ACL surgery and recovery

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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.

Links

Photos

Damaged ACL
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.

Patella
My kneecap as seen from the inside of the knee. The damaged ACL is visible.

Femoral Tunnel
The tunnel that was drilled in my femur. The new ligaments run through this tunnel.

Completed ACL
The completed reconstruction. The hamstring is now in the place of the ACL.

Post surgery side view
The side of my knee the day after the surgery. It’s swollen about twice the normal size.

acl-front.jpg
The front of my knee after the surgery. The yellow stains are some sort of antiseptic.

Phil
October 11, 2008 5:17 AM

I had my ACL reconnstructed using a hamstring graft 2 days ago. For some reason they kept me in hospital for 2 nights(got home about 2 hours ago). I'm trying to limit the amount of painkillers that I take. About 12 hours after the op the PT came to see me to show me some basic excises that I need to do, I found these to be quite painful. It was in April 2007 that I damaged the ligament but because of NHS waiting lists I've had quite a long wait, I not sure if this caused further damage or not.

Ali
October 11, 2008 10:55 AM

Phil - don't be too hard on yourself - take the painkillers - at least for the first week. I think you really need them - especially so you can do the physio which is essential.I'm three weeks post op and ditched all the painkillers after a week.Apparently paracetamol is the best thing for bone pain so at least stick with that. Unless your knee was collapsing a lot prior to the surgery it's unlikely to have caused any other damage. Do check with your surgeon,they'll have photo's of the inside of your knee which they usually show you and will be able to see if anything else had been damaged. Good luck with the rehab.

SportsMom
October 13, 2008 8:48 AM

ACl reconstruction scheduled for tomorrow. Thanks to everyone that posts on this site, I feel like I am prepared with all the experiences and insight provided here! I am looking to get off the pain killers as quickly as possible and get the PT started.

Kim
October 13, 2008 1:14 PM

Ali - I too sustained my injury paragliding (fast downwind landing) 1 week ago. Tore ACL,LCL,MCL & some meniscus damage. Will do the hamstring graft on the 31st. How did your 2nd surgery compare to first? I will fly off of anything but am a wus when it comes to needles and nausea. My biggest fear is trying to hard to get back and re-injuring. Did you feel secure getting airborne after so much time off? Were you able to at least do any kiting before 7 months? Would love to hear more about your recovery for this activity. Kim

FJ
October 13, 2008 2:42 PM

I has an Allograft ACL replacement 4 1/2 weeks ago and wished I had found this thread earlier. Although many have already described their experiences, I will do the same and hope it might help someone: - I tore my ACL playing soccer 06/29/08. The Dr who checked my knee thought it was stable enough and did not detect the tear at that point. He prescribed some therapy. After 4 weeks. things were going better, but it was clear that there was something wrong with my knee and my PT recommended an MRI. Sure enough, torn ACL, with small meniscus tear. Bottom line, if you have a doubt about the diagnosis, insist on getting an MRI ASAP. You should still wait before getting the surgery (all Dr will recommend you do so so your knee has some time to heal from the injury for an easier surgery). I had my first appointment with the orthopaedic surgeon in late August. Since 80% of the ACL reconstruction he did were allografts, he recommended I used this technique for faster recovery. I consulted a friend, an orthopaedic surgeon herself, who told me to go with the recommendation. - I had my surgery on 9/12/08, and started using the CPM machine the day after the surgery. I stopped using the pain killers after a couple of days and started walking with crutches putting as much weight as I could on my leg almost right away based on the Dr's recommendation (don't over do it). I also did the regimen of exercises recommenced twice a day (quad, hamstring contractions, leg raises...). - After about 2 weeks, I no longer needed crutches, maxed out the CPM range (120) and started walking with the brace unlocked. - After 3 weeks, I could walk about normally with a slight limp without a brace and started biking (stationary, 3 days/week, 10 to 20 minutes) - After 4 weeks, I stopped using the brace altogether. - After 4 1/2 weeks, I started leg press exercises during PT Overall, I am told that my range of motion is great and my recovery is going very fast (according to my PT). So if you wonder what type of replacement you should get, I would strongly recommend the Allograft based on my own experience. - Make sure to do the exercises religiously and start as soon as you can. - With the CPM angle, don't hesitate to increase the angle more than 10 degres/day as long as your knee feels OK and try to do it a few times a day. I did a lot better when I did it 3 times a days than in a straight shot. - Put weight on your leg as soon as you can (as long as you are comfortable, increase the weight until you get rid off the crutches altogether). I will post more updates whenever I have some. Cheers FJ

Matt Brunei
August 15, 2010 6:23 PM

Last week on the 9 Aug 2010 i did my ACL Surgery ... now recovery .... still feel very tight on my leg ....

cheryl odenbach
November 21, 2010 4:11 PM

help, i had my a acl repaired with my hamstring, and had some meniscus cartilage taken out and also had a partillaly torn mcl, it has been 7 months and i still have alot of swelling, and some days its really sore, i want to run so bad, but cant, can anybody let me know how long it took them to get back to normal, maybe its my age, im 49, thanks

Courtney
January 6, 2011 3:52 PM

My 9 year old son has a complete ACL tear. We have seen 2 different doctors to discuss options. Since he is so young the surgery is different than what they do for adults since they cannot go through the growth plates. We are pretty sure that we will move forward with the option to do the surgery because we do not want our son to do any more damage than what has already been done. Does anyone know of a young child that has been through this.

