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  #21  
Old 12.12.2011, 07:28
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Re: Knee operation - Advice and stories

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My question to everyone is:
"Is it worth taking the surgery option now, and forfeit another year of activity?
or take the punt and risk further damage?"
Well, my first question is, did you have instability before you had the meniscus surgery? B/c if so, there is the first problem. And if not, did you feel that you fully recovered from that before doing "crazy" activity (I know you, so I can ask that )? And maybe we need to talk about this outside of the public forum, but how did the first surgery fail?

Regardless, I am sorry to hear this news for you. I have had two ACL reconstructions, one with meniscus tears, one without, as well as a third surgery for meniscus alone...all on the same knee. ACL recoveries were six months each and the meniscus was about six-eight week recovery. I fully recovered, each time, played collegiate athletics, ran a mountain (almost) marathon, etc. It has been 15 years since the first surgery, 13 years since the second, and almost 10 since the last. Was it easy? No. It was awful...every time. And it is only a good idea if you are willing to work your arse off to fully recover. That is the hard part. It sucks, plain and simple. for months. It is definitely the most emotionally and physically draining thing I have ever done. And you have to keep tough, not feel sorry for yourself (too often), and keep the goal in mind... Only you are responsible for your recovery.

Again, we may need to talk about this more extensively, but my advice is that if you are extremely active, to the point that most of your general activity requires stability in your knee, then you should have the surgery now. I am very surprised at the 12 month recovery number but that must mean there are other complications that you aren't mentioning (or you aren't talking to the right doctor(s)). Most ACL recoveries are 4-6 months (depending on your drive and general health) with maybe the first month (max) on crutches. Again, that is for another discussion.

Since you have been doing PT, maybe this isn't an option, but if you are seriously opposed to surgery, try to build up your hamstrings significantly. I know plenty of people (men especially, and for physiological reasons mainly), that don't have ACLs b/c they have been able to create equality with the muscles in the front and back of the leg. Thus, you minimize the instances of the knee "giving out" (b/c you have strengthened everything around the knee) and the fact that you don't have a stabilizer in your knee doesn't affect you as much b/c there isn't the muscle imbalance pushing the instability during activity.

I wouldn't worry about the "more damage" point. Once the ACL is gone, it is gone. It will affect you if you are active. You heal easier when you are younger...thus, if you are ever going to have the surgery, have it now. And make sure you have someone to take care of you. YES, you will NEED that. full stop.

Oh, and get the good drugs.

Take a bit of time making this decision. And let me know if you need more from me.
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  #22  
Old 12.12.2011, 14:29
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Re: Knee operation - Advice and stories

Thanks for everyone's input so far. All the stories from every have really helped to give me some insight.


I guess my only 'pet peev' here (not worthy of another thread by Grynch) is that for 7 MONTHS nobody diagnosed the ACL as damaged in the first place.
In fact, the surgeon didn't even say it was. He said it is "Thin and worn out, and this is what is causing the knee instability"
.............. on one hand - Why couldn't this have been picked up before?
but on the other
I'm glad it wasn't operated on by the last bloke.

FYI - I am on my way to collect ALL past MRI's and will arrange another meeting with both the doctor and surgeon for an 'AS IF' analysis:
what would have done here knowing this now?

I guess my big issue is that, I really need to be moblie until at least March....... and then, I don't want to be busted up for the summer
....... but there is no good time for this sort of thing I guess.
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Old 12.12.2011, 14:37
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Re: Knee operation - Advice and stories

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Well, my first question is, did you have instability before you had the meniscus surgery? B/c if so, there is the first problem. And if not, did you feel that you fully recovered from that before doing "crazy" activity (I know you, so I can ask that )? And maybe we need to talk about this outside of the public forum, but how did the first surgery fail?
Well, was the knee unstable?
If it was, it wasn't diagnosed.

I did damage the same knee a year prior to the accident, but surgery was 'close' but not recommended.
It that accident I damaged both cruiates and the meniscus..... strange but true.

12 months on and I was running 10km every second day with no problems, and then 'BANG'.

This led to the recent meniscus surgery in May which has not since recovered.

The new surgeon seems to think that the damage was misdiagnosed and too much meniscus was removed causing 'more' instability and further stressing an already weak, thin, and stretched ACL

He said the instability is very clear.

He operates on all the pro ice hockey players and footballers here........ but don't they all say that?

For some reason, I felt like I could trust this bloke.
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Old 12.12.2011, 14:39
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Re: Knee operation - Advice and stories

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I was expecting a few more responses on this
Hello...hopefully this might help...! I have had two arthroscopies on the same knee (left). The first was following some form of rupture while playing football in about 2001. The cartilage was torn and frayed (like the Stones song arf) and had to be trimmed. I think there was some excess floating around too.

