ACL? ACL? We don’t need no stinkin’ ACL!

I waited a long time in the doctor’s office before he came in. The walls were plastered with various problem joints: knee, hand, ankle; and the ways they can all go horribly wrong. I averted my eyes from diagrams of pins and screws and plates and fractures.

Finally, after a good wait, the doctor came in. “The more we look, the more we find!” were his opening, cheerful comments. “They told you about the ACL tear, right? Here, you can see it on the MRI.” (I could do no such thing.) Then he directed my eyes to several other locations on the screen, “You can see the roughness and tears in the meniscus over here. And over on the other side – that white spot is a cyst formed because your knee is leaking fluid. There’s another tear in the meniscus on that side. And see this bruising? This must have been from your recent fall. It will take quite a while to heal. We call that a bone bruise.”

At the end of the session, I have five things wrong with my knee, three of which must be addressed:

1) Completely missing ACL. He says I must’ve torn it 12 years ago when I went skiing for the first time, and I haven’t had one since.
2) Meniscus tear 1 (lateral) – from my recent fall
3) Meniscus tear 2 (exterior) – from my recent fall
4) Cyst – from the meniscus tear
5) Bone bruise – from the recent fall

The cyst and bone bruise should heal themselves – or be healed by treating the meniscus. But that’s not one, but two surgeries laid out there. I would have to get ‘scoped for the meniscus. The ACL recovery would be rather more involved, probably including a cadaver tendon threaded through my knee and attached at both sides. Recovery would be in the months – to possibly a full year before I’m 100% A-OK! And lots and lots of physical therapy. (Although there’s a good prognosis that 100% A-OK would be the eventual outcome.) I honestly don’t know if I am going to do the ACL surgery, or if I’ll do it now. Maybe 7 and 10 would be better ages than 2 and 5 to be out of commission for a few weeks. And if I’ve gotten this far without an ACL… do I really need one? I’ve apparently hiked the Wonderland Trail without one. On the flip side, they make meniscus tears more likely, and meniscus tears make arthritis more likely. I think Dr. Google and I will have a long chat about this, but there’s no rush. The doctor said I could be a triathlete without an ACL – running, swimming, biking are all ok activities. Basketball, soccer and side-to-side activities are a real problem. I’d probably need a brace for even hiking.

The meniscus tears are more acute. They’re the probably cause of my swelling and pain. And possibly I have them because I had no ACL to protect me. So I have consented to the scoping surgery. I’ll schedule it for after my summer vacation.

The crazy thing is that with all this bad stuff going on in my knee… I’m actually walking ok. Not perfect, but ok. I was walking almost perfectly, WITH all five of these elements in play. I can walk distances without harm. I have most of my range of movement. I’m just…. kind of scared of it all. It all sounds like a big, painful deal that will have me flat on my back for weeks. I mean, when I got really sick this winter I couldn’t even take a few days off from my responsibilities – and I could make it upstairs. How would I do with weeks flat down and months of weakness? I don’t have TIME for weakness.

So that’s the news. I suppose the bright side is, well, I’m wasn’t overreacting to this injury!

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39 thoughts on “ACL? ACL? We don’t need no stinkin’ ACL!

  1. Like Father, like daughter. Dad hasn’t had an ACL since long before I married him. But you don’t want to worry like he has!

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  2. No no no, the bright side is you get to have a zombie knee! Glad the path forward is clear, sorry to hear it sounds like it will have a rather unpleasant stretch in it.

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  3. The meniscus repair is not bad at all. I had mine done in April and I am back to normal. The surgery took about 30 minutes!! I was in and out in about 3 hours and not walking with a cane or crutches. Started PT within three days and within a week was feeling really good. GOOD LUCK!

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  4. My son had an acl surgery wich failed,,long story and many Doctors later,,he was told not to get the surgery because of a condition wich he has that he produces a lot of scar tissue, which now has made his leg stronger!!! Just finished his 3rd year in college playing inside linebacker!!!!! With No ACL Good Luck to you!!

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  5. Thank you for writing this — I’m in this same predicament right now and feel pressured to make a decision soon. I tore my acl and meniscus 4 weeks ago skiing and am doing the physical therapy required before surgery…but the recovery scares the heck out of me. Just recovering from this accident alone is not easy, so I can’t picture what life will be like once I do surgery. (3 kids, job, etc. etc.) I’m just searching through the internet for people who opted not to do surgery and seeing if they’re ok. I’m not a professional athlete, but I run and exercise a lot…it’s difficult knowing if I’m making a poor choice not to do surgery and will pay for it later!

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    1. The surgery and recovery were tough. I can hardly say otherwise. But so was having my knee swell up every six weeks whenever the meniscus tear got engaged. It took me six months to recover from losing my ACL – since you haven’t done that recovery yet, I would encourage you to spend that six months recovering from ACL surgery instead.

