ACL survivors give me your insight

[alaskaskierdad]

Blew my knee out at Alyeska yesterday. ER doc thinks ACL, MCL and possible meninscus. Can’t get MRI until swelling goes down.

I have lots of Docs that are friends and I am getting a lot of opinions on who I should see. Hoping to draw on the collective knowledge of Pugskiers.

1. What questions should I be asking Docs when I start meeting with them?

2. Anyone have experience with the Steadman Clinic in Vail. Is it worth the trouble to travel all that way? They seem to be the best of the best.

Thanks for any insights.

 

[Beartown]

If you're willing to travel anywhere, I'd check out Mike Stuart at the Mayo Clinic. I know a number of people he's operated on after some pretty nasty injuries. Also used to work with him in the OR (I'm an anesthesiologist) and he's just a real nice guy. Team physician for the US Olympic hockey team, chief medical officer for the NHL. I also grew up with his kids (all three of whom are/have been NHL players).

 

[Ron]

Steadman is a superb clinic and you will get excellent care and a great outcome. You need to call them and get the ball rolling with them now though. The center performs surgery to the elite of the elite as well as mere mortals like myself . Best of luck to you and be prepared for a long journey. Its worth it in the end

 

[mdf]

1. What questions should I be asking Docs when I start meeting with them?

Which ACL replacement do you prefer, and why? (One of your hamstrings, part of your patellar tendon, or a cadaver ACL).
I recommend using whatever your surgeon likes best. If you don't like his/her choice, get a different surgeon.

I don't know how old you are, but make sure the surgeon knows you intend to return to skiing. If your surgeon is a skier that is a bonus.

 

[mdf]

Another thought -- this is way out, but I thought the Continuous Motion Machine helped me a lot. Someone did a study that showed they made no difference in final outcome statistics, so they are no longer part of the standard protocol. But final outcome among a population with a variety of motivation levels is not the only measure. I feel they make for an easier recovery, especially the first week.

 

[newfydog]

I blew my ACL 22 years ago and never had it fixed. Have skied hard on it ever since. A Steadman trained US Ski team ortho looked at it ten years ago and recommended I keep doing what I do, bike a lot, wear a brace to ski. It works for me, but definitely is not the right approach for some less stable knees. Don't rush the decision. The are very few knee emergencies.

Edit:
+1 find a doctor who knows something about skiing. My Orthopedic surgeon first met Steadman when she was a racer and he fixed her knee. Her husband was US Ski Team (they met at the clinic). When she told me she didn't want to operate and keep skiing on it, I had faith in her recommendation. She retired last year, so sorry I can't help with a referral.

 

[L&AirC]

First, sorry to hear this and hope you have a speedy recovery.

I've done both ACLs. Each incident included MCL and meniscus damage and the right one also had LCL damage.

In all honesty, in MY OPINION, ACL repair is getting to be like getting your tonsils removed. It's fairly common especially with so many young athletes specializing so young. Female soccer players I think have a higher rate than skiers - Don't quote me on that though.

Like Newfydog said, find one that skis as well. They have a much better understanding of what you need - not only in surgery but in the way of the burning desire to get back out their. I was fortunate in that the surgeon that did both of my knees (and RTC) is a hockey player and skier.

The biggest thing for me was doing the PT. You can't spend too much time on a bike. I bought a stationary recumbent so my butt could handle it. Don't feel bad about just sitting on the bike watching tv and going slow at first. You aren't doing it for the cardiovascular (that's later), it's for your knee recovery and it only needs your heart to maintain a beat, not improve. My opinion is the bike is the biggest bang for the buck.

If you don't have one, Concept 2 just came out with one and their gear and customer service is top notch. It isn't a recumbent but it is a nice one. I have their rower and love it. Their rower by the way will be (I think) helpful as well since you are still bending the knee. I don't think it is as strength building as the bike is though. Maybe someone in the PT business can answer that better.

