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  1. #1
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    Default ACL Reconstruction?

    Hi,

    I understand BC members are not doctors but I'm posting my problem here to seek for a second opinion.

    I injured my knee a year ago; never had an mri so i don't know what happened. Doctor just said to rest it and I did. It healed and I start playing badminton again but whenever I play competitively, after 1 game, it hurts to the point where I had to stop and someone have to replace me. I'm really tired of these pain i keep feeling so I decided to get an MRI to see what exactly is happening. MRI shows I have an ACL complete tear, medial and lateral meniscus tear.

    I had a surgery over the summer 2009, they fixed my medial and lateral meniscus cuz they said when they test my knee, they thought my ACL was there and my knee was pretty strong. SO, they didnt do the acl reconstruction.

    it has been 9 weeks after the surgery. I been doing physical therapy and I was fine. I walked again starting to run a little but not alot; can't sprint so I just slow jog.

    Today, I was running across the street cuz there was an incoming car. I didn't have my knee brace on and I accidently hurt it a bit. THis made me think back to the acl reconstruction. I was thinking, I can't even sprint. I been running slowly. I played badminton today and I was fine. I was practicing footwork and that went well. Even after the surgery to fix my meniscus, how come it still hurts cuz of the running? Is it cuz i don't have an acl? Should I get an ACL reconstruction? Will that fix my entire problem in the knee? These questions keeps coming up and I just can't decide. I did research and other people told me their doctor said If they want to play compettively again, they have to do an acl reconstruction. I been playing for a year without an acl reconstruction but then I keep getting more injuries.

    If i do an acl reconstruction, that's an estimation of about 9 months to a year to heal. I can't even stand 3 months without playing. during those 3 months, I didn't go to the gym at all. I just avoid it and focus on my studies and busy schedule. I just make myself busy so I dont think about it but that's only 3 months. I don't think i'll be able to do that for a year.

    My appointment with the doctor is on the 7th of december. People said to ask your doctor but even if I ask him, in the end itll be my decision to decide. If i can't decide now, how can i decide later on? If i need to do an acl reconstruction, the only time i can do it is during the 3 week winter break cuz I always take summer classes so I can't even do it over the summer break. I just don't know. I'm confused.

    What are your suggetions about acl reconstruction. DO you think I should do it or not and why?

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    Quote Originally Posted by tinh_duyen209 View Post
    If i do an acl reconstruction, that's an estimation of about 9 months to a year to heal. I can't even stand 3 months without playing.

    ...

    My appointment with the doctor is on the 7th of december. People said to ask your doctor but even if I ask him, in the end itll be my decision to decide. If i can't decide now, how can i decide later on?
    You currently have two issues:

    • You need more information
    • You're worried and nervous (an emotional issue)


    Don't try to fix emotional issues until you have some information. Your doctor can provide this information (or if not, he can refer you to a specialist who can). Find out what your options are, and what the likely results are.

    Prepare a list of questions to ask your doctor. Make sure he understands your situation -- in particular, that you play badminton, and how seriously you play badminton. Ask him what the long-term effects would be on your badminton if you did have the surgery, and also if you didn't have the surgery.

    If it's clear that the long-term effects of surgery will make a significant improvement to your badminton, or to your general health and fitness, then my opinion is that you should have the surgery.

    I understand it's a long time to be off sport. I was off for 3 -- 6 months (depending on how you define "back to sport"), and it drove me nuts. But it was worth it in the end.

    You need to make the best decision for your health and your sport. Think long term.

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    You seem rather confused.

    If your MRI reported an ACL tear and you had the arthroscopy, but the ACL was seen intact, then you have to go by the results of the arthroscopy. This means your ACL is intact and therefore, there is no point in thinking about an ACL reconstruction (since that bit of your body is OK).

    2 months after meniscal surgery - well, you have to account for the time away injured and post operative rehabilitation. It takes time to build up the muscle mass and the coordination again.


    As for the pain, your meniscus still is repaired but it's not like fixing a car where you can expect the car to work normal after a repair.

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    U say:"they thought the ACL was there". How can they THINK? There are ways and means to see this now, Like Cheung mentionned :Arthroscopy or even the MRI. Get a confirmation that your ACL is ok and take it out of your head and be patient with yr healing. Sorry if I'm blunt, I don't mean to b.