Vikki
January 8, 2011 8:50 PM

I had my Acl repair surgery 3 days ago, i can handle the pain and am attempting the exercises but am concerned that if i stand up for more than 15 minutes i get really dizzy and feel sick. Is that normal? Also how high am i suppost to be elevating my leg???

pamela vogel
April 26, 2011 6:18 PM

I am 26 years old I tore my acl feb 13 skiing and becuase i was stubborn didn't go to the doc til 6 week later. it was another 4 weeks before the surgery. I opted for the cadaver ligiment becuase i have 3 children and a full time job on the farm. i am one week after the surgery and remember to take the motrin only becuase of the swelling. i have taken two steps without crutches. I was instructed toput full weight on it and do full range of motion (to the best of my ability). this seems to contradict what others have said. So far it seems the more active you are the faster it heals. I also take a lot of herbs. pamelavogel319@hotmail.com

Sam
May 15, 2011 4:55 PM

I had my ACL reconstruction surgery roughly a week ago by a renown surgeon and have had a very rapid recovery which I think is surprising. The nurses had me walking to the bathroom the same day as the surgery (without any brace on the knee). I had drains in my knee which seems to have kept swelling right down to almost no swelling. Its now 6 days after surgery and i can hobble around quite comfortably without crutches without much pain. I am also not taking any pain killers. I have ~90 degrees of movement in the knee already, which I have achieved by doing the recommended physio exercises which are slightly painful to complete. Hope this helps those who are about to undergo surgery.

J Rider
May 21, 2011 1:34 PM

I am almost 3 weeks post acl replacement(left knee), partial meniscus repair, hammy lig. option. Waited 2 years for the surgery, roadbiking and x-country skiing only during that time. Avid gym nut, did pre-op leg stuff right up to day before surgery(day). Still on crutches, or a cane, when at home, doing physio, daily, and am quite slow getting rid of pain (6-7 out of 10) I use Advil, when going to bed. I have enough range of motion to ride a recumbent for 10-20 mins. pain free at physio., but the aftermath is swelling and pain to 7out of 10 for about 16 hours. Ice 6-10 times every 24 hours, and often ice at night when pain keeps me awake. The leg still loves to be elevated with knee 12 inches above heart. I am hoping the slight bulge through my skin on left upper entry cut, will settle down, it looks quite morbid, and chaffs on my DonJoy brace. Anyone have this bulge issue?

Tevin Thomann
August 2, 2011 10:40 AM

I just got ACL surgery last week. I went in to get a fix in my brace and they told me i need to work on straightening my leg so i can be up n down completely.. what stretches can i use to help this becuz i have become nervous about it lol to be honest...im a college bball player needing advise!

Kaylee Casteel
June 4, 2012 7:51 PM

I'm a 14 year old girl that tore my acl playing football like you did but I had stepped in a hole and foot got stuck. I knew something was wrong but kept playing (dumb) and didn't even find out what had actually happened for about 3 weeks. I had the surgery May 9th and when the nerve block thing wore off, the pain was HORRIBLE. Ive had many problems and am just now getting to where I can walk without crutches but still have a big limp. I'm starting to get the bump on the incision below my knee, and the scar tissue is starting to make a huge bump in the back of my knee which makes it hard to do some PT exercises. I'm worried about sports this year because it'll be my first year to play high school sports and they say it may take up to 6 months to fully recover, and practices start in August.

Steve
June 6, 2012 9:34 AM

All, It is great/sad to see this site up and running with so many comments. My last post was in 2005 when I had my surgery on Jan 14, 2005. I tore my L-ACL playing soccer almost 7 years ago. Well, if you are reading this post, than you will find that I just recently met with my ortho (same that did my 2005 op) this morning and was informed that I suffered a complete tear to my R-ACL this time. Kinda bummed, actually really bummed. I'm gonna wait until Sept to schedule the surgery so I can take the winter to rehab and hopefully be back onto the field by summer of 2013. What's different this time? The injury happened during a game and an opposing player fell on the outside of my calf just underneath my knee. The knee collapsed inside and I felt the shhhhh...ping...snap pop inside my knee and a series of crunching sounds. Not good I thought, actually I prayed (even though I'm not religious, by any stretch) that it was only a meniscus tear and would not require a full op. That was almost 4 weeks ago in early May. The funny thing is that I have way too much knowledge and know more friends and teammates that have had a major tear and everyone had a diagnosis. But, alas my trusty sports surgeon said, full tear, the knee test showed no stopping, just kept sliding. The bad... 1. I know what to expect 2. I am 7 years older, I was 32 when I did my L-ACL + meniscus 3. I don't know if my recovery will go quite as smooth as 2005 4. I have less patience now for dorment activities 5. My business is getting very busy 6. I know what to expect (maybe my niaveness was good?) The good... 1. I'm in much better shape now at 39 than 32 2. I know what to expect and can even improve on the things I skimped on the recovery process, although I was pretty "by the book" in 2005 3. I had some meniscus pain in the same knee, so maybe he can kill 2 birds with one stone and fix that too? Unfortunately, I tore that too. Alot of locking/clicking going on in the knee since the injury This site was very helpful during my recovery both writing and reading. I hope to share my second experience with everyone again :( Cheers!!!

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