Tell your PT what you want to achieve. Mine had me doing all sorts of crazy stuff that scared the other patients (i.e. jumping on one leg on a bosu ball) that had the same injury but don't ski. She would assure them that I didn't have to do them either if I would promise to quit ski racing. Not gonna happen.

Set things up ahead of time for the post surgery changes (car without a clutch, stool for the shower etc). Might need to rearrange some things in the house. Also consider the time of year and that crutches will be needed. Simple things like getting your lunch in the cafe at work back to your office become challenge going solo. But it is good to exercise the brain as well. I love puzzles and life's little challenges.

Once skiing again, don't become too dependent on the brace. I used one and then two for a while. I prefer to just use compression tights. I use Opedix and they work great. Remember to size them to your leg and not your belly. I had to return my first pair and size down. This made them go from compression tights to "Spanx" but it is also a reminder to watch what I eat and drink.

When you finally do get back to skiing, remember, timid skiers are the ones that fall the most and put their bodies (legs) under the most strain. Make it stronger than what it was before the accident.

Heal well,

Ken

 

[Philpug]

Wow, I am disappointed..you are an Alaskan...I would expect you to just chew the leg off and grow a new one.

 

[mdf]

When you finally do get back to skiing, remember, timid skiers are the ones that fall the most and put their bodies (legs) under the most strain. Make it stronger than what it was before the accident.

I noticed on the just finished Utah trip that when I fall I now instinctively guard my knees. (It has to be instinctive, since there is not enough time to think.) I keep both knees bent and slightly tensed as I go down. This was not something i planned to do, just something I noticed I was doing. (Well, except for the somersault -- too fast even for instincts.)

 

[moreoutdoorYuri]

O-FISH-L now 1 yr since ACL/MCL cadaver replacement and meniscus work. Both ACL and & MCL were fully torn off last Jan 28.
Doc did a good, maybe great job. I get the feeling that ACL/MCL replacements are very common these days - don;t think its that special anymore.
Not sure if it needs more than 'Surgeon who has done many', with some awareness that you ARE a SKIER and plan TO SKI AGAIN!
I was up and about in a few days, with crutches, riding the bike in about 3 weeks (as soon as I could get the knee to allow the pedal to go over the top)
skiing and skating proving to be the most stressful, cycling, hiking and such are mostly fully normal.
I iced a lot and still ice after heavy use.
Highly recommend an 'ice machine', I have this one - https://www.ossur.com/injury-solutions/products/cold-therapy/cold-rush-device
miraculous!
wearing brace whileskiing - it helps some... but what is the biggest issue are the micro-jolts the knee gets from going over the skiing surface. Depending snow conditions, my day can be 'done' in 4 hours of ski time - if I push for 'bell to bell', it will require heavy icing for most of the evening til bedtime.
Surgeon 'cleaned up' both side of my menicus, because he said it looked really bad from decades of abuse...
Rethinking that now, I would have asked he leave the meniscus alone, because I had no issues with it before the surgery.

I've always been a stickler about 'technique', but now I'm totally anal about staying centered and neutral with good separation.
I did love working the tails hard in turn completion - no longer.
Carving feels better, hurts less than smearing... Bumps are still actually fun, IF I find the right speed to match the bump line.
I'm encouraged that this past 3 days felt way better than the first 3 days of this season. I'm hopeful that next season will feel way better...
if I live that long... LOL!
good luck with repair and recovery!

EDIT: as noted by others - I use a compression knee brace under the structural brace, I think the compression is the most important and works to keep all the parts in proper orientation. Helps keep the swelling in check and really reduces the shock into the joint. The structural brace really doesn't do much in those aspects. I use it because it isn;t really a hinderance, so if it helps or proves to be a saviour - all good.

 

[fatbob]

I had patellar autograft and its been bomber. Find a surgeon you trust. I suspect it doesn't have to be a national superstar but anyone who does a lot of pro or serious am sports people will understand urge to get back to normal quickly.