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    Thanks for the reply and Kiloo, it's okay that you're blunt. Before the Mri comes out, they only diagnose that i probably have a medial meniscus tear but the MRI shows more ugly stuff and what they're surprise of is the ACL since they diagnose that everything else seems pretty intact especially the ACL. I was seen by 4 doctors and they all said it's the medial meniscus. None of them said anything about the ACL which was odd. THe mri just shows that my end strands of the ACL is wrapped around the PCL.

    Cheung, the last time i went to my doctor for a 6-week later follow up, he said my knee is healed 100% surgical wise cuz all he did was do an arthroscopy and cut about half of medial meniscus and repaired my left one by sewing it together but the pain still insist at some point like when I tried sitting on my knee, it hurts and feels sharp. How can that be 100% healed when I can't even sit on my knee without feeling pain? If he said it's 100% surgical wise healed then how can that be what you said that my meniscus is still repaired? Is it because my body hasn't adapt to that loss of meniscus that was remove? AHH iono! I guess I'll just do what I should do which is "ask your doctor".

    Gollum, thanks for your reply. I will certainly be doing that when I see my doctor. As for now, my emotional situation and confusion state has gone down quite a bit.

    I forgot to add that it's my left knee that got the complete acl tear. I'm a righty but I don't know how the left knee got hurt instead of the right.

    I asked a friend who got the acl reconstructions to get more information and she just told me, if you can lunge on it and be able to get back to your position, then your knee is fine because the acl prevents you from leaning forward when lunge. I tried doing that and it was fine.

    I recently notice that I don't really lunge with my left foot. I lunge with my right since I'm a righty. The only issue i have now is moving to the left back side corner because that's the side where I would put more weight on the left leg than right.

    I guess my only solution now is wait for 2 more weeks until I see my doctor and ask him a bunch of questions/concerns about my knee since he's the only one that will be able to give me an answer.

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    Hihi! I am in my 4th week after ACL reconstruction. Same as ur situation, when i had the MRI done, my doctor said that it's either a Meniscus or a ACL tear. Of coz, the results came out as ACL tear, even the MRI didn't show clear signs of a meniscus tear.
    I only got to know that i had a linear meniscus tear when my doc went in with the scope to check before starting surgery.
    If you are based in Singapore, i can recommend you the doctor that i consulted. He's a ACL specialist.
    When i was awaiting diagonsis, i experienced the same thing as you, i could do lunges,squats etc.... only thing that was a problem was the inability to run & achieve full straigtening & flex range.
    Am currently on phyiso rehab & doing very well =)

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    Tinh, u r confusing HEALING and repaired. If all is ok then they have repaired the damage, by sewing or otherwise. Now be a little patient, do yr physio correctly and let it heal. I'm sure U will be ok from then on. As Shadow says above, everything is in a correct diagnosis.
    All the best. K

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    Quote Originally Posted by tinh_duyen209 View Post
    How can that be 100% healed when I can't even sit on my knee without feeling pain?
    That's a question to ask your doctor.

    One possibility is that, during the inactive period that followed surgery, your muscles have weakened a lot; your knee joint may also have lost mobility.

    This happened to me after my shoulder surgery. I had to keep my arm in a sling for a month, to protect the shoulder and allow it to heal. When it came out the sling, I could hardly move my arm at the shoulder, and it hurt a lot to try.

    Over several months, I built up the strength and mobility through physio exercises.

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    As mentioned, when the ACL is torn the 'stump' inside causes it to not achieve full straightening & flex range.....Walking & climbing up stairs should be fine (in my case it was).
    Therefore it may seem that the knee is "full healed". Same thing my friend went through when her ACL tore, she assumed that she was 100% ok, but when she played her 1st match (rugby) her knee totally gave way!
    I suggest to consult a specialist

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    To add on.... Empirical studies have shown that if the ACL is torn and no reconstruction is done, it will eventually tear & cause more problems to you in the future. Therefore, a reconstruction is usually advised. Of coz den there's the whole issue 'bout Hamstring or Patella graft.
    But, if ur MCL & LCL were injured/sprained. 9 weeks is a little too soon for you to be doing any footwork training. Your ligaments still needs the appropriate time to rest.
    I totally agree with you that it's a long wait 9-12mths before you can resume badminton. Personally, i'd rather wait this 12mths & heal 100%, than to go around neither healed nor injured. I think it'll cause further implications as time goes by.
    These were the pros & cons that i was deciding on before making the decision to hv surgery. I wanna continue play badminton, so i chose to go for the reconstruction

    *All these mentioned above are my own opinions & decisions that i made to under go my ACL reconstruction. Am not a medical doctor.... Just another ACL torn badminton player sharing my experience =)

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    We still haven't worked out if this knee actually has an ACL tear. Functionally, it hasn't torn.

