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View Full Version : ACL, no good!!!


Ramhouse
05-10-2006, 08:39 PM
Just got back from the orthopedic and things don,t look good. He said that there is too much degeneration damage for an ACL repair. This is the first doc i have seen and going to see another one next week. He said though that i need a knee replacement. So just wondering who out the on TMC is riding on a replacement and how is it going. I've been wearing a brace for years and it helps but the pain lately is getting worse. :confused:

erkoehler
05-10-2006, 08:40 PM
Oh man, thats no good :eek: I'm sorry.

bcampbe7
05-10-2006, 08:54 PM
Big Mac may be the best one to answer your question.

That does suck though! Sorry to hear that. :(

LakePirate
05-10-2006, 09:07 PM
That really sucks.

Can't they just replace the ligament now days and not the whole knee?

alecams
05-10-2006, 09:15 PM
well i have an ACL replacment. the first one the doc used a cadver cartilidge which degraded and 2 years ago i had it done again using stips from my hammy. good as new. i originally blew it out on trick skies in 1994. get a new one, rehab 6-8 weeks and you should be on your way.

Hoosier Bob
05-10-2006, 10:26 PM
I have had a lot of thing explode and have always looked for someone who thinks they can fix me up! Seek many opinions and search everywhere on the internet. Be ready to be disappointed and maybe thrilled! Medicine is a wonderful thing and my Dr.'s always put me back together as good or better than before! Take care and the pain is only in your mind! ;)

bigmac
05-10-2006, 10:38 PM
Just got back from the orthopedic and things don,t look good. He said that there is too much degeneration damage for an ACL repair. This is the first doc i have seen and going to see another one next week. He said though that i need a knee replacement. So just wondering who out the on TMC is riding on a replacement and how is it going. I've been wearing a brace for years and it helps but the pain lately is getting worse. :confused:I'm not an orthopedist, but I ski every Thursday morning with two of them :) .

Generally, you want to delay knee replacement for as long as possible. The problem is that they tend to wear out, and at age 53, you'd be looking at another total knee in about 10-12 years when you're still young enough to need/want the mobility. Tactics to delay a knee replacment might include braces (usually don't work beyond a certain point), steroid injections, or steroid + hyaluronic acid (Orthovisc) (http://www.orthovisc.com/). Sometimes, if the degeneration isn't too bad, they can replace only the medial compartment with a joint liner, which is a substantially simpler solution than total knee replacement.

Eventually, though, if the degeneration is severe enough and those kinds of temporizing measures don't control the pain, it's time for a total knee. It takes about 3 months, lots of physical therapy, before the typical total knee patient is glad he/she had it done, but at that point they are REALLY glad. No pain. I have a good friend, 50 years old, that had both knees replaced and he's playing hockey. I suspect that water skiing would not be good idea, maybe wakeboarding , certainly hydrofoiling would be OK.

A second opinion is a good idea. Pick an orthopedist who does a LOT of total joints, preferably one who has post-residency fellowship training in joint replacement. That might be tough - there's only one such orthopedist in all of Minnesota, for example, and that's one of the guys I ski with.

sand2snow22
05-11-2006, 02:38 AM
Well said BigMac.

sand2snow22
05-11-2006, 02:39 AM
Whoops. Double post...


Well said BigMac. Dang, you know engines and knees. Nice.

Ramhouse-I've had both of my ACL's repaired. I'm a little younger than you, but my Dad tore his ACL playing football in HS. At 64 years old, he does OK, but I don't think he has lost any bone, yet. I saw your post on wakeworld, I recommended getting a second opinion and like BigMac said, look for a Doc who only works on knees.

Morgs
05-11-2006, 03:14 AM
Just got back from the orthopedic and things don,t look good. He said that there is too much degeneration damage for an ACL repair. This is the first doc i have seen and going to see another one next week. He said though that i need a knee replacement. So just wondering who out the on TMC is riding on a replacement and how is it going. I've been wearing a brace for years and it helps but the pain lately is getting worse. :confused:

My girlfriend is a Clinical Research Associate for a medical implant firm here in Switzerland. Itís one of the best in world and is more than likely the manufacturer of the artificial knee that you are referring too. I can tell you straight up, from what she sees on a daily basis, you want to only go through something like that as a LAST resort - e.g. you canít walk anymore. The reasons for this are vast, the trauma involved in the operation is really heavy, also, post op and recovery you may not be able to the type of sports you were able to do before the operation.

I am really surprised that you cannot have the knee repaired without having to do the full replacement - they can normally work wonders these days. I think Big Mac has posted very good advice, get a second and or third opinion and ensure that the Doc has done heaps of knees. Good luck, get well soon, hope it all works out for you.

bigmac
05-11-2006, 07:38 AM
I am really surprised that you cannot have the knee repaired without having to do the full replacement - they can normally work wonders these days.

They can only do so much once the cartilage of the joint is gone, and that cartilage loss results in an increasing pattern of wear. Once the joint space is lost and you are bone-on-bone, there is functional lengthing of the supporting ligaments on either side )collateral ligaments) resulting in enough knee instability that the remaining cartilage wears faster. Your problem is magnified by the even greater instability that resulted from the loss of your ACL.

Knee replacement is indeed a last resort, but it's an effective one. It would curtail some activities that you've liked to do your whole life, but your knee pain is doing that already, to some extent - sooner or later you will come to a point where you will be MORE functional after the knee replacement.

In the meantime, do consider steroid injections if you haven't already. Many or most people will get significant relief with injections of depo-medrol every three months or so - about 70% of people will respond well to that. Also consider injections of hyaluronic acid, which is supposed to help preserve cartilage that's left and provide some lubrication for the knee. About 30% of people will respond signifantly to that and if those things work, it's possible to forestall knee replacement by a few years, at least.

Ramhouse
05-18-2006, 12:53 AM
Thanks for all the info and reguards. Going for second opinion in a few weeks. I,ve been wearing a brace on the water for two years now when riding. Now i,m even wearing it on the golf course, ( i'm a teaching pro) and even playing now is begining to be a chore. All info is appreciated and if there is any more post it.
Thanks again, Richard

stevo137
05-18-2006, 08:16 AM
A second opinion is a good idea. Pick an orthopedist who does a LOT of total joints, preferably one who has post-residency fellowship training in joint replacement. That might be tough - there's only one such orthopedist in all of Minnesota, for example, and that's one of the guys I ski with.

I would go to that guy if possible. Nothing beats a good referal.
Hoping for the best for you Ramhouse.

Davo
05-18-2006, 08:42 AM
As I reach for my Glucosamine/Chondroitin, I am curious as to what BigMac's skiing buddies/orthos think about such supplements....?

Good luck to you, Ramhouse. I hope you're presented with different options upon seeking a second opinion.

bigmac
05-18-2006, 09:12 AM
As I reach for my Glucosamine/Chondroitin, I am curious as to what BigMac's skiing buddies/orthos think about such supplements....?

"Can't hurt, might help...go for it".

There have been some recent studies that indicate that those things don't help except maybe in extreme cases of degeneration. Even so, both of those orthopedists routinely recommend using it on the basis of the above quote.

Personally, I take it daily too.