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tfsphoto
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Anterior Cruciate Surgery Question

Mon Feb 20, 2006 7:08 am

Hi Folks,

I'm wondering if anyone can help me out with a question i have on knee surgery. A friend is having his anterior cruciate ligament replaced. I'm wondering if anyone has had this type of surgery before and how long was your stay in hospital, and how did you go about recovering after surgery.

Thanks in advance,

Lew

[Edited 2006-02-19 23:09:11]
 
redngold
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RE: Anterior Cruciate Surgery Question

Mon Feb 20, 2006 8:41 am

ACL reconstruction/replacement is a major surgery; I'd think he'll be in the hospital for at least a few days. He will be in a brace and on crutches for several weeks up to three months and in rehab for six to eight months.

Depending on the extent of the surgery, he may be put in a passive motion device at first - something that keeps his knee moving without his own effort.

More here:
http://orthoinfo.aaos.org/indepth/th....cfm?Thread_ID=14&topcategory=Knee
Up, up and away!
 
halls120
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RE: Anterior Cruciate Surgery Question

Mon Feb 20, 2006 9:32 am

Quoting Redngold (Reply 1):
ACL reconstruction/replacement is a major surgery; I'd think he'll be in the hospital for at least a few days. He will be in a brace and on crutches for several weeks up to three months and in rehab for six to eight months.

Depending on the extent of the surgery, he may be put in a passive motion device at first - something that keeps his knee moving without his own effort

My daughter had it seven years ago. In the hospital for two days, three weeks on crutches, six weeks with a brace, six months in rehab. Painful as hell. An older friend with the same surgery had that passive motion machine - it was awful to watch. My daughter didn't need it - the benefit of youth.

She had full recovery - she still downhill skis.....but no more soccer - she blew out the knee in a high school game, and won't go near the pitch.
"Suppose you were an idiot. And suppose you were a member of Congress. But I repeat myself." Mark Twain, a Biography
 
tfsphoto
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 1:58 am

Many thanks for the replies.

Red - thanks for the link, very useful and informative.

Halls - Many thanks for your information also, Would you be able to go into more detail as in the procedure that accurs directly after the operation, as in do they start flexing the leg e.t.c. basically what to look out for or whats going to happen directly after surgery. Any help would be appreciated.

Lew
 
aireuropeuk733
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 2:04 am

Quoting TFSPhoto (Thread starter):

Hi Lew, sorry to go off-topic but it's great to have you back on the boards - how you doing?

AE733
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tfsphoto
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 2:08 am

Quoting AirEuropeUK733 (Reply 4):
it's great to have you back on the boards - how you doing?

Hi mate physically I'm doing alright, I'm still slow in most things i do and my breathing is still a little shot out. I'm suffering emotionally now over a few things related to this incident and also my father. I've been back to the hospital today and had stitches replaced and talked about removing the scar in a few weeks time with some new treatment, i didnt really pay that much attention to it as she was explaining as she ripped stitches out of me one by one so my mind was elsewhere.

Other then that im totally exhausted and heading to bed for nap now, however i do feel more myself recently and have started to do things on my own now without assistance, which to me seems a step in the right direction.

Thanks for the concern  Smile

Lew
 
cornish
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 2:08 am

A friend of mine - who was a student placement with us in my old job had this op done in the UK last year. I'll have a word with him and see if he can shed some more light. He's back and playing football for his university team now, so it shows just how successful you can recover from it  Smile
Just when I thought I could see light at the end of the tunnel, it was some B*****d with a torch bringing me more work
 
oly720man
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 2:15 am

Small world; a colleague of mine just snapped his skiing a couple of weeks ago. He's going to see a specialist next week to find the best way to go.

One thing he's been told, and your friend may need to think about, is that you need to choose your specialist with care. Your everyday consultant is not a sports consultant and is only interested in getting people mobile again. A specialist sports consultant may have other ideas about the operation and post-operative recovery and physio.

Nice to have you back with us again and on the road to recovery.
wheat and dairy can screw up your brain
 
JamieD
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 3:09 am

Quoting TFSPhoto (Reply 3):
the procedure that accurs directly after the operation, as in do they start flexing the leg e.t.c. basically what to look out for or whats going to happen directly after surgery.

Hi Lew,

http://www.emedicine.com/pmr/topic3.htm#section~treatment

According to this article, the rehabilitation begins as soon as the patient awakens after the operation, and can continue for up to three months depending on the severity of the injury/graft. The rehabilitation begins with light stretches, and slowly progresses to more intense activities. Hope this helps.  Smile
 
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johnboy
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 3:28 am

I had this surgery done about 20 years ago.