Now...the surgeon at the time told me that I might it doing again in the future as the operation isn't often successful. Well, within about three months I was back playing football but I did severly cut back on the number of games I was playing (I had been playing four 11 a side games per week, plus training and five a side).

Then in about 2006 or 7 I noticed that my knee would 'pop out' and I wouldn't be able to move it unless I physically 'threw' it back into place with my hands. The pain was insane but doctors variously told me it was caused by the way I sit (I have a habit of putting one leg under me) but as time progressed it baceme much more common. Eventually, I managed to get a doctor to agree to take a look and because it was popping out every day by this point they agreed to operate.

The second surgeon told me that the doctor who said it 'probably wouldn't work' was talking nonsense and that if it's done properly, there would be no need for further surgery. Anway, I went for the second op in 2009 and since then, it's been fantastic. I was only out of action for about two months and, although I then moved to CH and stopped virtually all sports except swimming, I've not had the probelms I was having before.

I guess it comes down to one thing: if the pain or injury is preventing you from a lifestyle you would like, get the operation done. Yes it's time out but both times I've been very surprised by the recovery speed. I hope now to be op free for many many years!
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Old 12.12.2011, 15:03
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Re: Knee operation - Advice and stories

Make sure you get a good surgeon if you decide to go for it! with lots of experience and who operates on a regular basis. i could recommend Crossklinik, all doctors and physios are very sporty there themselves and a lot went through similar experiences themselves!
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Old 12.12.2011, 15:35
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Re: Knee operation - Advice and stories

Never an easy option. I snapped my ACL and missed last years ski season. I took the surgery option - and am feeling stable now. I used Dr Berbig - who made a "great save" on my knee (I think he used to be a former Swiss goalkeeper). I would recommend him. Skiing this year, also started up sqaush again - feeling stable ....
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Old 12.12.2011, 15:47
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Re: Knee operation - Advice and stories

Check this therapy system out before you go get operated on:

Spiral Dynamics

It's not the same as the English description for Spiral Dynamics which sounds like a load of psychological humbug. The link is for physical therapy and readjustment of ones bone structure and balance. There is a clinic in Zürich, a few of the medical insurance companies also pay for it (including Sanitas).
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Old 12.12.2011, 22:30
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Re: Knee operation - Advice and stories

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Well, was the knee unstable?
If it was, it wasn't diagnosed.

I did damage the same knee a year prior to the accident, but surgery was 'close' but not recommended. It that accident I damaged both cruiates and the meniscus..... strange but true.

12 months on and I was running 10km every second day with no problems, and then 'BANG'.

This led to the recent meniscus surgery in May which has not since recovered.

The new surgeon seems to think that the damage was misdiagnosed and too much meniscus was removed causing 'more' instability and further stressing an already weak, thin, and stretched ACL

He said the instability is very clear.

He operates on all the pro ice hockey players and footballers here........ but don't they all say that?

For some reason, I felt like I could trust this bloke.
What I meant was, did you feel unstable? A lot of times, the docs can't diagnose that...only you can tell how you feel with something like that. Besides, what you describe, the "BANG", is usually indicative of a catastrophic injury, not just a meniscus tear. Also, if you have had more "accidents" (as you describe), the damage is probably relatively old and you have just been living with it and able to "work around it", so to speak.

So the diagnosis of the new surgeon sounds right to me. The idea that the last surgeon missed the major problem, and then removed too much meniscus would definitely make the instability more prevalent...thus, it would expose the real problem with the ACL. The real question is, do you really trust this doc? If so, that is all that matters. If not, you need to find someone you do trust. You want to have faith in the doctor who is opening you up.
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Old 13.12.2011, 11:49
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Re: Knee operation - Advice and stories

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What I meant was, did you feel unstable? A lot of times, the docs can't diagnose that...only you can tell how you feel with something like that. Besides, what you describe, the "BANG", is usually indicative of a catastrophic injury, not just a meniscus tear. Also, if you have had more "accidents" (as you describe), the damage is probably relatively old and you have just been living with it and able to "work around it", so to speak.

So the diagnosis of the new surgeon sounds right to me. The idea that the last surgeon missed the major problem, and then removed too much meniscus would definitely make the instability more prevalent...thus, it would expose the real problem with the ACL. The real question is, do you really trust this doc? If so, that is all that matters. If not, you need to find someone you do trust. You want to have faith in the doctor who is opening you up.
I guess I have never really felt 'unstable'.
I'm not even sure what an unstable knee should feel like. It's more of a case of constant swelling and pain.

