Sounds great. Maybe I missed it, but what type of graph did you get?
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Sounds great. Maybe I missed it, but what type of graph did you get?
Quad this timeQuote:
Originally Posted by mcski
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Question for the vets- how long were you in a locked extension brace in the immediate post op period. I talked to my wife's Ortho's assistant on the phone yesterday going over some pre and post op plans, and she said she would be in a locked extension brace for 6 weeks Post op. My understanding is thats only normal for a meniscus repair, not a straight ACL reconstruction. Seemed odd , and we will ask the surgeon before surgery. , but just wanted to see what's the norm here.
Hmm, I've had it done once on both knees.
ACL reconstruction only, no other damage.
IIRC is was back to surgeon in 2 days for dressing removal/inspection.
Then locked for two weeks moving to limited ROM.
So then you have a little divot above the knee now? It took the better part of 3 years for mine to flush up to normal.Quote:
Originally Posted by montanaskier
~~~~~~~~~~~~~~~~~~~~~~~~~~~
@Duff - dang, 6 weeks doesn't sound right to me. I had full acl, meniscus nibbling and a partial mcl tear. Not to mention the completely separate surgery of harvesting the quad graft
Iirc, I was in the stiff brace for a few days, maybe a week. Had a full donjoy right after and even that was only for maybe 4-6 weeks.
We're all different and that's the key. Some heal faster, others drag on and on seemingly.
Have cadaver grafts become old news? Seems like most I hear about these days are harvested. When cadaver grafts started becoming common the consensus was they were stronger. Sounds like that perception has changed for most docs? Given the harvest options, I think I’d feel better w the quad compensating than the hamstring
My cutter said autografts are typically better for active types aiming at returning to their previous [/bestskieronthemountain] levels of performance.
IIRC cross sectional area is quite a bit larger with an autograft (IE 9mm diameter vs 7mm for cadaver graft; which has been irradiated so not as supple).
He said 6% loss off hamstring strength but no one would notice that unless they were like an Olympic sprinter or something ...
I responded with the aforementioned [/bestskieronthemountain] comment
But I just break'em.
I'm just past 9 months post-op on 2/22.
PTed soft, then PTed hard.
15 days skiing since 1/30 when I started my Powder Pilgrimage.
1\2 days, but charging.
:)
That's exactly what my surgeon told me, but he was wrong, I do notice it.Quote:
Originally Posted by pfluffenmeister
It's possible some of us ski harder than the average doc realizes.
I'm not even saying it compromises my skiing, but I do notice it. Stepping into Marker Griffons, which are known for being very stiff, and it is noticeable between one leg and the other. Had to switch to Attacks [emoji3]
That’s why I kind of feel like I would feel it less if the graph was from my quad instead on the hammy but who knows.
I do think most of the docs under estimate the use cases for most of the tRG type folks
Wife is 5 weeks out from injury & 2 weeks out from cadaver graft surgery, she is 100% weight bearing & brace is unlocked to 90 degrees. She got her surgery done at Hoag HOI in Irvine with Dr Parveresh who is supposed to be "one of the best".... will give updates as to how things are going.Quote:
Originally Posted by mcski
Attachment 488649
Some good news for Mrs Duff but now uncertainty. 8 weeks from the injury and she's been prehabing hard. Full range of motion, about 80% strength to other leg, a little lateral pain but that's prob from the small meniscus tear and bone bruise. Has been skiing east coast icy groomers with the kids but not going hard .
Went in to plan surgery and had the Ortho recheck the knee since the MRI read high grade near complete tear of proximal ACL , but it wasn't 100% . Same Ortho who noted laxity and + Lachmans and pivot test last time said she could only feel subtile laxity on the Lachmans and that a resident might not even notice it. Discussed options and said it was totally up to the wife what she wanted to do and that no decision was wrong. The Ortho knows she wants full function and doesn't want to be a ACL deficient coper . Also discussed the possibility of a repair vs the quad tendon reconstruction as one bundle of the ACL may be intact or healing.
My wife is more stressed now because she had mentally committed to surgery . Her concern is that leaving it alone is a ticking time bomb that will cause problems. I understand this and the Ortho didn't disagree and said that you simply won't know how the knee will hold up until you push it
Anyone have a similar situation? I feel if I was in that spot I would want to avoid surgery , potential weakness and complications, and the long 6 -9 months rehab (6 if its just a repair , 9 or more if it's a quad tendon recon). But her thought is she's fit now, in a good place to rehab it aggressively post op, and doesn't want to have doubts about the knee going forward skiing aggressively.