I was playing football (American) in a gym, and my foot caught underneath me while the rest of my body kept on moving sideways. One twist and "major pop" later and my knee was swollen and painful.

I had arthroscopy first, (they actually taped it and gave me a copy!) and saw the two ends of my ACL floating like two sea anemone in the ocean.

After the surgery, I was in a cast for about 2-3 weeks, then various braces with crutches, then a cane for the next 6 months.

I will have to say, the physical therapy after the surgery was probably the most horrible thing i have endured yet in my life. I nearly passed out at the first session from the therapist "breaking up" the scar tissue. It took me about 2 months before I could complete a single revolution of bicycle pedals.

Good luck to your friend!

PS Glad to hear you are back again. Take it one day at a time with your recovery -- it'll be easier after awhile.
 
redngold
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 5:23 am

My estimate was a very conservative one, allowing for complications, because of what I saw a classmate go through in high school. She may have torn more than just her ACL. All I know is that her recovery didn't go very well and she had to have at least one followup surgery to remove scar tissue and trim out more damaged cartilage.

I hope your buddy doesn't have to go through the same.

As for me, I've always bounced back rather swiftly from surgery - twice I had surgery under general anesthesia on a Monday and was back in school on Thursday of the same week. I've been lucky.


redngold
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halls120
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 5:32 am

Quoting JamieD (Reply 8):
Quoting TFSPhoto (Reply 3):
the procedure that accurs directly after the operation, as in do they start flexing the leg e.t.c. basically what to look out for or whats going to happen directly after surgery.

Hi Lew,

http://www.emedicine.com/pmr/topic3.htm#section~treatment

According to this article, the rehabilitation begins as soon as the patient awakens after the operation, and can continue for up to three months depending on the severity of the injury/graft. The rehabilitation begins with light stretches, and slowly progresses to more intense activities. Hope this helps.

That is exactly what my daughter went through. Some of the phyiscal therapy sessions were quite intense - and painful - but it was worth it, as she has recovered with a knee joint that is 95% as strong as the other knee.

[Edited 2006-02-20 21:33:28]
"Suppose you were an idiot. And suppose you were a member of Congress. But I repeat myself." Mark Twain, a Biography
 
airbusA346
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 5:40 am

Quoting Johnboy (Reply 9):
I could complete a single revolution of bicycle pedals

Arrrrrr  ouch 

I have not had the operation, but I've got through some pain with my knee.

When I had major bone and muscle surgery last year, the surgeon cut an blood vassal in the back off my knee and had to turn my leg the opposite way while still on my back (the bone was already broken, by the surgeon).

He lost his markers in my leg (not in my leg) and put my leg in the wrong place, so it is now not aligned properly.

It was my right leg.

Little diagram coming up, they are all views looking from the front.

Normal leg - | = leg , () = knee , <> = foot

.|
.|
.()
.|
.|
<>

My Right Leg - | = leg , () = Knee , / = Lower leg , <> = Foot

...|
...|
...()
.../
../
<>

Hope you can understand it and I have had to use dots to make it look right.

Tom.
Tom Walker '086' First Officer of a A318/A319 for Air Lambert - Hours Flown: 17 hour 05 minutes (last updated 24/12/05).
 
TACAA320
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RE: Anterior Cruciate Surgery Question

Tue Feb 21, 2006 5:58 am

Unfortunately I'm a candidate to that surgery. Nevertheless, since my case is not that bad, I will postpone it.

Good luck.
'Science without religion is lame, religion without science is blind'. Albert Einstein
 
tfsphoto
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RE: Anterior Cruciate Surgery Question

Wed Feb 22, 2006 6:07 am

Thanks for the replies all. Maybe some of the folks who have experienced this can answer this. After a ACL reconstruction would the patient be placed in a cast following surgery?

Lew
 
JamieD
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RE: Anterior Cruciate Surgery Question

Wed Feb 22, 2006 8:11 am

Quoting TFSPhoto (Reply 14):
After a ACL reconstruction would the patient be placed in a cast following surgery?

I'd imagine (and I think it's mentioned in the article that I posted a link to) that the leg is put in a kind of brace or "knee immobiliser", so that it can be taken off and the rehabilitation exercises can be carried out more easily.
 
redngold
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RE: Anterior Cruciate Surgery Question

Wed Feb 22, 2006 8:21 am

Quoting TFSPhoto (Reply 14):
After a ACL reconstruction would the patient be placed in a cast following surgery?

JamieD has the answer. Usually the knee is dressed with gauze and an elastic bandage, then put in a hinged brace that extends from mid-calf to mid-thigh and hinges at the sides of the knee. It allows for knee bending without lateral movement.

It probably will look something like this:

Hotlinked from: http://www.clarksorthopedic.com/orthotics.html


redngold
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tfsphoto
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 2:26 am

Ah ok,

Thanks for that.. any predictions as in time lengh to be walking un-aided?

