My SO messed up her ACL skiing a few years ago and then last year tore the posterier ligament as well. Apart from cycling and walking she can't really do any exercise. We are considering ACL reconstruction surgery. I know of some horror stories of people who've had it, but this was some years ago. Anyone had any recent experience? Cheers.
Anterior Cruciate Ligament Reconstruction Surgery
no experience of the injury but i work for an NHS Innovation Hub and we have helped develop this product. it's miles better than the rest of the competition because it fixes into the bone better and therefore there are less cases of failure.
developed in manchester, but the lead surgeon (Martyn Snow) now works out of Birmingham.
it's available on the NHS as of this year.
That looks the biz.
I haven't had the operation yet but after it was diagnosed the hospital phiso told me to come back to him first before I picked a surgeon for a recommendation.
He said that most people spend more time working out who the best mechanic is for their car (or bike) than who the best surgeon is with the best outcomes. People who have had the operation are rarely the best people for recommendation as they only have one example to go on.
Hopefully this October.
I recently had the pleasure of rehabing a few people who had undergone ACL reconstruction surgery. 5 weeks on and they were able to stand on their affected leg on a trampoline and throw a ball against a wall and catch it. They had no problems. Full return to normal sports activity takes around a year though.
Might be an idea to find out if your local hospital has a "knee group" run by the physio dept and speak to them.
I had ACL reconstruction surgery about 18months ago. The surgeon used a graft made from my hamstring on the same leg to create the new ACL. The graft is attached under the knee joint using a clip and has regrown onto the joint above the knee.
The surgery was a couple of hours in a BUPA hospital, with one overnight stay. The knee pain wasn't too bad during the first few days (managed with Tramadol and dihydracodeine).
Recovery with physio started a few days post op, with stretching at home and flexing the joint. I started attending a physio two weeks post surgery. (I can still remember the pain and sense of achievement when I made it bend 30degrees! I thought I'd never bend it fully again).
After some months of physio, light exercise and making sure not to over stretch it I was advised to sit on a static bike and spin the pedals, it was great to get back on some sort of bike.
After six months I was back cycling, slowly, and not straining the joint. It too me about 8months all in to have full, comfortable and strong use of the joint.
Now 18months down the line, I have a stable, strong joint. One tiny scar, and a small amount of surface numbness around the scar.
It's not a horror story, but it is a long road. I'd strongly suggest getting a surgeon with lots of experience. Mine had worked a sports injury specialist in US and Australia. He reckons he's done in excess of 1000 ACL reconstructions so I was confident under his knife!
Happy to pass on more gory details / tips if required.
Thanks BigG, that's really helpful.
Interesting. I snapped my ACL a few years back but have shied away from getting it re-constructed. I ride pretty much every day & race with very few problems - a long road ride might leave it aching a bit but then I should probably stretch a bit more.
Still thinking about surgery as I don't want to store up problems later on, but I don't know - doesn't seem to be an issue at the moment.
Whether or not you'll be offered or recommended for an ACL reconstruction is dependent on there being instability in your knee. If there's no instability then generally you're better off not getting it done.
I crashed my DH bike in practice back in August last year....
After the swelling and stuff went down, the consultant in Whitehaven told me I would never ride again, and that I would walk with a permanent limp. This made me a bit grumpy.
I paid to get a private MRI down in London, and paid for a consultation with a knee specialist down at Oswestry called Mr Simon Roberts. I was referred to him by my GP, saw him quickly and got a much better answer, it would appear that my cruciate had been gone for a while, since a crash at Bucknell in a Pearce Race near the end of the 09 season, and when I crashed at Alwinton I dislocated my knee and ripped up some of the meniscus a bit.
I got the ACL rebuild surgery done by Mr Roberts in late January with the NHS. Was discharged the next day, saw the Physio the day after that, and did lots and lots of physio over the next 3 months. I got to spinning on a roadbike on a turbo trainer with no resistance 7 days after the surgery, and got on a road bike outdoors 2 months after the surgery. Have been recovering really well, I have as much extension in my operated knee as in the other one, started riding mountain bikes again at the start of May.
