Surgery or More Surgery? WWMD?

[AK G-Dog]

Not that anyone cares but my two year anniversary of finding this little home away from home is drawing near. With that being said, I found this place (well, the other place) while looking for advice on ACL repair. Two years have gone by and my knee still bothers me. So much that the day after anything strenuous is reserved for recovery. I am constantly taking Aleve or Ibuprofen. I went and saw a different surgeon today as the pain has really started to limit what I can and can not do. My original surgeon is in the Navy Reserve and has been deployed (although I think he is back now). The new surgeon come VERY highly recommended and I had to pull some strings just to get in as a new patient. He has spoken at several Orthopedic Seminars and has several knee instruments patented.

All that being said, he thinks my original ACL repair is a failure. While the repaired ACL is intact it is too loose and is not doing it's job. He thinks it is allowing my knee to damage itself more and more everyday. He made a lot of since and really has me thinking. A lot of what he said were thoughts that I had prior to seeing him and he confirmed. He recommends surgery to re-repair the ACL and see what other damage may have happened over the years. One thing is for certain, it is not getting better on it's own and it really hurts.

Should I just "bite the bullet" and get it fixed again? Should I try and see the original surgeon again? Should I just roll the dice finish the season? Should Ryan get back together with Marissa?

[ak_powder_monkey]

It depends, how much do you like to fish/ bike?

[Samwich]

Well, if it were me, i would ski the rest of the lift-accessed season, taking it real easy-like. (no hucking, no high speed craziness). Then i would get the operation done right. It's always sensible to trust doctors that come highly recommended, but you still have, what, another month? See if you can schedule surgery for one month's time, and ski right up until then.

[Sublime]

I'd say Sam has it right.

I wouldn't really trust what your orginal doctor just for the fact that if he would have fixed it right you wouldn't be in the postion now. Going to a highly recommended surgeon that has patents sounds good to me. I would see what he recomends as to when to schedual the surgery since it might be doing more damage to your knee. On the bright side at least you would only miss the tail end on the season.

[Dexter Rutecki]

Jesus, that sucks. One thing about NYC is you can rely on finding good doctors (insurance coverage is another matter, sometimes, but...). Just make sure your new guy is one who's done hundreds of ACLs (it sounds like he probably has) and is at a (teaching) hospital known for its orthopaedics.

[PaSucks]

If your going to get it fixed, dont put it off to long. That was my dads mistake and now he needs a knee replacement. The doc told him if he had just gone to see him a few years earlier he would have ended up fine, but instead he can barely walk.

[ulty_guy]

get it done, rehab like crazy (while it's nice out), and probably be 100% by the time the snow flies next year.

good luck!

[Big E]

Sounds like you're at the point where everything you do causes more damage to the knee. Not a good thing. Bag the season and get it fixed immediately. If it hurts that much on a daily basis, clearly somethin ain't right, and you can be sure that the damage that's being done now doesn't "scale linearly" - meaning every day of wear and tear now is aging the knee more like a week or a month (like dog years for the knee). Yeah I want to keep skiing, biking and playing b-ball, but I want to be doing those things when I'm 50 (and 70) too, not hobbling around on a walker.

Good luck, far too much experience on the board with this type of thing.

[Vinman]

Good advise here, get the repair done. I am somewhat in the same boat as you except with a meniscal tear from a previous surgery that has probably gotten loose again.

[Odin]

Originally posted by AK G-Dog

Should I just "bite the bullet" and get it fixed again?

You should get it fixed "RIGHT" this time, eh?

Should I try and see the original surgeon again?

I heard that doctor that got arrested and thrown in jail for beating up the cabbie and stealing his cab actually is a REALLY good surgeon with good principles about ACL repair...... conjugal visit perhaps?

Should I just roll the dice finish the season?

See #1

Should Ryan get back together with Marissa?

NO, or um...... I don't know what you are talking aboot.

