not sure if it was bad luck, bad genetics, or bad doctor.