My wife just popped her ACL at Snowbird on Tuesday. Had X-ray at Snowbird clinic same day (bones all ok) and MRI same day in SLC. MRI results show ACL. We have both X-ray and MRI results on hard disk. Currently have knee brace, crutches, and on the R.I.C.E. program.
Now the interesting part… We are travelling around the West by truck camper from the East Coast. We have a place in Bozeman for a week (here now) then we were planning to go to PNW mid-March. We just left SLC area to come get our stuff stored in Bozeman, but could go back that way if warranted.
Looking for recommendations/connections/advice for ortho surgeons that might have availability. This is all new to us and we feel like we’re in a bit of a rock and a hard place situation. We live in very rural Maine with not so great health care. Thinking that orthos out west would have better experience and more positive surgical outcomes. Wife (52 y/o)wants to continue to ski hard for decades.
Any Mag help appreciated!Thank you. Adulting sucks!
Duffman, you mentioned that your ortho suggested the acl is healing? I didn’t know that was a thing…
The young sports med doc that I consulted (1 of 4) suggested that a high stability brace (eg donjoy custom) could/should work well for support of additional injury for higher risk activities. That doc basically told me that any middle aged athlete that works hard in higher risk sports (e.g., skiing, soccer, football, BB) very likely has compromised soft tissues in their knees that are being compensated and supported by muscle strength. You and wife may also want to look at published studies of injury of her other knee as a result of her current injury. My 30kft skim is that she has a more likely chance to injury her “good” knee now compared to before her injury earlier this winter.
Singlecross, I do not have specific answers, but know there are several othro’s in SLC area that work with US ski team and other pro athletes. Also, I experienced a very rapid turnaround in December when I got my donjoy custom brace after finding, coordinating, and meeting with one of their reps.
hey single... I see your getting advice on doc and surgery route...
I would highly recommend something like this.... there are quite a few, will hold ice for a long time while resting, etc...
https://www.amazon.com/NEHOO-Continu...17&sr=8-9&th=1
was well worth the comfort
In general, allografts have a faster recovery but a higher failure rate long term. I was locked at 0 for a few days but certainly not for 6 weeks. I was in a brace when I was out and about for awhile, mainly to make sure people knew to give me space. The Vail area has a ton of great knee surgeons….id recommend vail/summit orthopedics….you might find a surgeon that could turn it around quickly.
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Need some advice, hopefully positive mojo to get me through to next year.
Mid-January while on a big trip to BC I tore my left ACL, bucket handle meniscus tear, and sheared off a nice chunk of cartilage. Surgery 1 month ago (ACL repair with quad autograft, meniscus repair, and internal fixation of cartilage). Non weight bearing for another couple weeks (surgeon being conservative because of the meniscus and cartilage), lots of time in the CPM, PT 3x/week now with extreme focus on regaining extension. Plan on rehabbing hard as soon as I can be weight bearing.
From reading various forums, I'm getting the feeling that I will be on mellow groomers for much of next season.
What say you who've been in a similar situation? Is next season just about getting comfortable mentally and physically, or can I plan on some fun skiing. I I assume planning a ski trip out West is not a good idea until I have a better sense of how the knee feels. If I'm stuck on groomers, I'm considering buying a slalom ski or something more front-side oriented and sticking some Protector bindings on them.
About me: ~40y old, usually get 50days in a season. 40 at resort, 10 in backcountry. Was running 30-40miles/wk last year in anticipation of this season after realizing how aerobically deficient I am. Running those kind of mileages this summer is looking unlikely, and I'm hearing I should consider switching my cardio to a bike instead, which doesn't really get me jazzed either.
I’d plan on mellow groomers. If you bust your ass in rehab and get your repaired leg quad strength back to the same as the good leg you can ski more. That takes awhile and the mental part takes awhile too. I started out mellow groomers this year and have eased my way back into skiing “normal” stuff, variable snow, etc…. Gotta be patient, rehab like a madman, and don’t expect much.Quote:
Originally Posted by eastcoasttreehugger
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Thanks for this. What about touring resort laps for exercise? I assume thats doable the first year?Quote:
Originally Posted by montanaskier
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You will hear all kinds of anecdotes but the PT told me don't do anything stupid for the 1st 9 months and its going to take 3 yrs to completely recover
I'm a three time soft tissue injury in roughly the last decade and have some anecdata to provide:
2015 right ACL; hamstring allograft
Didn't PT long enough really and skied at 6 months post-op (not smart, but nothing bad happened).