      Good luck! It’s not simple, I know!!!

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    2. Ohhhhh so sorry you are in this situation too! I am mom of 3, a runner, had a ski accident in March (last day, last hill of the night…am not a big skier to begin with), tore acl…grrrrr! Not much swelling or pain, a little instabilty, doing PT…bummed to have dropped out of 1/2 marathon training….not keen on surgery…have run here and there but it’s not the same….wondering if I should drop running to preserve knees, but that is very hard for me to consider!…hmmmmm

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      1. I know what you mean!! I’m worried of making a poor decision NOT to do surgery and regret it later. I don’t have much swelling or pain either. It’s been six weeks of PT since accident and I’m meeting with the surgeon next week to make some kind of decision. I’m thinking of holding off for a year, and if I’m still feeling too unstable, go ahead with it. We’ll see what the surgeon says…but I do miss running!!
        Good luck with your decision as well!!

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      2. …Ohhh we are so in the same boat! are you on FB? if so, find me! ๐Ÿ™‚ I was supposed to run a half this weekend, bumped down to 5k and will run with my kiddos and younger sis..it will be fun, but was planning on breaking 2:00 this year….my older sis bumped to 1/2 from Full due to IT issues……I ran 6 miles with my run group and felt awesome..body, soul, except for R knee later…then I realize I have to be careful as don’t want to do more damage….I do hear of other runners w/o acl…..my hubby had acl surgery years ago and has arthritis, limited range of motion now…I don’t have any of that…knee was sore after running the 6…..I did have a little trouble when I turned to talk to someone and lost balance, couldn’t balance on R leg and would have fallen hard if friend didn’t catch me….ummm,not good…but….still a little tender today…..PT says to really work on glutes, calves, hamstrings…I’m thinking of making that my summer goal, maybe some light mileage several times a week, more for my emotional/mental time that I love about running….amping up cardio doing something else….and re-evaluate later in year….But, I meet with sports Dr. again next week…..so we’ll see….I’m not even that big into skiing…grrrrrr!!…let’s stay in touch as we are in the same situation!

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      3. Help!!I tore my ACL and minuscis 3 weeks ago. I am still on 1 crutch. Dr said not to repair ACL cause I am 54. I am very active, run, ski, bike. What to do????

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      4. ..Ohhhh I am so sorry Pennie! Are you seeing a physical therapist too? what kind of Dr. did you see?….for me, I am 2 1/2 months out from injury. I had about 6 weeks or so of PT and have a program at home to strengthen quads, calves, glutes. Thus far, my knee has been fairly stable, only random moments of light buckling…some moments of sharpish pain if I step a certain way. I am allowed to run 3 miles several times a week, and increase gradually, but I haven’t gone any higher. I also use the stationary bike or outdoor bike. I have been jogging some 5K’s with my young sons…But, it is tough. My knee is not the same, yet I’m told I may be fine to just keep strengthening. I do have an appt. with a surgeon in June just to discuss options. My sports Dr. said she would be hard pressed to have surgery if she tore her ACL and she is active in sports other than running. She said she would wait 6 months to a year to see how it would heal before deciding on surgery. I know folks who have been happy with surgery and folks who haven’t. I found out recently that my hairdresser tore her ACL 20 some years ago and didn’t have surgery. She has done some running and also wears a brace for skiing (only greens/blues) and has been fine…no current signs of arthritis etc. I think it all depends on how stable your knee is and how it responds to PT….why did your Dr. say no to surgery?

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  6. …Hi friends!!..my dogs were playing and barreled into me, OUCH said my ACL less knee!!…still about the same, curious as to what surgeon will say in June…miss my old leg, really notice how much stronger my other one is….

    …wanted to say that there is a ton of info. on a site called SKi Diva..if you goggle Ski Diva torn ACL it should come up..if not, let me know…there is a gal there who did a ton of research…she opted for no surgery and is doing pretty good from what I can tell…others have had surgery…

    Also thought to check in the blog author of this post that connected all of us!
    And see how you are today! ๐Ÿ™‚ Deb

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  7. Hi My name is Sabrina
    I just got diagnosed with a complex tear of medial meniscus and complete loss of my ACL. anyone have this?

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    1. Sabrina,

      That’s close to what I had. My meniscus tears (both sides) ended up having to be shaved off, and my ACL was completely missing. I went with a donor ACL, and was very glad I did. I will never be able to run marathons, but I’m close to full function now!

      Brenda

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      1. So some days I feel like its a little better and I will turn the wrong way and Im back where I started.This isn’t going to get any better without surgery is it??