The fact that the knee has progressively felt worse, and even sport has been limited by this suggested to me that something was wrong.

The recent surgery failed to restore the knee, so where I was convinced that perhaps the last surgeon had 'done something wrong' (and in fact, he had, but this is a different story), I now know (or am led to believe) that there has always been a pre-existing injury causing the pain.

To tell you the truth, I really just don't know who to believe or trust.
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Old 13.12.2011, 21:56
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Re: Knee operation - Advice and stories

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...
To tell you the truth, I really just don't know who to believe or trust.
So just as a last comment on my part (at least on the forum), you need to figure out what you do believe and what is important to you. If you have done extensive PT and have no relief, that means either surgery is necessary (unfortunate but true) or that you are going to make a "lifestyle adjustment", where you minimize activities that cause all the pain and swelling.

If no doctor has made you feel comfortable enough for you to let him/her open you up, then find one that does...and perhaps prepare yourself (mentally and emotionally) for having surgery. Once the decision is 100% made, there will be relief...for sure.
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Old 20.03.2012, 19:08
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Re: Knee operation - Advice and stories

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Never an easy option. I snapped my ACL and missed last years ski season. I took the surgery option - and am feeling stable now. I used Dr Berbig - who made a "great save" on my knee (I think he used to be a former Swiss goalkeeper). I would recommend him. Skiing this year, also started up sqaush again - feeling stable ....
Just to conclude this thread.......

I have in fact had the ACL surgery on the left knee, and did use Dr Berbig.

First impressions seem great.... but only the recovery and therapy will tell. (fingers crossed)


Thanks everyone again for your support and advice on the matter.
(I did read the thread again prior to surgery and it was helpful to confirm that I was doing the right thing).
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Old 20.03.2012, 19:32
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Re: Knee operation - Advice and stories

tore ACL last Autumn - told atleast 80% rupture, had physio 2 x per week, )and once a week since decision to do surgery) , still unstable tends to give way especially if child/dog etc knock into it, had a cpouple of painful slips in the snow, everytime I try to increase activity severe pain in knee, also still difficult to completely straighten leg without pain. Answer - having ACL surgery next week........
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Old 21.03.2012, 14:33
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Re: Knee operation - Advice and stories

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tore ACL last Autumn - told atleast 80% rupture, had physio 2 x per week, )and once a week since decision to do surgery) , still unstable tends to give way especially if child/dog etc knock into it, had a cpouple of painful slips in the snow, everytime I try to increase activity severe pain in knee, also still difficult to completely straighten leg without pain. Answer - having ACL surgery next week........
Good luck with that.

That sounds like an identical story to me.

I refused to believe I needed surgery and persisted with Physio for months.

The recovery was "up and down like a whore's drawers".... but mostly down.

I tried snowboarding this season, but I was limited to just one day every now and then with a 'VERY ordinary' performance.

Can't run
Can't ski
Can't do anything like before
........... Surgery was the only real option.


So far things are good.

After your operation you can expect the following:

1. NO use of your leg whatsoever, but the muscles will begin to respond in about a week.
2. Seemingly unexplained sharp pain in the lower leg and ankle. Try to stay still and on your back as much as possible.
3. Everything is difficult. You can't carry anything, so you will need help to perform the easiest of tasks...... and this takes forever.

HOT TIP:

Ring up your Physiotherapist NOW !!!

You will know when you are released from hospital, so arrange all your appointments now.
(this has been a nightmare for me, and this is the best tip I can give you for now).

The surgeon should supply an indication of the physio care, but if not.

Go for 2 times a week for a fortnight, then 3 times a week for a fortnight. (so that's 10 appointments).
In a month you will know what is best to do.

Good luck.
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Old 21.03.2012, 17:24
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Re: Knee operation - Advice and stories

good advice and what I expected. Staying in hosp for 5 days, and told will be able to slightly bend leg by the time I come out. Start physio 3 hours after operation! then twice a day each day I am in. Using kinetics machine etc whilst in hospital. Already have my physio appts for when I come out, so just need to get on with it now and hope for the best!!
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Old 21.03.2012, 17:47
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Re: Knee operation - Advice and stories

Well here is my experience -- When I was 27 I tore my ACL and MCL in a skiing accident. I was a very active soccer player also. The doctor advised me to take some time before considering surgery as sometimes the ligaments 'find themselves' and grow back together. The MCL 'found' itself, the ACL did not. At the time, my sister who was playing collage volleyball, tore her ACL and elected for the surgery to play again. Her experience frightened me so much I decided not to have the surgery. Her knee swelled up to twice its size and turned purple and stayed like that for a few years. Not only could she not play volleyball again, she lost full movement in her knee and 12 years later it still is swollen and pains her.