2021 Ruptured left Achilles.
No fun and no joke; 5 weeks no weight bearing.
One must PT completely (and I did).
Skied at 8 months post-op.
2023 left ACL; hamstring allograft.
PT'ed soft ... then PT'ed HARD!
Just started my Pretirement and skied at about 8 months + a week post-op
Skiing strong and charging with uncompromised line choices (albeit, until recently for just half days).
Skied 22 days in the last 35.
Feel great ... and tired.
:D
Good to hear, thank you! I plan on treating the PT as primary job so hopefully next season will surprise to upsideQuote:
Originally Posted by pfluffenmeister
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I’ve toured the resort but again it sort of depends on how recover. Like stated earlier,Quote:
Originally Posted by eastcoasttreehugger
I’d plan on a very gradual uptick into “regular” skiing. I did 30k vert yesterday, my biggest vert day of the year. Zero way I could have done that in Nov or Dec….just ease back in.
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Awesome. How far out from surgery are you now?Quote:
Originally Posted by montanaskier
Bumping this as Mrs Duff had her surgery yesterday . A couple of interesting findings...
1- The "high grade near complete proximal ACL partial tear" (as read on MRI) had actually stabilized nicely (as expected by me given her significantly improved Lachmans test ). The surgeon found the ligament was mostly intact but had laxity, so she was able to do an internal brace repair to reduce the laxity and strengthen it. So good news from a recovery standpoint there , and no graft site morbidity to deal with
2-The vertical lateral meniscus tear seen on MRI and the likely source of most of her discomfort was more extensive than on MRI with a complex radial component as well. This was suture repaired which long term is way better than a resection , but she is now 4-6 weeks of minimal weight bearing and in a locked extension brace except for PT.
Win some lose some.
So the good news is the ACL was in pretty good shape , and adds to the recent evidence that partial proximal tears do have a decent capacity to heal more than traditionally thought. The complex meniscus repair will totally slow down the initial rehab period, but a full return to skiing and such should be possible by 6 months or so compared to 9 or more for a full ACLr
That’s pretty great news about the acl! I hope the healing and rehab is fast, and the meniscus healing goes well. Right leg?
In the mid-90’s, I had an injury in my left knee from skiing. I was 21. It bugged me, flared up occasionally, but was not a chronic issue. Went to a top surgeon who worked on the SD Chargers, had MRI, dx’ed as meniscus tear, had surgery for trimming, and the surgeon found the meniscus fully intact but a torn up plica. He trimmed the plica, and I was out of rehab in about month (I was in top shape/condition). I had a VHS tape of the surgery. Surgeon was surprised about the plica and lack of meniscus damage based on his exam and the MRI. Goes to show….
Any of you middle-aged folks wear a high stability brace prophylactically? One of the docs that I saw told me that my good knee is very likely not 100%. I’m planning to get non-custom high stability brace for that knee for skiing as prophylactic protection.
Update for my bad knee: I’ve been skiing pretty hard all season with a donjoy custom brace and doing my best to maintain/focus on the strengthening recommended by my PT and on leg blasters, which means less fun activities on off days (like long sunset trail rides) because of available time with other factors of life. My knee still bugs me, but I’m still patiently building more strength and dealing. I have not had a destabilizing episode in 11 months, but I’m also taking care in some of my daily movements.
Many of my ski days are 6+ hrs on skis and making turns (volunteer job). I’ve been staying away from cliff drops or jumps, but have had no issues with jump turns or poppy-style mogul skiing. Even after many days, I’m still gaining confidence that my brace will keep the knee stabilized. Tele turns definitely feel less stress on the joint than alpine turns: the motion and physics of unweighting and transition between turns is less stress on the knee when telemarking. Crashing, standing up, and feeling fine because of the brace is still a weird sensation.
Good reports from both of you!
Unfortunately I have joined the 2024 ACL class. Damage happened three weeks ago at Kirkwood. Initially thought it was just a MCL tear, however after the MRI it turns out I have a completely torn ACL, a grade 3 MCL and a grade 2 PCL tear and a small fracture in the tibia. Doc didn’t see any damage to the meniscus so that’s a small amount of good news. He thinks the MCL and PCL can self heal. He did his poking and prodding of the knee and leg and said that my knee is still pretty tight. Currently I’m non weight bearing with a brace for the next 3 weeks. Then we can talk about the ACL.