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      2. …first, I am so sorry about your injury Sabrina…what happened? it is tough to adjust to a complicated knee injury…..what I’ve learned thru my journey is that everyone is different and every injury/recovery is different..I have a minor lateral meniscus tear and bone bruising along with a complete ACL tear. I didn’t have pain or swelling on impact or after, except after some jogging. I did PT for a couple of months and a home exercise program. I was allowed to jog per progress/situation. I had some random buckling. I haven’t had any buckling for a couple of months and just a light sensation of knee catching during a 5K last week…have been jogging a couple of times per week and some bike riding…but weeks have been so busy I haven’t been as consistent as of late.

        I met with a surgeon today as it was scheduled months ago. We talked, he examined my knee and said that unless I had buckling/instability or locking/catching of the knee, I didn’t need surgery..I also don’t participate in lateral sports and am not sure I will ski again or maybe I will look into a brace, but it certainly wouldn’t be skiing anything above the beginner Green hills…and I am fine with that…

        I wouldn’t be surprised if at some point I do need surgery and may seek a second opinion just for my own peace of mind. I want to keep running, though am not concerned about pace…but don’t want to aggravate or cause the need for a bigger surgery down the line by running (surgeon did not think that would be the case if I kept running). Biking and swimming are better sports for the knees and I suppose they will become a bigger part of my life as time goes on…I was very flexible prior to surgery (cross legged no problem) but my ACL-less knee is compromised a bit still…Dr. says surgery will not help that…I’m hoping yoga/stretching will…it has gotten better over time…

        I’d say…start with physical therapy, most surgeons want any knee swelling to go down and for some physical therapy before surgery…Start talking to others to see who has had ACL surgery or not…by now, I’ve discovered folks (my hairdresser and 2 friends) who didn’t have surgery and were fine within a couple of years (I know, sounds long, but…) folks who have had surgery and were glad they did and have run half and full marathons since…others who still have random buckling years after ACL surgery, including my husband, but Dr. says that isn’t normal and they should be seen..It’s interesting to me the number of folks that I’ve talked to who had knee buckling/instability but no MRI after knee injury, who are good now….time is what helped most…..talk talk talk to others as much as possible and see how your body does to help you decide what is best for you at this time…p.s. I am 45 years old..

        Hang in there! Let us know how you are! Deb

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    1. I’m no doctor, so I can’t say for sure. My meniscus tears would do exactly what you described, though. I tried PT for a whole summer. I don’t think that will get better without surgery. As for a second opinion… I’m not sure it’s that complicated. Your knee hurts. It’s torn. There’s like one surgery for that. What’s to double check?

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      1. Ugh .. so I felt pretty good yesterday and today I’m paying for it!! It’s noon still in bed with my leg propped up ,I have taken a muscle relaxer and Hydrocodone ,which I think does nothing for the pain.Today I have a sharp burning pain.I talked to the Dr and they said I have a complex tear which will not get any better! Some days I’m really depressed.Im 41 ,I still want to enjoy my life,my kids.
        It’s going to be months before I get the surgery!! I guess I’m just stuck for a while.Does wearing the brace I bought do ant good???

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      2. …so sorry Sabrina! Hang in there, you WILL get thru this…it just…takes time, time is your best friend…it took me awhile to realize that….it’s a tough injury because it doesn’t heal like other torn ligaments…BUT, the best thing to do is get to a physical therapist…it sounds contradictory, but keeping it still isn’t necessarily the best thing for an ACL tear…has your doctor recommended PT? If not, my thought would be to try to get an evaluation…maybe call a PT and ask their thoughts…course they will want a referral…….but even some small, gentle exercises to start will be helpful over time…it’s important to build up the calves, quads, glutes, even before surgery….yes, our legs will never be the same…BUT, it’s very important not to let this become your life…so hard at this stage, I know….this is just a bump in the road of life……ice ice ice…..I also used a compression sleeve intially that I had around…just felt good for support and possibly helped with swelling inside….I’m not you, but try not the major pain meds at this point…motrin though to help with inflammation, pain…more ice ice ice for swelling/pain…..keep in contact with friends…focus on other things…you will get thru..xo Deb

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      3. Thanks Deb!! Its so nice to be able to hear advice from people that have the same problem as me.

