Tell me about your ACL reconstruction

Please tell me about your experience with ACL reconstruction.

I’m not asking for medical advice, which I am getting from my doctors. They both think I need ACL reconstruction, and so I’m going to have it. (I’m tired of my knee giving out, too.) I want to hear about it from the point of view of the patient.

For instance, I work in a job where I can sit in a chair with rollers and scoot around the area that I need to be in. I only need to hobble/crutch to my chair in the morning, and I’m good. How much time will I need off work? Is a week enough?

How soon did you start feeling basically better?

How much do you trust your knee now, after healing and physical therapy, etc.?

What questions should I be asking that I am not thinking of?

And please, in answering … try not to scare me to death. I am trying to help prepare myself for this mentally, not collect every horror story under the sun.

My brother blew his out in an heroic rebound manuever. Screeching pain and whatnot ensued, then surgery and therapy. He is back to being a superstar basketballer against doctor’s orders and runs marathons. This was noto overnight and the therapy lasted a long time but he is currently unstoppable.

I had a full time office job at the time of my surgery and was back to work in a week. I used an extra chair and brought a pillow to prop up my leg.

After the first 2 or three days I felt okay and recouped from the surgery. I went back to my part time job that involved walking/lifting/climbing ladders/bending/kneeling in about 8 weeks.

Totally. It has been 5? years since my surgery. I can jog, tap dance, and kneel sitting my feet again. The only time my knee feels weak is when it very occasionally (like once every few months) hyperextends. That is how I injured my knee in the first place though, so it is scary!

How many physical therapy appointments will your insurance pay for? Important for you and the therapist to know up front.

In the interests of the following answers, I destroyed my ACL, MCL, LCL, tore other cartilege and my meniscus. The word jello was used during the MRI. I had the ACL replaced by a cadaver which is less invasive. I took off a week, but could have gone back after 3 days.

Initial post-surgery pain was awful. After a couple days of Vicodin, I was perfectly fine in terms of pain tolerance, but you will still feel it. I was off crutches for a week, but be prepared to move slowly, because you will feel uncoordinated and hesitant at first. Be prepared for decently lengthy rehab, although after the first few visits you’ll know enough that you can do pretty much every exercise at home. The better shape you are in pre-surgery, the easier your recovery will be. The more exercises you can do beforehand to pre-strengthen your leg muscles, the happier you will be when true rehab starts.

Technically none since I tore it again, but I’m a bit on the extreme when it comes to the amount of torque my knees have to deal with based on my height. Still, even without an ACL, I tend to not hold back in what I do. Most surgeries work, I just happen to be an outlier when it comes to joint stress.

Talk to the physical therapists. Mine initially gave a minimum number of exercises/reps to do. I asked them for the maximum so I could build up strength more quickly. If you have a pretty high work ethic and enough time to devote to it, be sure to do the maximum allowable rehab.

You will invariably have moments when you bend your knee too much after surgery, don’t freak out about the pain. As swelling and fluid gets worked out by your movements, it goes away and gets much better. Get a stationary bike in your house. Low impact, promotes lots of movement and range of motion, and keeps the rest of your body in shape to compensate for any initial weakness.

I tore my ACL (complete) & MCL (partial) in skiing wipeout back in ’94. They cut a strip of my patellar tendon and pinned it in place of the ACL, which left me with a 5” long scar on my knee. Afterwards, I wore a full leg brace and was on crutches for about 3 weeks, but went back to work after a week and a half because of a bad bout of cabin fever. Then I went to my knee brace for several weeks until I felt sure-footed enough to do without.

Rehab started within the first week, and it was hard to bend the knee even a little at first. The PT’s push hard to get the knee flexing and to build up strength right away, so I had a regular soreness and swelling in the knee after each session. Rehab was painful at first but nowhere near as excruciating as the original injury was. A couple of ice packs are essential for PT. One thing that helped me –my PT facility let me borrow the knee bending machine on weekends so I could bend and stretch my knee safely for longer periods while trying to get past the initial stiffness. I went to PT for about 8 weeks. I had good insurance at the time, and only paid about $800 out of pocket for all of my surgery, hospital and rehab.

Now 13 years later, my knee feels pretty good. There’s no normal activities that I can’t do, although if I’m really exerting myself I can tell that knee is not as strong as the other. I also have slightly less flexion in that knee, so if I squat down low to the ground I feel a little strain in the joint. Overall, I trust it and no one would ever know otherwise. I don’t have regular pain or any hint of arthritis, but I think that’s due more to the fact that I luckily had little meniscus damage in my injury. From what I’ve read and heard, meniscus/cartilage damage is more likely to cause ongoing pain and arthritis.

