Anterior cruciate injury recurrence

Hi,
I'm new to the forum, and looking for a bit of advice about my dodgy knees!

I'm a 22 year old student, keen hockey player that was playing to quite a high level until I suffered a string of knee injuries.

At 19 I sustained a right knee injury playing hockey. After 2 months of physio treatment on a suspected cartilage injury I went private to see a surgeon. After an MRI he confirmed that I had partially torn my ACL, but the scar tissue had formed well and the decision was made not to operate, but to undergo intensive physiotherapy and rehab to strengthen leg muscles, and core muscles. I didn't play hockey for 8 months

Two years later I suffered an injury under similar circumstances to my left knee. Once again I paid for physio treatment, underwent a lot of rehab, and returned to hockey within about 6 months.

Almost 2 months ago, I suffered yet another knee injury in almost identical circumstances, this time it was my right knee again. My physio reckons its another ACL injury, and referred me. Being a student I can't afford private treatment and am currently on the NHS waiting list to see a surgeon.

7 weeks later, still limping badly, still without full ROM- can't fully straighten, or bend bearing weight, still in a lot of pain. It's got to the stage now where it is seriously interfering with my teacher training. At the minute my main priority is getting through my last year at uni, hockey comes after that.

I'd really appreciate it if anyone could give me some advice. Do I risk permanent damage the longer it hasn't been seen to? If I am given the option of surgery or rehab, which should I choose? Is it worth getting a loan to go private?

Thanks,
Katie

Hi Katie

Sounds like you've been through a bit with your knees.

I reckon your ACL hasn't really been able to do it's job properly for some time now. The ACL basically is the main stabiliser for the knee when we change directions. Generally people who have an ACL injury rupture it completely.

Did you hear a popping sound when you originally did it?

Either way if your ACL has ruptured and you want to keep playing sports where you need to change direction, like hockey, you will require a ACL reconstruction at some stage.

If after 7 weeks you can't get your knee straight you probably have a large tear of the meniscus or cartiliage in addition to your ACL rupture. It's often referred to as a buckethandle tear. That can be cleaned up during the surgery. The other thing that may have happened is that one of the bits of the torn ACL is getting jammed in the knee and preventing if from going straight.

I'm not sure what it is like in Scotland but here in Australia most ortho surgeons see patients both publically and privately. Why don't you try and see a surgeon privately to get the diagnosis and then ask to be placed on their public waiting list? I don't know how the NHS works though...

As long as you stop playing hockey you don't risk further damage to your knee waiting a while for the surgery.

In regards to what to do now I would recommend that you focus on trying to get the knee straight. You should be able to walk alot better if you manage to get it straight. Have you got access to an exercise bike? Riding one of those slowly at first maybe even starting with half revolutions will help free up the knee. Then build up from there.

Even something a simple as trying to get your heel to be the first thing that strikes the ground when you walk will help to straighten your knee.

Get some exercises off your physio that will help you get it straighter.

Good luck and let us know how you go.

Dear Kges1:

One of the most overlooked problems with the knee is that the knee locks and unlocks due to the function of the popilitus and planterius muscles. If you have not had these treated, you should look into the possibility that these are causing problems for your knee.

There are other causes, but it appears that you have investigated some of these.

Hope that you find this helpful.

Best regards,

Neuromuscular.

Hey,

Thanks for taking the time to reply. Since I last posted I have seen an orthopaedic specialist who sent me for an X-ray that showed no bone damage. I'm now on waiting list for a scan which could be a few months.

I mentioned my history of knee injuries to the specialist, he said it was very unlikely that I'd ruptured it completely. After examination he reckoned my knee was stable enough and didn't think there was any ACL damage but said the scan would give him a better idea. Didn't offer much advice, so I'm still in the dark!

The knee is still giving me a lot of bother after 3 months, too painful to flex and extend fully. I've been in the gym using the exercise bikes and doing some weights too as theres been a lot of muscle wastage about the knee. For someone that's usually very active, the past 3 months have been awful, just so annoying!!