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View Full Version : I need ACL surgery and bought 1st boat in August


moski
11-12-2012, 11:16 PM
Need a little advice. I am really down. I finally bought my 1st boat (1997 MC prostar 205, I know I need to put pictures up of it) and I have a tear in the ACL in my left knee. It happened back on 11/4 Sunday night. I was playing flag football. I was running the ball and went to pivot and then ouch my left knee. I guess at age 35 years old, wearing cleats, pivoting, and going a 110% is not the best thing to do. I tried to shake it off on the sideline, but went home. Next day went to urgent care and xray showed bones are okay. I then had MRI and have a tear in my ACL. Sorry if i mispell: cartlidge and miniscus are in good condition, so i guess that is a good thing. I was told I need ACL surgery. I asked about PRP injections, but thats for partial tears or something. He said my 3 surgery options are: using a cadavor tendon from somebody else or using part of my hamstring, which he said both of these are good for people in their 30's and on up. 3rd option is doing BTB (making another cut and using my own tendon) which his analogy is for teens and people in their 20's due to age and activity level is very high. I'm thinking the 3rd option, because my activity is very high. I love slalom sking, barefooting, i did the Tough Mudder, running 1/2 marathon (goal is to run full marathon), tennis, basketball, etc..... I've never had surgery, stiches, etc.... I know i've been lucky. I'm really scared because my dream is complete on getting a boat a few month ago for my wife and 2 kids (ages 5 and 3) and now i have to get ACL surgery. Anybody have ACL surgery and get back to 100% slalom skiing and barefooting?

milkmania
11-12-2012, 11:33 PM
March 2011, my 13 year old son "pivoted" in the batter's box.....with cleats

knee cap on right, should be under grass stain :(

he came home last week and said "I want to try wrestling".... I said, "nope, and don't ask again"




http://www.therideinstyle.com/knee/original/3-March%202011.jpg

then football August 2011

http://www.therideinstyle.com/knee/original/6-August%202011.jpg


http://www.therideinstyle.com/knee/original/13-PostOp.jpg

milkmania
11-12-2012, 11:35 PM
but, they gave him "the good drugs"

http://www.therideinstyle.com/knee/original/1000007937.jpg

http://www.therideinstyle.com/knee/original/1000007932.jpg

JimN
11-12-2012, 11:39 PM
Need a little advice. I am really down. I finally bought my 1st boat (1997 MC prostar 205, I know I need to put pictures up of it) and I have a tear in the ACL in my left knee. It happened back on 11/4 Sunday night. I was playing flag football. I was running the ball and went to pivot and then ouch my left knee. I guess at age 35 years old, wearing cleats, pivoting, and going a 110% is not the best thing to do. I tried to shake it off on the sideline, but went home. Next day went to urgent care and xray showed bones are okay. I then had MRI and have a tear in my ACL. Sorry if i mispell: cartlidge and miniscus are in good condition, so i guess that is a good thing. I was told I need ACL surgery. I asked about PRP injections, but thats for partial tears or something. He said my 3 surgery options are: using a cadavor tendon from somebody else or using part of my hamstring, which he said both of these are good for people in their 30's and on up. 3rd option is doing BTB (making another cut and using my own tendon) which his analogy is for teens and people in their 20's due to age and activity level is very high. I'm thinking the 3rd option, because my activity is very high. I love slalom sking, barefooting, i did the Tough Mudder, running 1/2 marathon (goal is to run full marathon), tennis, basketball, etc..... I've never had surgery, stiches, etc.... I know i've been lucky. I'm really scared because my dream is complete on getting a boat a few month ago for my wife and 2 kids (ages 5 and 3) and now i have to get ACL surgery. Anybody have ACL surgery and get back to 100% slalom skiing and barefooting?

You're young. They do the same surgery on pro athletes and they strain their joints a lot harder than you probably do. Just be patient, do your PT and get stronger before you try anything fancy.

jschildm
11-12-2012, 11:42 PM
I can't really give you any advice, but can sympathise very much. I have a boat very similar to yours (98 PS205) and love it. I also just tore my ACL (Nov 1), and am pretty bummed about it. I am actually in the process of making the same decision (either hamstring or patella tendon). I play basketball 5 days a week, ski all weekend, and go for runs with my wife and dog in there as well. I just want to make sure that whatever method chosen, the end product is as strong as possible.

