Last week I went skiing for the first (and probably last!) time.

It seems that I’ve got a complete/grade 3 tear of my ACL after a crash (on the last day of course). I saw an orthopaedic knee injury specialist today who showed me some movements definitely not normal for a knee and shin (and drained a lot of fluid out of it), with an MRI tomorrow to confirm.

I gather some people proceed without surgery even with a grade 3? I just thought I’d see if anyone can share their experiences of the same injury, and thoughts on surgery vs not.

An initial chat with the consultant suggested that without surgery I would struggle with the injury in the long run, particularly for the things I like doing (dh, steep trail running and big days out hiking/backpacking). I’ve heard a few stories of people who develop early arthritis post surgery, as well as those who have had no issues even without surgery. I’m 31 for context.

Cheers!

ACL full tear – what’s the prognosis

This may give some useful info. Good luck with the rehab whichever path you choose!

Did the same when I was 30. Had surgery then 9 months of proper rehab. I’m now 46 and knee is fine. I continue to Ski, MTB, CrossFit, football, run, hike. I’m sure others have horror stories but for me it’s been all good.

I ruptured my ACL early in 2016 and didn’t actually know as physios suggested it was cartilage damage. After my knee recovering I’d go back to sport and I’d end up with it “collapsing” when side-stepping or putting a sideways load through it. When it was recovering I’d wear a knee brace and then stop wearing it when it was “better”.

Eventually I got a bit fed up of the issues and went to see a specialist who got a MRI done and confirmed the ACL was ruptured. This was in 2019. She said as I’d managed to continue doing all the sports I like to do (more on that in a minute) I could elect not to have surgery and then if I found it causing issues further down the line I could then do so.

I’ve been able to keep going with all my normal sports. I’ve never had any issues mountain biking, cycling, or running, and I’ve done some trail running/Munros with no problems. I play tennis and that’s been ok. The only sport I’ve had issues with is touch rugby, as there’s a lot more lateral movement. When I play that I wear a knee brace. I’ve played in the last few European Championships and have the World Cup coming up this year, and although it is just age grade level as opposed to the open teams, I’ve got on fine.

I also went skiing this year for a week with no issues. I wore the knee brace for that as a precautionary measure but never felt there being any issues.

I have a friend who ruptured their one years ago and, at the time, was playing for the Scottish women’s rugby Union side. They recommended not to get surgery and she went through a strengthening regime of all the muscles, etc round the knee and went back to playing international rugby.

And maybe better to rupture your ACL on the last day of your trip rather than the first!

Everyone is different is the honest answer. Some people will have significant stability problems and others (once recovered fro the initial injury) seem to manage perfectly well.

There is not a right or wrong answer, early onset of arthritis can happen regardless of surgery. It seems more dependent if there was an associated meniscal injury.

A good knee ACL knee brace can be a game changer (that allowed me to play tennis, without it I couldn’t hit a backhand).

Personally, I would try rehab fist and see if that was sufficient to allow me to do all my activities, if it didn’t then I’d consider the surgical route. Rehab will not be wasted as it will put you in a better position if you do require surgery.

The rehab post op is 6 months long (for return to everything) and absolutely essential. If you cannot commit to this then do not have the surgery, you will not have a good outcome.

Thanks folks.

@dlabz was yours a complete (grade 3) or partial?

Good note on the physio, I can feel my muscles working hard to keep it stable as it is, so I’m thankful for having strong legs anyway. I’ll discuss this option with the consultant when I see them next.

Get on with physio as early as possible.  even pre surgery If you can move it. Hydrotherapy was really good.

@spicer it was a complete rupture. I did it playing touch rugby, and it hurt a bit when I did it, but didn’t get much swelling around the knee and so the physios assumed cartilage damage. When I eventually got it scanned the specialist confirmed I didn’t have an ACL in that knee.

I’ve followed (not in the literal sense!) this girl for a while, she’s recovering from a damaged ACL. She talks through her recovery and physio. She’s also a skier so you should have something in common! 😀

https://www.youtube.com/@DelilahCupp

I tore mine playing rugby about 20 years ago. Keyhole surgery to tidy it up and did a load of physio to get back, you’re basically looking to build leg strength so the muscles do the work of the ACL. Was all fine until a drunken fall and instability in the joint and surgeon suggested an ACL replacement, which involves grafting some hamstring. Lots more physio for recovery, which was painful and hard, you need to work at it to get the range of motion back. Now 15 years later I don’t notice it at all, done marathons, fell running loads of riding and don’t notice any difference to my good knee. Amazing what they can do.

Just as an update to the other thread on this topic, my son’s is a complete tear plus fairly catastrophic meniscus damage,

In the words of the consultant “This is as serious as it gets without needing a new knee”.

The MRI didn’t show the full extent of the damage, which was a root tear; it was explained to me as follows: imagine the roots of a tree – this is how your meniscus is attached to the bone. Your son’s meniscus & all its roots have been ripped out of the bone, so it was just floating around inside. It was also torn almost in half & folded back on itself.

In the first operation the meniscus has been sewed onto the bone & he’s now 3 months into his rehabilitation. The strengthening & stability exercise regime he’s been given is brutal, & he struggles with it, but the results are slowly coming.

That said, & this is where it relates to  you @spicer he can now perform most movements  including basic ball skill, lunges, squats & any “closed chain” exercises without any great issues.

Had he been just a snowboarder or cyclist they would leave it at that & forgo the ACL repair/replacement; the fore-aft movement is now minimal as his muscles are literally taking up the slack, so it’s perfectly possible to have an active life without an ACL.

Thanks everyone, it’s really interesting to read these replies and the other thread.

I’ve got a surprising amount of strength and stability back over the last few days after making an effort to keep it moving and keep the muscles working, but range of motion is very limited (I’m not sure what exactly is causing that) and I don’t need the MRI results to know there is some damage to the Lateral ligament too.

However, this small progress and some of the comments here are giving me some reassurance that I’ll get back to normal, whether it’s surgery or not. Let’s see what the scan says on Tuesday!

@Spicer

I managed fine with a knee brace for tennis for >5 years before I went for the reconstruction. I played squash, ran, HIIT and skied with no problems at all (and didn’t need the brace).

Unfortunately my knee was unstable walking and after it gave way 5 times in less than 1 mile I bit the surgery bullet. Surgeon couldn’t believe I had no problems with squash and skiing yet couldn’t walk to town without giving way but everyone is different.

Tore mine with an unplanned dismount almost a year and a half ago. Unfortunately due to my age they wouldn’t even consider an MRI to check the extent of the damage let alone a repair 😔 (diagnosed with anterior drawer test).

I was 3 months off the bike and with physio regained a good range of movement by around the 6 month mark – probably a little longer before I could kneel properly. Walking reasonably normally now although some days I limp like the OAP I am 😂 and my knee does occasionally give way. I wear a hinged brace for biking (mainly BMX trails) and my strength doesn’t seem to be affected but anything involving twisting movements is definitely a no no.

Good luck with the recovery and yes, definitely go for the repair 👍

Thanks folks. I just thought I would give a little update: surgery is booked in for mid-may, which gives me time for ‘pre-hab’ to get movement back and for the swelling/fluid build up to go.

It’ll be a fairly standard hamstring graft surgery, with support from a synthetic brace.

I’m surprised how much better movement has got in the last week- it’s come along a long way!

I may have just spent a fortune on LEGO for the recovery period! 😀

Good to hear. Good luck with the recovery – keep us updated 👍