11 Nov 2004
Google has my site ranked rather high for some searches about ACL injuries and some people have emailed and commented about my surgery. A number of those are people with recent ACL injuries that want to know what to expect for their surgery and recovery.
I tore mine playing indoor soccer. I planted my right foot and pivoted hard to the left, but the bottom half of my leg didn’t turn with the rest of my body. The knee sort of twisted and my momentum kept carrying me forward, bending my twisted knee sort of sideways.
The surgery and recovery will vary from doctor to doctor. Certainly tell your doctor if return to sports is your goal.
My surgery involved removing a portion of the hamstring where it connects to the shin. That was used as a replacement for the ACL. They inserted a metal pin into the femur and looped the hamstring over it and down into the knee. They drilled a hole through my tibia and threaded the hamstring down through that hole. They secured the hamstring into the hole with a screw that will eventually be absorbed into my bone. All told they cut six holes in my skin. The one where they removed the hamstring is about 3 inches long. one is a pinhole where they poked a wire into the skin to help align the hamstring onto the metal pin. The other four are small holes where they ran arthroscopes and tools into my knee.
Other replacement techniques include using a cadaver ligament or a portion of the ligament from your kneecap to your shin. It depends on what your goals for surgery and the preference of your doctor on what they’ll use to replace your ligament.
I was put under general anesthesia for the surgery and woke up about 4 hours later. The surgery itself took about 3 hours. I went home that day. I was nauseated for 3 days from the anesthesia and the Vicoden. I had the surgery on Monday and left the house for the first time on Thursday afternoon. The pain was mostly gone by then. By Saturday I was at the soccer field watching my kids play in a tournament.
I’ve heard from other people that this sort of fast recovery isn’t normal. Many people that I’ve talked to were in the hospital overnight. Most couldn’t work for three days, while I was doing some limited work the afternoon of the surgery. So don’t make any plans for about a week after the surgery.
The following Monday I had a physical therapy appointment and learned some simple exercises. They’re hard to do and quite painful, but if you don’t stick with them you won’t fully recover.
I’m on crutches for about three weeks. The recovery and movement is progressive. At first I had a brace that was locked straight. After a few days I was able to unlock the hinge and sit with my knee slightly bent, but when I walked I had to have the hinge locked. Now the hinge is unlocked all the time and I don’t need to wear the brace while I sleep. Each new step causes all sorts of new aches and pains. One of my PT exercises is the indicator of when I’m done with the crutches. When I’m able to complete the exercise, my leg is strong enough to ditch the crutches.
I’ll need to wear the brace for 4-6 weeks from the date of the surgery. As soon as I can walk without crutches without a limp, I can take the brace off.
It will be 6-9 months from the date of the surgery before I can play sports again. I can expect my knee to swell up at random times for no apparent reason for the next 2-3 months. I plan on going to Disneyland for three days at Christmas and will have just gotten out of my brace. The doctor tells me I’ll be fine, but expects that I’ll need to ice my knee at night.
Some links to good ACL information and arthroscopic pictures of my surgery are below.
The damaged ACL before the replacement. The metal object in the photo is a probe that is pushing apart the two halves of the ligament.
My kneecap as seen from the inside of the knee. The damaged ACL is visible.
The tunnel that was drilled in my femur. The new ligaments run through this tunnel.
The completed reconstruction. The hamstring is now in the place of the ACL.
The side of my knee the day after the surgery. It’s swollen about twice the normal size.
The front of my knee after the surgery. The yellow stains are some sort of antiseptic.
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