I’ve read through most of this thread but anybody have advice on helping the MCL/PCL heal. Supplements, diet, anything else I might be missing?
TIA
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What were your symptoms that made you think MCL? Is the knee unstable? And why non weight bearing?
Copying and pasting this for Ima Gaper crosspost from Midwest thread. Has more details.
Wow.Quote:
Originally Posted by Ima gapper
Totally above my pay grade. When the surgeon is telling you no weight bearing that is damned serious.
I wouldn't hesitate to get a second opinion either. This doesn't sound like a standard acl tear. I went to a local guy for mine, but it was literally as straightforward as you can get.
I know the U of Iowa is doing some newer acl grafting techniques that are working out well for instance. One of our local racers gals just had a graft I'd never heard of from them.
Hopefully you'll get some more feedback in the acl thread.
Also, https://14erskiers.com/blog/2017/03/...-knee-surgery/
Brittany is own of our own and has some great advice.
Mcski
On the initial assessment at the Kirkwood clinic the doctor did some range of motion stuff he thought the knee felt good in the front to back stability but there was a lot of movement/instability laterally. That was the initial prognosis of what he “would guess is a partial or full tear of the MCL”.
When I saw the ortho surgeon yesterday he is wanting to protect the knee from any accidental reinjury of the mcl/pcl. He said it takes about 6 weeks for the mcl/pcl to heal. I believe that is why non weight bearing for another 3 weeks
Ugly$ I’ll give that blog a read
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Sadly, I now need to read this thread. Surgery scheduled for April 25th.
That sucks man. Hope all goes well with the surgery and rehab.Quote:
Originally Posted by The Iron Horse
Shit, vibes man.Quote:
Originally Posted by The Iron Horse
does get better
I've learned more in the past 10 hours about ACL surgery than I ever wanted to know.
Today was a shock. Last year I damaged the meniscus of my left knee and had surgery to clean it up, along with removing what little was left of the cartilage in that knee. Most of it was just floating around getting in the way. After 12 months, I finally felt like it was close to good... sore as hell, but tolerable. Been skiing my ass off all season, getting stronger and stronger. Now, however, the right knee decided to give me the big middle finger.
Partially torn ACL, meniscus, lots of cartilage damage. Absolutely crushed to find out, but I knew it was different than the left. Doc seems stoked to go in and get it done. Also talking about possibly performing some "microfracture drilling." I haven't read up on it yet, but I get the idea. Said he'd make a game-time decision once he goes in.
He's trying to buy me time until I need a full replacement in both. Hoping to put that off for another ten years, until I at least reach 62.
Sry ^^^. That sounds pretty rough. I’m hoping that the tech and techniques for TKR continues to advance in the next few decades.
Honest question for y’all: how are you affording your surgeries? Great, low deductible/premium insurance, spot insurance, rainy day fund, general debt, etc? I’d like to think that $$ hasn’t exactly influenced my decision to not operate, but it’s be a chunk of $$ and we’d likely go into some sort of payment plan. With insurance offered by my work (high deductible plan) premium and deductible, we’d be $14k out of pocket (if everything was in network) before accounting for the pharmaceuticals.
Canada eh, so its covered for everyone by the medical plan but you have to wait for it, mine was 8.5 months during covid lockdownQuote:
Originally Posted by bodywhomper
Wife had microfracture surgery with a meniscus repair, it helped.Quote:
Originally Posted by The Iron Horse
Good luck!
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Fortunately insurance is not something we have think about. My wife and I were both in the Marine Corps, and she toughed it out for 21 years. The Corps destroys your body, but Hey!, if you survive until retirement you get great health insurance for practically pennies!Quote:
Originally Posted by bodywhomper
Thanks. The microfracture surgery seems to make sense, glad to hear it helped her. My doc said he has had good success with it. Downside is I think it slows recovery down, as he said I'd be non-weight bearing for 5 or 6 weeks.Quote:
Originally Posted by montanaskier
In my case I had high deductible insurance and had to pay about $6,500 out of pocket. Above that amount everything was covered (no co-insurance). Yeah it sucked to write that check. But if you have a Health Savings Account you can actually pay for stuff like that tax-free, which helps ease the sting a little bit.Quote:
Originally Posted by bodywhomper
/\/\/\
Yup, my three have all run me about 6k (max out of pocket).
The total billed was roughly 25k-30k.