This morning I went in to physical therapy, walking flawlessly down the hall. “So what’s up?” my PT asked. “Funny you should ask….” He looked downright put out when he heard the extent of the interior damage. “Let’s retest you and get a new baseline.”
So I laid down and bent my knee. I straightened it. He moved it left and right, up and down, all around. Finally, he put his hands on his hips, “Are you sure they had the right MRI, because there’s no instability at all in your knee.” So it’s not just me… I really am super stable sans ACL.
Still, I have a big decision to make. It’s not ok for me to spend the next several years of my life never bending my knee. Moments like that dinner will happen again, and you know… sometimes it’s not convenient not to be able to walk for several weeks. So I’ve more or less decided to get surgery. I was sure pretty much from the get-go that I’d get the meniscal tears mended. The recovery time (as in normally walking) is 2 – 4 weeks on that, probably more like 4 since I’m having two procedures done. I can do both ACL and meniscal procedures at the same time. The recovery time for an ACL reconstruction is 4 – 6 weeks. Both procedures will require months and months – up to a year for ACL – of physical therapy afterwards. With the ACL reconstruction, it will be 6 months before I’m up to my usual habits as an elite athlete. (Oh wait…)
On one hand, I seem to do pretty darn well without an ACL. On the other hand, the “incremental” cost of an ACL replacement is 2 or so weeks from just a meniscal tear. I also save “incremental” physical therapy costs by bundling the surgeries. Additional data points to consider:
– not having an ACL makes it more likely I will tear my meniscus… which means this whole scenario could happen again
– meniscal tears make arthritis more likely
– I am pretty active. I like hiking and would enjoy playing raquetball.
– my children are 2 and 5 … a two year old is hard to manage with a healing knee
So my tentative plan is this:
1) Plan for surgery in mid-September. (I’d like to enjoy my summer, thanks!)
2) Spend the next two months getting my knee super strong and healthy to make my recovery period as short as possible.
3) Can’t help but wonder if it would be better if I could lose some weight. Of course, if that was easy vanity would have already accomplished it.
4) From mid-September, with say 8 weeks of serious knee instability, I’m likely to be walking well by mid-November. This means that by the time the snow flies, I should be pretty stable.
5) Six months from September means that by next summer I should be fully healed, and should be able to, for example, go backpacking.
6) Surgeries are done on Tuesday. I’d probably take the remainder of the week off (sort of depends on how I’m doing with pain meds) and then work from home for another week or two.
7) I’ve done some investigation on my dr. and hospital, and they seem middle of the road: not the best in the state but perfectly fine. Is that good enough?
There’s absolutely never a good time for a young, working mother to be out of commission for a month. But I do need to be able to walk, and this appears like a permanent solution (assuming I never, ever, ever go skiing ever again).
So I’m curious what you guys think. Am I missing a data point? Am I correctly interpreting the abbreviated recovery? Do I need to replace the ACL at all given the stability? What would you do in my place?
4 thoughts on “Knee analysis”
If not getting surgery today makes arthritis and long term debilitating problems more likely, then in your position I would get it despite the risk inherent in surgery.
In recovering from my meniscus repair surgery (mine was medial and really badly torn/shredded). I took the day off for surgery, worked from home the next day and was back in the office the day after that. I had PT twice a week for 4 weeks and I was pretty much as good as new. I think the recovery will be shorter than you have anticipated. I had my surgery on a Tuesday and was limping around like a wounded kitten until 3 days later at my first PT session, my PT told me to stop babying the knee and walk on it correctly. I took her at her word and was walking normally by that weekend. I’m not saying it was without pain, but the pain was SIGINIFICANTLY less than pre-surgery and really didn’t require any of the strong pain meds they gave me. Good luck!
You’re waaaay too young to get a knee replacement (even 10-20 years from now), so anything at can hold off osteoarthritis is good, IMO.
Ask your surgeon how many times he (I’m assuming, since most orthopods are “he” – but if you can find a woman, she’s probably had to work twice as hard as the guys so I’d go with her!) does your particular surgery in a week, in a year. How many years has he been doing this procedure? Is he planning on trying out any new techniques on you? What percent of his practice is made up of you, i.e. your type of patient? What’s his complication rate? Infection rate? And how do all of those numbers compare to other surgeons doing similar things?
Does the ortho dept in general have a busy surgical practice, is the hospital a busy hospital even if it’s not one of the “big ones”?
Are you going to a teaching hospital? September is OK then. The new residents and fellows come in in July and things are more chaotic in high summer. If it is a teaching hospital – will his fellow assist? Do the follow-ups? How much interaction will you have with the surgeon himself?
I’ll stop now 🙂