I will let you know if I get any information. Keep mo posted on what you decide and how things go. Where from the midwest are you? Best of luck!

milkmania
11-12-2012, 11:44 PM
Like Jim said "do your PT"

don't cheat it either, it'll show

nkorep2
11-13-2012, 12:08 AM
I dont know anyone personally with water skiing and barefooting, but Ive seen many people come back to full strength in gymnastics. I dont see there being an issue if youre committed to it. Surgery has come a long way, and there is no reason to think that afterwards you wont be able to do what you love.

XtwentyNot
11-13-2012, 01:22 AM
I tore my ACL, MCL, and LCL back in the 90's on snow skis. Back then we didn't have the same options. My choice was to slice my own tendon and make it out of that. I was 18. The doctor told me to continue working out up until the surgery. That was very good advice as I was in excellent shape when I had surgery. When they started me on physical therapy it was a breeze, in fact I only went a couple of times and just went back to the gym and rehabbed myself. I could not have done this without all the work i put in before the surgery. I have not had any issues and still do everything I did before the injury, I made a 100% recovery.
I would advise against taking the tendon from your own body! It is very painful and increases the healing time!
You will be in a lot of pain right after the surgery. Other then that try not to pivot on it until its fixed or you could be on your butt in pain.
I haven't had to deal with it so I'm not sure of the best fix, but whatever pro athletes are doing would be a good indication to the route I would choose. I would guess cadaver?

sand2snow22
11-13-2012, 01:44 AM
Xtwenty- great advice. I tore my right ACL in 93, age 18 and my left in 97, also cartilage tear in left. Had the best doc in town (TrailBlazer's ortho). Used patella tendon on each. Painful after surgery, never the same but 100% all sports, no knee brace. It is hard to crawl around on my knees with the kids, bending for extended periods of times sucks...

I'm out of the loop on the latest and greatest, but I would guess cadaver. What did Adrian Peterson use? That guy is back in full force in a short amount of time. Save your own tendon in case you tear it again :(

Rehab, ride the bike, build muscle until you go into surgery, then get your range of motion back and rehab like crazy after surgery. Once you are back, never favor your bad knee, make sure you are well balanced. I firmly believe my left ACL might be due to overcompensating for my right knee.

BTW, my 1st ACL: I was the unlucky 1 in 500 who got an infection. In the hospital for 2 weeks, high fever, lots of pain and a very swollen black and blue leg :( I still remember when doc came in and said, 'where does it hurt the most'. Then he pulled out the biggest needle I ever saw and sucked a liter of fluid from my leg. Never blamed the hospital, lucky to be alive and thankful to have the best knee and infectious disease dr.'s looking after me!

malibu-dale
11-13-2012, 08:13 AM
Just went through this. Tore my ACL wakeboarding this summer. Had surgery in mid-July.--Hamstring graft. Healing seemed to go fast the first month or 2. Hamstring area bothered me more than my knee did. Am now 4 months in,,and not feeling quite as "optimistic" that I will ever be the same. Have quite a bit of stiffness and some swelling in my knee. Have started doing a little "jogging" trying to get back in shape. Looks like I wont get to play much basketball this winter,,but hopefully back to normal by next boating season.

JBrew
11-13-2012, 09:30 AM
March 2011, my 13 year old son "pivoted" in the batter's box.....with cleats

knee cap on right, should be under grass stain :(

he came home last week and said "I want to try wrestling".... I said, "nope, and don't ask again"




http://www.therideinstyle.com/knee/original/3-March%202011.jpg

then football August 2011

http://www.therideinstyle.com/knee/original/6-August%202011.jpg


http://www.therideinstyle.com/knee/original/13-PostOp.jpg

I can relate to your son... I had the same thing happen to both knee's. Once from wrestling and the second time on wakeboarding when my foot came out to the binding during and air trick at the cable park.

willyt
11-13-2012, 09:30 AM
at this point its really up to you:
I tore my left ACL + cartilage damage in feb of 2011, had surgery in march. while i'm missing cartilage in my left knee, i rarely ever notice it. i'm back about 99% in all sports. I had the patella graft... i've been advised that do either the hammy or patella unless your a professional athlete and need to come back as quick as possible - cadavers arent the strongest of the bunch but will hold.

check out the pros man, you'd be hardpressed to find a pro that's been riding for awhile that HASNT done it (look at ossur's add in alliance sometime)

jschildm
11-13-2012, 09:32 AM
Pro's almost always use the patella tendon. They actually take bone cores with the tendon in this method, so the bone fuses to the bone that's drilled out for the reconstruction. The result is a slower initial recovery, but faster recovery overall. I am not sure if there is a difference in strength of the graft long term, but for professional athletes, getting back a month sooner might mean millions of dollars for them or their team.