[AK G-Dog]

I guess I should have made it clear that there is no "blame" in the original doctor (who is highly recommended as well). There are a million reasons ACL repairs fail. There is only an 80 to 90% success rate anyway. Besides, what is labled a success? I can still walk and I do not fall down all the time? I guess someone has to be on the wrong side of the curve.

I guess I am just bummed out because the last two years (and several thousand dollars) have been a waste. Not to mention we are on the verge of our best spring/summer season in years.

The cabbie beating, cab stealing, drunken cool doctor is a hand surgeon, otherwise I would be partying with that guy!

[Plakespear]

Fix your knee and be sure to make lots of semi-coherent posts while you're on painkillers.

[Dexter Rutecki]

Originally posted by AK G-Dog
I guess I should have made it clear that there is no "blame" in the original doctor (who is highly recommended as well). There are a million reasons ACL repairs fail. There is only an 80 to 90% success rate anyway. Besides, what is labled a success? I can still walk and I do not fall down all the time? I guess someone has to be on the wrong side of the curve.

True enough, but I've never heard a figure like that for ACL repairs (and I think anyone could just walk around without an ACL). I'd like to know how close that figure is, and how it compares from hospital to hospital and within different sample groups. I may check online, and I'm seeing my ortho on Thursday, so...

[AK G-Dog]

Taken from http://www.orthoassociates.com/ACL_Indications.htm

What it often boils down to

In the patient with a recent acute ACL injury, reconstruction offers an excellent chance of restoring normal or near normal stability of the knee, with no known increase in the risk of re-injury. The chances that this person will be able to return to their normal level of activities after a 6-8 month period of recovery are as high as 80-90%. The risk of serious complications are very rare, and most of the post-op problems that patients complain about are annoying, like swelling and discomfort with heavy use.

In my experience, the vast majority of patients who are active athletically or who want to be, given all the alternatives, will choose to have their ACL's reconstructed, and are satisfied with the results. Like any reconstructive surgical procedure, however there are real risks - in the 10-20% range - that there will be a less than perfect outcome. Unfortunately, it is impossible to tell ahead of time who will get what kind of result.

I have just come to accept the fact I am in the 10% - 20%

[Dexter Rutecki]

OK, that's a little different than just an 80-90% success rate, though--it sounds like 80-90% of the time there's a perfect outcome within 8 months (I wonder if the rate gets higher with more time), and then there are some less than ideal outcomes. Your surgery sounded like almost a complete failure, and that's what sort of surprised me. As many here do, I'm sure, I know a fair number of people who've had reconstruction done, and I think you're the first one I've heard of who had bad results.
Good luck, man. Get that fixed.

[Dexter Rutecki]

BTW, I just finished reading through most of that site, and it's pretty damn good. Probably answers most people's questions about ACL reconstruction (but I wonder why that doctor/hospital doesn't use spinal anesthesia, instead of putting everyone out).

[Big E]

FYI, www.eMedicine.com is another really good one.

[AK G-Dog]

Well of course I am going to look at the numbers in a negative light, I have to get it done again. I liken it to people with car problems. When I bought my car everyone says, "Oh yea Dodge rules, what a great car" then when the car breaks down "Oh yea, Dodge sucks, you should have known you would have problems with them".

From speaking with my new doctor, he made it very clear there are "less then perfect" outcomes. He does a pretty good job of tracking his surgerys, but it all boils down to what each individual considers a success. Like I had mentioned before, sure I can walk with out a limp and my knee has some amount of stability to it. Many would consider that a full fledged success.

I am very excited about this new doctor. He only does knees and like I said, he is very highly recommended. I really think I will have a better outcome then the last time, but then again, what is "better"?

I like that website and I recommend it to people that are looking for general information. Someone at the "old place" recommended it to me years ago.

BTW, my new doc has a website www.mcguiremd.com

Not as good as the other one, but decent general information with cool pictures!

[Odin]

Originally posted by AK G-Dog
[B]
He only does knees and like I said, he is very highly recommended./B]

I know a guy like that!