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      4. Thanks Deb! It’s nice to be able to chat with people that are or have experienced the same issues:)

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  8. I’ll share my experience in hopes it helps someone out there: During an indoor 60m sprint on 1/26/13, I felt a pop behind my knee which caused it to buckle on the next stride. I then fell and caused broken ribs, fractured shoulder blade and collapsed lung. But, back to the knee. When it buckled, I partially tore the LCL, ACL and suffered a compaction fracture of the femur and tibia. The pop I felt was an avulsion fracture of my fibula caused by the lateral hamstring forcefully pulling on it during the sprint. That caused the instability and the knee buckling. It’s now 6 months later and can jog/walk a mile in 14 minutes. I don’t have any instability episodes but get twinges on the lateral side of my knee. My surgeon attempted an ACL reconstruction with my hamstrings but it failed due to my many pulled hamstrings and tendinitis throughout the years. My hammy tendons weren’t strong enough to substitute for the ACL. I hope the intact posterior ACL bundle is enough to carry me through the years. Did you know the ACL has 2 bundles? I tore the anterior bundle which helps with back and forward motion and the posterior bundle helps with rotational stability. I’d rather have rotational stability because I can-and have- strengthened my quads and hamstrings to help with the back and forward stability. So far, so good. My first road race is on 9/13! I’m currently doing bone stim to help with the fibula avulsion fracture. Here’s the video of my injury:

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    1. …So sorry about your injury and thank you for sharing! …that is interesting about the 2 bundles! I’m thinking that is why my knee is doing well, must have tore just one…running only several times a week, 3-4 miles…plan to slowly increase as I get back to the gym for my leg strengthening…ran a 5K recently in 28 minutes and came in first in age group! ๐Ÿ™‚

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      1. Congrats on the age group win! Your post is more positive compared to the first one from April. Hope you can build back up to half marathon training again.

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      2. Same here. I was on pace to breaking 1:30 for the half a few years ago before I cramped up at mile 12 and had stop to stretch. I came in at 1:32. Now that my sprinting days are over, lots of 5k’s 10k’s and half’s are in my future.

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  9. I have torn my ACL *AS WELL* as everyone else. I have not torn anything else in the knee, MRI was all clear for that but I do have some deep bone marrow bruising on the femur, a small impact fracture and a kiss contusion on the tibia.

    I am also in 2 minds about whether to have the surgery or not. From what everyone has said doing the work before hand is key, and working hard after surgery to get good results. which is fine, and I would be committed to that. Is it quicker to get back by going hard out strengthening the muscles to stabilize the knee? Of course this is if it works ๐Ÿ™‚ If I was to not have surgery and give the rehab a go when could I expect to be back playing netball?

    I am still getting some pain in the knee and am assuming this would be from the bone bruising/impact fracture.

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    1. Well, I’m 5 months out after tearing my acl…I finished my 6-week pt and have continued working out at home…running 12 miles a week, working out at the gym, etc…hoping the “instability” would start to get better. I’m finding if I miss two days of exercise, there’s more “play” in my knee. And the knee pain continues to come and go. I talked with my surgeon and have planned to have surgery in January — I think, for me, this might be the right decision. I thought over time it would get better, but it’s not…and being in my early 40s, I don’t like feeling I’m “old” when I have to walk down a hill, or the stairs, etc.
      It seems the more people I’ve talked to, it’s a matter of accepting that unstable feeling — you can continue to play netball (with a custom brace) and may need to get used to taking aspirin more often. Good luck!!! I feel your pain! ๐Ÿ™‚

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  10. I would absolutely give this a major think, I tore my acl in 2010 had a reconstruction and was totally naive about it all. Long story short I am now on my second graft which had recently failed. And now awaiting my 6th operation/scope to date. The date isn’t set but likely feb-April 2014.It’s easily the worst thing I have had to deal with.
    And quite honestly driven me to the edge of despair, and frankly I too was operating fine without my acl.
    Give this tough thought, perhaps trim the miniscus to avoid onset pain in later life, but if your happy, active , comfortable and strong on your current knee. It’s hardly worth it, I wouldn’t.
    My advice would be to carry on as you are, it’s speculative surgery at best and the recovery percential are far from accurate.
    I’ve always felt vulnerable and ultimately over obsessed on my knee since news it was torn . When really I should have been more confident because they fixed a weakness with the graft.
    It’s tough and horrible to deal with, especially if your active.
    My whole lifestyle had changed, I can only walk limited distances, my knee often swells, and work as a carpenter is very challenging.
    Ultimately if your happy enough, why take a risk that could change everything for the worse.
    Be wise and make the right decision for you, and good luck!

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    1. I’m so sorry Aaron…my husband also had ACL surgery…he was pretty much back to normal after intensive re-hab/PT. He was in the beginning stages of hire for law enforcement when it happened, they said they would not hire him unless he had the surgery. That was 15 years ago. He still has some swelling and periodic pain. Sometimes he has to ice it. It can be challenging at times. He is an avid skier and loves to bike. When he is doing those things, it takes his mind off of it and other life stresses. Keeping glutes, quads, calves, abs strong is helpful as it takes pressure off of the knee. Prayers that this next operation provides relief…hang in there..

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  11. I have no ACL in my left knee. Totally tore it eight years ago. I was supposed to have surgery, but couldn’t afford it. I rarely wear my knee brace. I have even gone hiking without the brace. I rarely have any pain.

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