Partial ACL tear - no surgery

[syamir]

Hi guys,

i'm 22 and a very active sportsmen.. i play rugby (club level), football/futsal (college level) and tennis/badminton (occasional)..

He asked me to do some self physio such as cycling and swimming for rehabilitation. a need for immediate surgery was not neccesary in late nov 2011 i partially torn my ACL at rugby training while i was side stepping.. went to see the specialist & got myself an MRI scan.. the doctor confirmed that it was a partially torn ACL..

an immediate surgery isnt necessary.. since i'm still doing my internship, the specialist gave me time to regain strength and rehab my knee before the next check-up.. if there is still signs of instability, a full reconstruction may be required.. after 2 months of occasional swimming, cycling & weights training, i do have full motion of my knee but it still hurts at times..

My questions are:
1) can anyone define "instability"?
2) is there much benefit of "arthroscopy"? *arthroscopy: trimming out the torn portion
3) after rehab, the chances of turning a partial tear into a full tear is there. does strapping tape help in anyway during sports?
4) after a complete reconstruction, does the possibility of the same injury increase, maintain the same or decrease? Is the new ACL stronger, the same or weaker than the original ACL?
5) trough the thread, there are contradictions between PTs and patients.. PT says use what u hv left (use it until fully torn with possibility of MCL injuries as well), patient says straight reconsruction.. can anyone verify who to follow?

hope someone can help out.. really want to get back on to the field.. a young man that really wants to get back on his feet..

[Dolores]

First of all you are very young so that's a good thing!
If you allow it to heal and stop doing the activities that are making your knee pain worst then it might get better,,,but if the MRI has confirmed that there is a partial tear then it's time to make adjustments in your life by modifying your level of activity,,,Many people who continue their active life styles after partially tearing their ACL, end up breaking it completely,,,,
I would recommend that you take it easy with the physical therapy,,,I know its hard but just try not to overdo it and listen to the signs that your knee is sending, if its painful just give it a rest, ice it, wait until the pain is gone before doing more training and wait until the ligament feels stronger before doing the cycling movement and especially the weight training...avoid painkillers as they trick the mind by masking the sensation of pain and puts your ACL at more risk for further injury,,,BE VERY CAREFUL
I've been dealing with a similar injury for 11 months and was able to start walking with a cane just 3 months ago,,,It took me so long because I wore a brace that immobilized the entire leg for 5 months,,I probably over did it so my quads and calves muscles on that leg shrunk drastically making it a lot harder to stand on it but I had to brace it because at the time of the injury my ligament was so sore I couldn't even bend the knee,,and
i kept on making it worse by forcing myself to walk when it wasn't ready,,it's definitely been a slow recovery but I've had to deal with other issues too,,,
what I've learned is that the less stressed out you get, the faster it will heal,,,but the healing process does takes a long time,,, my ligament still hurts a lot at times and feels unstable unlike my other knee which feels solid and strong,,
At this point I'm trying to avoid the reconstructive surgery to see if it can heal on its own mainly because I don't trust "Doctors",,don't have insurance, a place to live nor anyone who can take care of me if I get a surgery,,,that's something you must keep in mind, a lot of assistance and proper accommodations will be required after surgery,,,but if you fully trust your surgeon, have a comfortable place to stay plus someone who can help you during your recovery then consider yourself blessed!
Just follow up with your orthopedist surgeon,,,and take it easy,,,eat very healthy,,,fruits, vegetables, legumes, drink lots of water,,,try quinoa, it aids in the repair of tissues...Do stretching exercises like soft yoga but take it slowly,,,breath deeply,,,Google the knee pain guru,,it's got a lot of useful and conscientious information about knee injuries and how to deal with the pain,,,it's the anti-surgery approach,,,
I don't know man but I think that the proper treatment for this injuries is complete rest,,,unless the tear is so bad that the tibia is completely dis attached from the femur,,,there's a couple of videos on you tube that show an ACL tear and it looks terribly painful! Check them out when you get a chance,,,
just avoid forcing yourself to walk if the knee is not responding well because you can actually cause more damage, delay the healing process and/or injure your good knee...so try to stay off of it as much as you can,,,and by that I mean get a wheel chair while its healing and keep strengthening the quads and calves without putting too much pressure on the injured ligament...play it by ear,,,listen to your body
In my opinion, instability of the knee is the symptom of an injured ligament, tendon or cartilage in the joint. It's caused by the inability to properly bear weight on the knee making it hard and almost impossible stand up for more than 10 seconds because of the lack of support in that mid joint. So instability is basically whenever a cane, a walker, a crutch, walking stick, or anything that can aid in regaining some sort of balance in order to keep the upper body perpendicular to the ground is needed.
Arthroscopy may sometimes be necessary,,I'm not sure how effective it is,,,Ive heard in some cases it can be helpful but I've also read/heard that it can increase the risk for future arthritis...just keep doing more research and talk to people who have had the procedure done...As far as the ligament reconstruction is concerned,,,same thing, Ive heard positive things about it like people being able to walk, go back to their active lifestyles and even play sports again! but just like with any other surgeries there's always a risk for complications. I've heard/read negative things like the reconstructive tissue getting infected, breaking again or not being flexible or strong enough, or irreparable damage on the site used for the graft ,,so I guess it depends on many factors...it's a tricky one that's why you must be very selective with the surgeon you choose ...Good Luck to you!