For me, not having surgery, it pains my only once in a while (just an ache really), but I completely had to be committed to changing my lifestyle. No more soccer or any sports with lateral movement. So I rode a bike. It gives out now and then when I am fatigued, but I can handle it. Not that I am 44, I'm glad I made the decision not to have surgery and am just as happy riding my bike. Maybe just think about your future and having to change your lifestyle and how much pain you are in. Just my experience.
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Old 21.03.2012, 19:04
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Re: Knee operation - Advice and stories

have to think positive thoughts, thankfully I know a number of people who have had it done with good success. I am fully aware I am atleast facing another 6 months of physio. But after falling a couple of times in the snow and ice, because my knee gave way and then slipped and fell - get the feeling that this has also damaged cartilidge because knee now locks quite a bit - but Dr says he will assess this during the op and fix as necessary, I feel I am going to end up breaking something else. Even walking up steps I feel I cannot put full weight on it. Over the last 6 months I have tried to increase exercise at the gym, but after the bike I have awful pain for about two days, I have tried to build muscles with leg presses etc, walking and very slow running on a treadmill (leg gave way whilst on it), so I guess I have no choice. I am not the fittest of people but need to try and be better than I am.
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Old 21.03.2012, 20:02
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Re: Knee operation - Advice and stories

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have to think positive thoughts, thankfully I know a number of people who have had it done with good success. I am fully aware I am atleast facing another 6 months of physio. But after falling a couple of times in the snow and ice, because my knee gave way and then slipped and fell - get the feeling that this has also damaged cartilidge because knee now locks quite a bit - but Dr says he will assess this during the op and fix as necessary, I feel I am going to end up breaking something else. Even walking up steps I feel I cannot put full weight on it. Over the last 6 months I have tried to increase exercise at the gym, but after the bike I have awful pain for about two days, I have tried to build muscles with leg presses etc, walking and very slow running on a treadmill (leg gave way whilst on it), so I guess I have no choice. I am not the fittest of people but need to try and be better than I am.
NB-

True and you made me think of another thing my doctor told me - which was age and how long it takes people to heal. The success stories on this thread might be from younger folk. He told me it takes a longer time for older people to heal from the surgery, if at all, and they really don't know the "time" when it's ok to start the normal activities again (skiing etc.). They go by how people feel and those over 30 have a 63% chance of the same injury to other muscle/ligament injuries because the body compensates itself and uses other means so you think it's ok --- but oops. So that's part of why I opted out of the surgery.
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Old 21.03.2012, 23:54
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Re: Knee operation - Advice and stories

Can't believe I missed this thread the first time around.

As mentioned above, if the knee was even a bit 'unstable' before, you were only ever on a downward slope. But you're going to be a lot better off after the surgery.. just think about all those footballers, skiers etc. who've made complete recoveries.

I had the full ACL transplant op 5 years ago (titanium pins and the replacement ligament spliced out off my thigh - way more hardcore than the 'tie a knot in it' alternative !). I made a full recovery and actually became fitter afterwards as I become more confident in my post op knee.

You will hit some lows in the coming weeks. You will weep with frustration. But you will get to a better place.
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Old 27.03.2012, 22:30
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Re: Knee operation - Advice and stories

ACL Op now done with a quadricep ligament graft, onto day 5, walking well with crutches, wearing splint full time. Able to shower without it but leg feels not good when not wearing it. Had physio twice a day when in hospital, able to get a good contraction on my quads, no swelling on my knee. Used a kinetic machine for upto 7 hours a day and easily get a 80degree flexion. Physio and Dr more than happy at this stage. Able to stand on tiptoes today with the use of one crutch and no splint under careful eye of physio. Taking high dose brufen for pain with no other additions. So far so good.
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Old 28.03.2012, 00:50
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Re: Knee operation - Advice and stories

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ACL Op now done with a quadricep ligament graft, onto day 5, walking well with crutches, wearing splint full time. Able to shower without it but leg feels not good when not wearing it. Had physio twice a day when in hospital, able to get a good contraction on my quads, no swelling on my knee. Used a kinetic machine for upto 7 hours a day and easily get a 80degree flexion. Physio and Dr more than happy at this stage. Able to stand on tiptoes today with the use of one crutch and no splint under careful eye of physio. Taking high dose brufen for pain with no other additions. So far so good.
That's great news & thanks for posting follow up.

What hospital & Orthopaedic surgeon did you use?
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