As for advice, I think the previous poster covered that well.

I was over 40 when I tore my ACL and some knee cartilage a few years back. I had the same procedure as Bad Samaritan, where they took the middle section of my patellar tendon and used it to replace my ACL. (I was scheduled for a cadaver transplant, but as the time of my surgery came up, they didn’t have any available, and my doctor asked to do the patellar thing instead.) The scar on the front of my knee is only about 3.5" long. :wink: The doctor also tried stitching some of the cartilage (I had a bucket handle tear).

I was off work for a week, and on crutches for about 2 weeks, largely because they wanted to give the cartilage a chance to heal. The physical therapy for me was almost as bad as the surgery. The first day I left PT without having cried through the whole session was a big celebration for me! But I have something weird going on with my knee/hip connection, and it added a lot to the pain.

My knee is really pretty stable now, and that’s what I wanted out of the surgery. I’d hoped to have less pain overall, but that hasn’t really happened. As time goes on, both knee and hip have been more painful. But I have a lot of joint pain anyway, and that knee doesn’t have the full complement of cartilage anyway (they had to remove some that was torn), so I kinda just deal with it.

Be sure and do ALL the PT and stretching/strengthening exercises that you can. They really will help with the healing, and with how you feel. Continue to do exercise on the affected leg even after surgery. I think having good muscles supporting your knee has a protective effect.

Thank you so much for all the responses here. I’m not looking forward to surgery, but I’m having far too many moments when I nearly fall down because my knee is giving out. Also, I’m relatively young at 32, and my doctors hope to keep arthritis and future strain on the knee to a minimum by restoring stability.

I had no knee (or any joint) problems before injuring myself in July, and I’ve been doing PT in the meantime to get stronger. I know I’m going to have to work hard, but I’m hoping that I’ll be able to get back stability and get rid of most of the associated pain.

I’ve really appreciate the experiences and advice that you’ve given. I would not have thought of asking my insurance company how many PT sessions I could have.

My husband and I had been dancing around the idea of purchasing a stationary bike, and a couple of things in the last two days have cemented the decision – one of those things was this thread. When he gets home from work today, out we go to get one. We’re getting a recumbent for comfort and ease of getting on to it (especially when my knee will be in bad shape), and we may even spring for the one that has no “bar” in the middle – you can just swing your legs around without lifting them.

Thanks again, and if there are others out there with experiences to share, keep it coming!

Mine was replaced in 1998 using the quadriceps tendon–not a common procedure. I wish I’d asked about PT sessions beforehand because I definitely could have used more. It was months before I really felt like the knee was in good shape and strong again but I never had to use a brace and now can do everything. Maybe once every 6 months I’ll hyperextend it or it will just feel a bit achy but in terms of function, it’s all there.

What I remember about the immediate aftermath of the surgery is the following:

  1. Have them instruct you on using the crutches BEFORE the surgery, not after as you’re still coming out of the anesthesia.

  2. Stay ahead of the pain by taking the painkillers on schedule. I only used the percocet for 2 days.

  3. Get one of those coolers that circulates cold water through a velcro pack on your knee–that was a godsend when I went back to work (I was only out one week).

I do have a pretty big scar on my knee, but I view it as a badge of honor… :slight_smile:

This is a GREAT idea. I had one of those, and it really helped to keep the pain and swelling at bay. You can also freeze paper (or plastic) cups of water. When your knee hurts, you can peel the top edges off and rub the ice on your knee. The part that you hold in your hand is still insulated by the cup. Genius.

The first thing they had me on to try to restore flexion was a stationary (not recumbent) bicycle. You start by pedaling backwards, a little more each time, to force your knee to bend. It’s important to get both flexion AND extension back, for you to walk normally.

I had an ACL reconstruction in 1998, after a football injury during my junior year of high school. I think I was probably laid up in bed for about a week after getting out of the hospital, and maybe on crutches for a bit afterward. I had my surgery around Halloween, and I know I was able to take the brace off for good (outside of sports) by Christmas.

Your knee will be surprisingly useless when you get out of surgery, or at least that was my experience. They wheeled me down for an initial physical therapy session before I left the hospital, and I remember being shocked at essentially not being able to bend my leg at all. This can be pretty depressing, especially since most ACL surgeries are performed on people who (as you describe yourself) are almost able to use their knees normally anyway before surgery. So, don’t let it get to you - just be aware that it’ll take you a while to get your flexibility back.

On the same note, keep in mind when you make plans on returning to work that you’ll probably have more problems with bending your knee than with straightening it; i.e., it may be hard to sit in your chair if you can’t stick your legs out or rest your feet on something.