 

[Brad J]

I like Newfydog never had it fixed, I did mine 20 hers ago this month , I was lucky that i still had good stability, and did the necessary PT to ski that next fall. I wear a brace and have no problems , I did do a Quad tendon rupture on the same leg 12 years later, which was a no choice operation . was never sure if they were related, but i did the PT and was back at it in the fall. I am always a little skeptical at the operate first way of thinking. i really think with the proper amount of PT one will end up in the same place. One thing I would not do is screw up one ligament to fix another, but thats me . Good luck on what ever way you go, get and do all the PT its the ticket for success

 

[Pequenita]

Agree with all those who have recommended finding a surgeon you trust who works with active people, and that ACL reconstruction for non-pros is common now. I wouldn't choose the surgeon based on the graft they use, but rather, choose the graft based on what the surgeon is most comfortable with and also what works for your situation based on the surgeon's professional judgment. Make them explain why they recommend a particular path for you.

I partially tore an ACL, strained the MCL, and had meniscus work done in 1990 (ski injury). My small hometown surgeon took a very conservative route of doing nothing to the ACL, tightening up the MCL, and trimming the meniscus. In 2003, I completely tore the same ACL (soccer) and had the ligament reconstructed with a hamstring graft by a large east coast city surgeon who specialized in hamstring grafts for female athletes. In 2017, I had a tibial plateau fracture to the same knee...and all ligaments were intact, to pretty much everyone's surprise. Now I wonder if the reason is because both my ACL and MCL have been surgically "strengthened".

 

[mdf]

I skied 9 days in a row in Utah, opening to closing except for a long lunch socializing. (9th day was a half day because of pscking). I had no knee problems, not even soreness. An excellent outcome is possible!

 

[Ken_R]

Blew my knee out at Alyeska yesterday. ER doc thinks ACL, MCL and possible meninscus. Can’t get MRI until swelling goes down.

I have lots of Docs that are friends and I am getting a lot of opinions on who I should see. Hoping to draw on the collective knowledge of Pugskiers.

1. What questions should I be asking Docs when I start meeting with them?

2. Anyone have experience with the Steadman Clinic in Vail. Is it worth the trouble to travel all that way? They seem to be the best of the best.

Thanks for any insights.

Hi, My wife busted the ligaments in her knee but she got a small tibia fracture in the process as well so she had to wait quite a while for that to heal before dealing with the ligaments. She is getting surgery in a few weeks here in Highlands Ranch Colorado. There are several great doctors here in Colorado that specialize in that type of injury and fix it using arthroscopic surgery. Its obviously quite common given the sheer volume of people that ski here.

Steadman is an amazing clinic with great outcomes. Call em.

 

[Alba Adventures]

We have shared this video here on PugSki and was also featured on the late late EpicSki a year ago. Not sure if this helps though this is a story of my wife's ACL recovery - you should see her skiing now - sans ACL.

 

[moreoutdoorYuri]

We have shared this video here on PugSki and was also featured on the late late EpicSki a year ago. Not sure if this helps though this is a story of my wife's ACL recovery - you should see her skiing now - sans ACL.

always nice to see a positive outcome... I didn't watch in entirety, but did scan for clips - was it mentioned how long the period was from injury to first time back on the hill?

everyone's different/injury is different - no way I could NOT have had ACL/MCL replacement. I couldn't even walk on a very slightly sloped driveway without knee giving out, before my surgery... I'm the last to go under the knife, attested by both my shoulders... everyone's situation is unique...
glad your wife is in a happy place!

 

[Alba Adventures]

always nice to see a positive outcome... I didn't watch in entirety, but did scan for clips - was it mentioned how long the period was from injury to first time back on the hill?

everyone's different/injury is different - no way I could NOT have had ACL/MCL replacement. I couldn't even walk on a very slightly sloped driveway without knee giving out, before my surgery... I'm the last to go under the knife, attested by both my shoulders... everyone's situation is unique...
glad your wife is in a happy place!

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