I am a bit of a gearhead, and end up working on my knees quite a bit, which is one major ding against the patella graft, if that's going to be painful for the rest of my life.

jdl xstar
11-13-2012, 10:06 AM
I have had BOTH the cadaver and the patella graft.

Patella was when I was 18. Cadaver was when I was 32. My advice is to do the cadaver - all day long. It is not "cheating" whatsoever. The surgergy methods/technology/techniques have come a LONG way since the 90's when it was considered patella graft only. I am still very active - snowboard/wakeboard and both knees act the same.

Cons of the patella graft- the surgery is much more involved and takes a much greater toll on your body. It was horribile at 18 , cant imagine at 35. Think about it, it is two surgeries and two recoveries since you are dealing with carving out the patella and then sticking it in the ACL spot. Rehab was much longer since you have to heal the patella and the knee joint.

With cadaver, its one surgery and one recovery. Much easier on the body. Plus what makes it easier is that they will do it by only cutting a couple holes in the knee as opposed to a 4 inch slice down the knee.

Your active lifestyle will not be impeded one bit by having the cadaver insert.

Also, I had the same doc perform both surgeries on me and I remeber both conversations about the options- as an 18 yr old, go with patella (18 yr olds recover better and I had nothing else to do with my life at the time but rehab/recover). 14 yrs later with advancing medicine, he basically didn't even give the option of the patella- said cadaver was the way to go and to this day, I am thankful for it. Good luck

milkmania
11-13-2012, 10:40 AM
moski, you will be amazed at muscle atrophy that sets in from not using that Quadracep Femoris Muscles during recovery.... it doesn't take long for those muscles to lose their tone.
I saw my son's muscles feel like jell-o when he flexed, after 8 weeks in a brace

_fng_
11-13-2012, 12:34 PM
Sorry to hear about your injury but congrats on the boat, I've got the same year/model. As a PT I suggest you do a little "prehab" to speed up recovery. These things will help after surgery (reason why these surgeries are delayed now as opposed to a few years ago). If you can get good quad strength/contraction (turn off/on the muscle without effort), full range of motion, and minimal knee swelling you'll be set up for a good recovery.

As far as grafts go I'd suggest you find a surgeon you trust/like and do whatever he/she suggests. At this time you can find pros/cons to every graft therefore I'd suggest do whatever the surgeon is most comfortable with using. BUT if it were me I'd prefer cadaver first then hamstring and patellar tendon last!

Good luck!

barefoot
11-13-2012, 01:07 PM
I've had two ACL surgery's on my right knee...the first using the patella tendon and second hamstring. Patella didn't hold...tore it less than a year after rehab. Went in for a second surgery using the hammy and i've never had a problem since. It's strong, I do the same activities as before, and never had an issue with pain, stiffness, swelling, etc.

I went into the first surgery in great shape. I was a soccer player and probably in the best shape of my life. Having the strength helped a lot with PT. Breezed through it and back to normal pretty quick. Then I tore it again playing soccer. When the second happened, I could tell it was going to be a harder climb. Rehab was longer, my attitude was worse...but I got it done.

As others have said, the more you put into it, the better the outcomes. Put the time in...start now...and it will make the rehab quicker. The stronger you are going into the surgery, the better prepared you'll be, both mentally and physically, to do the work necessary to rehab back to normal.

moski
11-13-2012, 11:52 PM
thanks guys for all the input. I have spoken with 3 doctors. The young doctor yesterday (his thoughts using my own patella tendon). An old doctor this morning (his thoughts I dont have to fix it now, rehab for few months). I then spoke with the third doctor late this afternoon. The third dr is the physician for the St. Louis Cardinals ( i live in Missouri). My wife and I felt really good with him. He said 3 options: 1) use my own patella tendon, which is another cut and yes little longer recovery. I will have hard time kneeling down/squating. 2) hamstring, but he said something about kicking motion might be bothersome. 3) he said he is 44 yrs old, and he said he would even do this which is using a cadavar (im thinking cadavar). He said if i dont do anything then that just will speed me up on arthritis and he does not like that option and I could do more damage to my knee. The Cards doctor really was happy to see that I have very little swelling, good range of motion (just cant straighten all the way), good muscle tone, cartlidge is good, and one small area on miniscus has little damage. I am just so pist at myself. I have never had any issue like stiches or broken bones. I finally bought my dream boat and pop a damn ACL. I know there are worst things out there that people are dealing with, but I am new to this. All 3 doctors said I have had good luck from birth to age 35 and I am a first timer. But my wife is right in that I am hard on my body when I go do anything active (always going at it 110% or like a teenager). This will make me think about doing something active. Still go hard, but think before I act. I was planning on getting a barefoot boom over the winter so that I can learn to barefoot and do a rope off the boom. Also I just want to be able to ski hard again. I know there are a few ski courses on the lake i go to and I was planning on working hard on the ski courses. It sounds like I will be back to normal and be able to ski and barefoot 2 summers from now.