Lew
 
JamieD
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 2:38 am

Quoting TFSPhoto (Reply 17):
any predictions as in time lengh to be walking un-aided

It really depends on the severity of the injury and how extensive the surgery is, but the article suggests anything up to three months before light jogging should be undertaken again. The immobiliser can be removed three to four weeks after surgery.
 
FrancoBlanco
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 4:06 am

Walking should be possible a few days after the surgery. You have to mobilise the knee in order to recover, there´s no sense in keeping it in a cast for weeks. There are (European-) football players who had their first match three months afterwards.

I would also recommend to see a specialist focused on sports medicine. I am currently working together with a highly respected and competent one (I assisted him in his last three ACL reconstructions) and he always says that every individual patient needs individual treatment in this case, you cannot say in general whether the surgery is actually needed or not, how further rehabilitation has to be done etc.

Sebastian
'Pointless!' - NY Times
 
tfsphoto
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 6:39 am

Quoting FrancoBlanco (Reply 19):
I would also recommend to see a specialist focused on sports medicine. I am currently working together with a highly respected and competent one (I assisted him in his last three ACL reconstructions) and he always says that every individual patient needs individual treatment in this case, you cannot say in general whether the surgery is actually needed or not, how further rehabilitation has to be done etc.

Many thanks for that. Can i ask how long does the surgery last for? My friend's had a arthroscopy and that confirmed that the ACL ligament was torn. He's seeing a surgeon who specialises in knee injuries and he did go into alot of detail regarding sports injuries and did seem very helpful from what i was told. And it will be him who preforms the operation.

Lew
 
FrancoBlanco
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 7:09 am

The surgery should last about two hours, depending on whether the patellar ligament or another tendon is used as graft. It could take longer, though when there is other damage to the knee, i.e. damage to the cartilage or the meniscus.

Sebastian

[Edited 2006-02-22 23:16:03]
'Pointless!' - NY Times
 
tfsphoto
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 7:27 am

Sebastian,

Many thanks for that, the doctor however did tell him that the new ligament would be made out of hamstring would that be a easy option or something that is going to cause more hastle if you know what i mean.

Lew
 
redngold
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RE: Anterior Cruciate Surgery Question

Thu Feb 23, 2006 8:00 am

Lew,

Please make sure that your friend knows he has to be absolutely honest about any medications or drugs he might take, legal or illegal, when interviewed by the anaesthesia provider. This includes the occasional cigarette, aspirins, weed, whatever. He should also tell him/her if he's had any reaction, even a minor one, to prescription medications.

As for the hamstring graft; there will be some pain from it, but the hamstring group is a bundle of several muscles and there's plenty of it from which to harvest enough for an ACL replacement.

Pass on my best wishes.
redngold
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FrancoBlanco
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RE: Anterior Cruciate Surgery Question

Fri Feb 24, 2006 2:39 am

Hamstring grafts take a bit longer to heal and recover, the rehabilitation afterwards takes a bit longer. On the other hand the stability of the extensor muscles and ligaments (thus the stability of the knee) will be better.

Sebastian
'Pointless!' - NY Times
 
tfsphoto
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RE: Anterior Cruciate Surgery Question

Fri Feb 24, 2006 5:40 am

Sebastian,

Thanks again your help is greatly appreciated. If they were to remove the new graft from the hamstring would the patient end up with more then one scar? Or opening? so to speak.

Thanks in anticipation,

Lew
 
FrancoBlanco
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RE: Anterior Cruciate Surgery Question

Fri Feb 24, 2006 6:54 am

Lew,

Thank you for putting me on your RU list!  spin 

Using the hamstring (namely either the semitendinosus or the semimembranosus muscle) produces a slightly smaller scar, in fact. The surgeon accesses the knee from the anterior and then he "fishes" for the tendon on the back side of the knee, cuts it once, brings it to the front and cuts it a second time at its insertion point on the inner side of the tibial plateau.

The patellar ligament (only a section of it, actually) would be cut between the patella and the tibia but together with a piece of bone at both ends. That´s the reason why it would heal faster; the graft is put into its final place between the tibia and the femur and has to connect to the bones.

I hope this explanation is clear enough, otherwise don´t hesitate to ask further questions!

Sebastian
'Pointless!' - NY Times
 
tfsphoto
Topic Author
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RE: Anterior Cruciate Surgery Question

Fri Feb 24, 2006 7:04 am

Sebastian,

Once again many thanks. I think you explained that clearly enough. Many thanks.

Quoting FrancoBlanco (Reply 26):
Thank you for putting me on your RU list!

Your welcome.

Lew

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