I found physical therapy pretty easy to get into when my leg was annoyingly useless. It was a lot harder to get motivated for it four months or so after surgery, when my knee felt fine most of the time but was physiologically still not in top condition, and I think this definitely slowed down my long-term recovery. So, don’t be like me.

I ran cross-country my senior year of high school, partly out of concern over re-injuring myself, but mostly because the ACL tear helped convince me that I was not very good at football and not really the right size for it. In any case, the knee never gave me any real trouble by this point, either during those distance runs or during wrestling season that winter. Now, nine years post-op, it’s more or less indistinguishable from any of the other minor pains I’ve accumulated in joints, although I am careful with it and will immediately take my life a little easier if it starts to feel sore.

On preview, KSO described that feeling better than I did: I may hyperextend it occasionally, or it’ll feel sore, but the function is all there.

I don’t really know how it is now, but just before and after my knee surgery, I got a lot of help and encouragement form Bob’s ACL Board. They were the ones that helped me find a method that finally helped me get good flexion on my knee. Sometimes just hearing others’ experiences helps too.

My orthopedist told me not to bother with surgery for my ACL. His comment was “Hell, the only exercise you ever get is getting out of the chair for another beer anyway!”

Thanks, Heppy. Love you, too. But he was right. I’ve gone 15 years without my left ACL, and it only rarely bothers me.

My husband tore his ACL and had a nasty “bucket handle” tear in his meniscus (cartilage) while playing racquetball. (Planted his foot, pivoted, shoe stayed, knee went. Nasty.)

The most important piece of advice I’d give you is to not put it off–he used to be stubborn about seeing the doctor (this experience changed his mind) and because of the time between the injury and the surgery, there was more extensive damage to the cartilage that the doctor couldn’t repair, so now he only has about half the cartilage in his left knee. Since he loves tennis and racquetball and running around, it was good to get the ACL fixed, but the surgeon warned him to limit high impact activities because the lack of cartilage will contribute to early arthritis. (Early as in around 40 or so–he’s 25 now.)

Physical therapy:
His physical therapist was a god send. I’d recommend taking your SO or whoever will be taking care of you the first couple days after your surgery with you during the pre-surgery consultation with your physical therapist, and also making sure you’re comfortable with him/her and feel like they’ve got your back. You’ll be working with them for months (if your insurance will cover it) and you should make sure you like them. For example, in addition to explaining the technical details and answering all kinds of questions, my husband’s physical therapist interceded for us with the doctor a couple times (asking if he could have an advil when his pain medication was delayed, etc.) and got much more respect/better information from his office than I had.

Also, given that they’re competent, definitely listen to your physical therapist! (not that you wouldn’t, just saying.) They’re helping you walk. Walking is useful, right? Your recovery will probably be delayed and you’ll feel much weaker for longer down the road if you don’t stick with the program. My husband did it for about 6 months, and now 2 and a half years after his surgery, he feels completely stable on it.

Pre-Surgery:
One thing we were surprised about late in the game was how we were supposed to purchase a brace for post-op before he went to the hospital, and bring it with us. Your doctor will give you more information on it, but you should be prepared to drop a couple hundred on it, depending on your insurance. This will stretch from your hip to your ankle after surgery and have a hinge at the knee. I’m being told over my shoulder as I type this: “It really sucks. Be sure to tell them how much it sucks. And itches.” :frowning: Sorry. Good news is, you only have to wear it for a little while.

After he’d been in therapy for a few months, he had to buy a really tough long term brace that was much smaller and much more expensive than the first one that he had to use whenever he exercised with it. It’s supposed to be suitable for indefinite use (well, until it breaks) for whenever his knee feels wobbly and he wants to exercise/play/etc.

This is based on the arrangement of our apartment, but: a few days before your surgery, prepare some handy snacks and premade meals that you can keep in a cooler or something near where you’ll be recuperating for your time off. I had easy food in the fridge for him while I was at work, but he hated his crutches so much that he often ended up not eating until I got home, which was pretty bad for someone recuperating.

He was out of work for 1 week and worked from home the 2nd week. He tried to go back the 2nd week, but his cubicle was too cramped for a comfortable arrangement. Luckily he was able to work from home. If I were you, I’d try figuring out a setup at work for propping your leg up before your surgery and give it a trial run to see how you can handle it.

To clarify: The long term brace was the one he had to use whenever he exercised. The first one is, I think, mostly for stabilty during healing?

Also, his physical therapist was, of course, a godsend, not a “god send.” sigh.