XtwentyNot
11-14-2012, 03:21 AM
2 summers? No way, you will be back next summer!

barefoot
11-14-2012, 10:13 AM
Next summer, for sure. Do the rehab and use the boat as inspiration. You'll get through it no problem.

Older guys are getting back into barefooting because their is less risk for injury. Unlike a wakeboard, there is nothing attached to your feet to drag and twist. I think more injuries can result from a 20mph fall then a 40mph fall. In barefooting, at least there is a proper way to fall. If you learn that, you might get the wind knocked out of you...or see stars...or rattle your back...or tighten up the muscles in your neck, but you'll be fine.

willyt
11-14-2012, 10:22 AM
dude, have the surgery now and you can be wakesurfing as soon as you can get the boat back out, you wont miss a beat

JRW160
11-14-2012, 01:08 PM
I had hamstring autograft 4 years ago. I haven't had any problems out of it since then. I was back playing soccer and wakeboarding at 6 months and at full strength around a year.

I went with hamstring autograft because that it what my doctor recommended. My doctor said that using cadaver tendons is the fastest recovery, but the quality of the donor tissue can be an issue. He said a lot of people have some pain when kneeling using the patella tendon graft. It also produces a pretty large scar on the front of the knee.

beach.bum
11-14-2012, 03:58 PM
there are alot of things to consider for a ACL reconstruction. the patella BTB was the gold standard back in the 80's but the hamstring which uses the gracilis and semitendonosus tendons from the hamstring is now the most common and is the strongest option of the autograft options. these two tendons are doubled over to create a four strand (often called double bundle) graft. Many surgeons believe that this four strand graft to be closer to your original anatomy. Although the ACL is referred to as one ligament, it consists of two functional bundles. These two bundles are named for the place where they attach on the tibia. There is an anteromedial (AM) bundle, which inserts more anterior (Towards the front) and medial (towards the inside) of the tibia. The posterolateral (PL) bundle inserts most posterior (towards the back) and lateral (towards the outside) of the tibia. the patella graft is not capable of reproducing the double bundle effect. if you go the allograft route there are a bunch of different grafts that they could potentially use. the can use the patella, Achilles, anterior or posterior tibialis, ect. find out what your surgeon would use and make sure it is what you want.

another thing that i believe no one has touched upon is the actual technique the surgeon will use to determine the tunnel placement on the femur. this is actually very important because the most common reason for failure of a ACL reconstruction is tunnel malposition (this accounts for about 75% of acl reconstruction failures). the two main techniques are called transtibial approach, and anteromedial (AM) approach. in the AM approach the femoral tunnel is drilled independently from the tibial tunnel. the AM approach allows the surgeon to place the femoral tunnel closer to their native attachment point on the femur. the main benefit to this technique is that the graft will then provide anterior stability and also has greater rotational stability. in the transtibial approach the femoral tunnel placement is determined by placing a guide through the previously drilled tunnel in the tibia. the trans tibial approach will also provide anterior stability but typically provides less rotational stability. some surgeons claim that they can achieve the same tunnel placement transtibial but it is very dificult.

It may be beneficial to talk to your surgeon about which technique he uses and determine which one is best for you. in my opinion the additional rotational stability provided by the AM approach is definitely something to consider. good luck and dont sell your boat, you will be back on the water before you know it!



attached is a link from the university of pittsburgh that may be helpful.

http://www.orthonet.pitt.edu/content/DoubleBundle.htm

sand2snow22
11-14-2012, 06:29 PM
Good info beach.bum!

tex
11-14-2012, 07:34 PM
I had both-Go to PT! You will be fine you young buck!

XtwentyNot
11-14-2012, 08:56 PM
Good info beach.bum!

I know, thanks Doc :) great info!

moski
11-14-2012, 11:07 PM
thank you beachbum and to everybody else. I feel more positive hearing from you guys. I just wanted to make sure I can get back to slalom skiing, barefooting, doing Tough Mudder Races and normal life. I have my neighbor coming over that is a PT to show me some excercises to strengthen leg before surgery.