Travelling Magette ACL help/advice.

[grskier]

Five knee surgeries here with each ACL done, see avatar haha. Have been treated at U of U and they are excellent. Was treated many years ago for a complicated femur fracture at Steadman Hawkins in Vail and they were excellent. However both of my knee surgeons, in southern CO, and here in SLC, are Steadman Fellows and they are everywhere. Great credentials to look for. Also ask them how many of these things they do and on what patient population. Be very up front about expectations and intentions ie: "skiing hard for decades to come".

All that said, your wife will want to 'prehab' for 4-8 weeks to get that knee back in shape. There's swelling and pain that causes shut-down of muscle firing and proprioception, muscle atrophy, and severely reduced ROM. Any good surgeon will put her on this program and it's good to be in formal PT 2-3x/week for at least the first few weeks. She'll work to get the swelling down and get ROM back, then work on strength and stability. She should be feeling mostly back to normal for day to day activities and have close to 100% of her strength and ROM back pre-op. They'll have stationary bikes and weights machines etc. at PT and they might let her go in on her own when she doesn't have formal sessions. She'll want access to this stuff every day one way or another.

I did my first ACL at 24 and was ski patrolling full time at six months out. My next was at around 35 and was much harder. My expectation of skiing at 90% six months out was not even close. I returned my season pass and redoubled my rehab efforts. Then by nine months I was feeling pretty good and bought a spring pass.

I'm 50 now and would not want to do it again but plenty of people do. Your wife will do fine but it will take a lot of determination and also patience. Good luck you guys!

This is all great advice. If you decide to go Steadman route in Colorado (not just Vail anymore), there are a few of us that have used their services here.

[singlecross]

Thanks to all for the advice, experience, and support.

We met with the Orthopedic doc in Bozeman today… ACL is torn, but some unknown portion is still attached as seen with MRI imaging. Everything else including Tibial Plateau will be fine with time and rest. Weight bearing allowed as tolerated and range of motion exercises encouraged as tolerated.

Mrs. single is obviously done skiing for the season and will wait to fly back East in mid-March as originally planned. We will then eventually have the knee scoped and see if ACL replacement is warranted depending on how much ACL is intact. No rush to perform surgery and our situation is stable.

Thanks again Mags! This is a great community with many of you reaching out to offer help. Much appreciated.

[gretch6364]

Sounds to me like the right call and best outcome given the situation. Hopefully she can still enjoy the rest of the trip and you get some skiing in still. Good luck on the rehab!


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[Duffman]

Thanks to all for the advice, experience, and support.

We met with the Orthopedic doc in Bozeman today… ACL is torn, but some unknown portion is still attached as seen with MRI imaging. Everything else including Tibial Plateau will be fine with time and rest. Weight bearing allowed as tolerated and range of motion exercises encouraged as tolerated.

Mrs. single is obviously done skiing for the season and will wait to fly back East in mid-March as originally planned. We will then eventually have the knee scoped and see if ACL replacement is warranted depending on how much ACL is intact. No rush to perform surgery and our situation is stable.

Thanks again Mags! This is a great community with many of you reaching out to offer help. Much appreciated.

Ms Duff is in a very similar situation, mostly torn but some anterior fibres still intact on MRI. Notable laxity on exam ,so plan was prehab extensively and reassess in 6 weeks. Surgery right away didn't work for her anyway due to life schedule, similar to you guys, and she felt good and had full ROM so the Prehab route made sense.

In 2 months regained 85% of quad strength compared to intact leg, full ROM, stability improved significantly on Lachmans testing. Even skiied about 6 groomer days braced with the kiddos. Ortho recommended pushing it a bit to see how she felt. But when she ramped up more intense activity, didn't feel confident in the knee and is having significant pain, possibly from the ACL instability or from the small lateral meniscus tear that happened at the same time. She still doesn't feel confident in the knee , fears it will just give out at some point , and wants to go back to full activity with no restrictions long term, so decided for a similar approach , scope to repair or clean up meniscus, assess remaining ACL and then either attempt a repair with an internal brace vs quad reconstruction if absolutely necessary.

[mrkbrnblm]

Like others said - don’t underestimate the value of pre-hab. I’d find a good PT wherever you are and start going 3x a week ASAP. Hope she heals up quickly!


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