[Dolores]

Are you able to walk at all? When are you planning on getting the ACL reconstruction surgery? What type of graft are you planning on using?

[syamir]

Are you able to walk at all? When are you planning on getting the ACL reconstruction surgery? What type of graft are you planning on using?

I can walk 3 days after I torn my acl.. the problem is not walking but getting back to competitive sports as I am a sportmen.. my target isnt just to be able to move but run, side-step, tackle & hope as soon as possible..

it should be done by march and i'm using the hamstring as recovers faster.

[Dolores]

I can walk 3 days after I torn my acl.. the problem is not walking but getting back to competitive sports as I am a sportmen.. my target isnt just to be able to move but run, side-step, tackle & hope as soon as possible..

it should be done by march and i'm using the hamstring as recovers faster.

I wish you the best on your recovery and future plans! Take it easy though, try not to overdo it until your knee is fully healed. I totally understand your need to get the surgery,,trust me, I've been struggling a lot for the past 11 months with this disabling injury waiting to see if it's ever going to heal at all and I still can't walk without a cane,,,can't stand nor bear weight for more than 2 minutes on the injured leg because the knee joint just gives out and then my back starts hurting from overcompensating, and to make things even worse now I sprained my ankle for putting all the weight on it,,,so I can't stand on the foot with confidence anymore and im afraid my hip joint is also suffering the consequences of that torn acl or knee joint derangement because it also feels funny,,,

Whoever wrote in this forum that the acl is not a supporting structure might just want to re evaluate that because if it wasnt a supporting/stabilizing structure in the knee joint, then the ankle, the hip and the back would not be overcompensating for that lack of SUPPORT.
The fact is that once any ligament of the knee joint is damaged in some way, it off sets the balance of body and starts a domino effect of injuries that simply leads to more problems and a disjointed way of life, I know this because it's exactly what I've been having to go through,,,and its a very complicated situation because I can't even get a job with this injury,,,I'm totally broke and actually making arrangements to go to a woman's shelter until my disability claim comes through, well that's if it gets approved,,so getting that sucker repaired it's definitely the way to go especially for a young competitive athlete. Keep us updated on your recovery,,,I'm interested in learning more about your surgery, maybe I'll go get one too! Take care

[Dolores]

Has anyone heard anything about the arthrogram/mri contrast agents “gadolinium”?
The reason why Im asking is because the ortho sent me to get one so he can figure out what is wrong inside the knee joint, but I still havent had the guts to schedule the appointment.

After reading about the adverse side effects and countless law suits against it, I just got very skeptical about the procedure. I'm just wondering how safe it really is? The last thing I need is to have more damage done to whatever is still semi holding my knee joint together,,but I may be wrong and perhaps that silver based agent is not that harmful,,but I'm still VERY confused....