Upsides of surgery:
Dont overflex my knee when I stand up too fast.
Can crank out of the saddle without feeling unstable (it's made a big difference).
Downsides of surgery:
A tiny set of scars from where my hamstring was harvested
Lots and lots of physio (Cumbria NHS physio is pathetic, so £30 an hour at the private one)
No racing for me this season
I lost 8kg of mass in 7 weeks, I now have no power when riding uphill, its a wierd feeling.
It definately feels worth it, Simon Roberts did an amazing job, and my physio Neil was a lot of help getting me up and going again, and pushing me to improve.
I ruptured mine totally back in 2005 and had the surgery to repair it in 2006. The surgery went fine with only a couple of small complications during recovery. I did physio prior to the surgery so post surgery recovery would be quicker. I was in a brace leading up to the surgery and very limited with my activity, dislocations of the joint were quite a common occurrence.
Post surgery I had a few issues with the joint but nothing overly serious. The surgery itself involved an overnight stay in hospital and then 2 weeks of limited activity. The surgery I had was a graft done using my hamstring. I was left with scarring and some numbness to the lower leg.
Last year the graft gave way completely and I have been told by specialists that it simply isn't worth repairing. Specialists and Physios are of the opinion that as I suffer Hyperextension in my knee joints its pretty much guaranteed that the surgery will fail again. I have not sought a second opinion on this and have just accepted it.
Now I am 1 year on with a re-ruptured rupture and everything seems to be fine. I cycle on a regular basis and try to maintain a high level of fitness. I have had periods of brace usage which has been annoying but mostly I am fine without it however the specialist has emphasised the need for a high level of fitness to be maintained to support the joint to prevent further injury.
This post probably isn't relevant to your current situation though. Hopefully your SO can get something sorted out which works for her and doesn't fail! Good luck and a speedy recovery
*EDIT - a big thing for me was getting confidence back in the joint as after a long period of regular dislocations I was quite timid in using the knee again and shied away from many activities because of this. This is still the case now. I cycle but only on the road and not using clips/spd's and try to avoid any activity that has a twisting or impacting affect on the joint. I found this was the biggest obstacle to overcome.
I tore my acl on a mx bike. Struggled on for about 6yrs with physio etc, but had the reconstruction about 5yrs ago.One of the best thing I've ever done. It does take about a year for full recovery, but I was riding a bit after about 8 wks and slowely built it up. Just bear in mind much of the graft dies back before a blood supply is established !! just make sure you don't subject it to any trauma untill it strengthens up again. Its back to square one if you do
Had mine done 7 years ago. I'd say to OP it depends what your SO wants to do sports wise and as another poster said how stable it is now for those activities.
It is a long old haul but in my case worth it. The physio laster a good 6 months with anouther 3 before I felt confident on it. I did LEJOG about 15 months after and got quite a bit of pain from it at one point so a bit worried I'd overdone it. But it lasted and from then on It's gone from strength to strength. It sometimes aches but other than that, I've now skied on it and also played a bit of five a side. So well worth it in terms of my enjoyment of life
ACL surgery is not just about ibstability. Also about managing long term risk of artgritis.
If it needs doing nhs is fine.
There are plenty of good surgeons about.
Worth having a chat with someone who does them. Like many things in orthopaedics it is not one size fits all and is based on the patient as well as the injury.
Had ACL recostruction in mid December.
Started physio after 3 days
Turbo trainer with little resistance after 3 weeks
Easy road riding after 4 weeks
Light gym work after 7 weeks
Off road riding with knee brace on after 8 weeks
From week 8 onwards, kept up physio, gym and riding and now 4 months later almost back to normal riding wise, however only started jogging 2 weeks ago as there was too much pain around the fixing point into the shin and still don't have full movement of my knee. Still stiff and a bit sore most of the time but I don't think I do enough stretching. Just remember that this type of op takes 9-12 months for full recovery.
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