    MRI's, although good, can get the diagnosis wrong. If you don't believe me, shadowcat confirmed this in post #6!

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    Quote Originally Posted by Cheung View Post
    MRI's, although good, can get the diagnosis wrong. If you don't believe me, shadowcat confirmed this in post #6!
    MRI's are only a tool that an experienced health practiotioner can use to diagnose your condition. They show more detail than both xrays and CT scans but, because they show so much detail it takes time to examine all the detail that is there.

    I had an MRI scan a year or so ago on my shoulder. The consultant on examining the MRI wrongly diagnosed the problem as arthritis because that was the first abnormality he saw and he didn't look any further. It turned out to be something else entirely - tendon inflammation which he repaired a few days later by shaving some bone away and a couple of months later I was playing pain-free.

    I suppose the moral is trust your instincts. I was sure the pain I was feeling was not arthritis, so I challenged the consultant and it turned out that I was right and his initial diagnosis was not. If you feel that what you have is not consistent with an ACL tear, ask to see the torn ACL on the MRI - if it's torn it will be obvious.

    My feeling is if you had a complete ACL tear you would barely be able to walk, never mind jog or play badminton. I had one many years ago - couldn't walk for 2 weeks, couldn't jog for 6 months and badminton was a no-no for 18 months

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    Yup... MRI diagnosis needs to be done by a doctor who can really read it. In my case, my doctor did highlight that the Meniscus could've been torn, but the report didn't report anything about it.
    Thank goodness my doc went in with a scope 1st before doing anything, otherwise i won't hv known that my meniscus got torn too.
    On the conturary, i had my ACL fully torn & i was walking perfectly normal after 1week of the injury. Which surprised friends who has the same injury, as mentioned by petert,all of them couldn't walk but i could. So it's a case to case basis?

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    Quote Originally Posted by ShadowCat View Post
    On the conturary, i had my ACL fully torn & i was walking perfectly normal after 1week of the injury. Which surprised friends who has the same injury, as mentioned by petert,all of them couldn't walk but i could. So it's a case to case basis?
    I remember I had a partial acl tear first then a complete one because my cousin told me not to wear a knee brace cuz it blocks the circulation and said that every knee is made to heal on it's own. I shouldn't have listen to him. 2 months later, I play badminton without a knee brace and my knee twisted which made me do a 360 turn and fell on the ground. That pain I experience was very painful. I couldn't straighten my knee nor bend it or even move it at all. But I was able to walk after a couple of weeks.

    THe doctor showed me the mri and showed me the area where the acl should be. He didn't see the strand at all. I'm able to jog now (slowly building it up) and walking is fine for me now too.

    I talked to my physical therapist, she said that my knee is still in the process of healing even though the doctor said it healed 100% because I still have to get my physical activity up and heart rate pumping so I guess I'll put the acl reconstruction aside until I heal from this meniscus surgery, start playing badminton again and then see if it gives out.

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    I've had complete ACL tears in both my knees (from other sports). After my first tear in my left ( I am right handed), I could not play badminton at all. It was very unstable, in fact I could not pivot and turn on the knee without it buckling. I also had the same problem as you and couldn't go to the back left side especially if I tried to hit an overhead.

    I did my first ACL reconstruction on my left knee and started competitive badminton after 4 months. However I have to caution you against this approach. Technically you are not supposed to resume training at least 6 months after your recon, but I had a very important tournament then and decided to give it a go. I had to go for therapy and gym work everyday after the knee operation. In fact I was on the stationary bike a week after operation and after swelling was down.

    Now my right knee has a torn ACL and my left has a reconstructed ACL and I have decided not to do a reconstruction on the right. I decided not to do it because despite what all doctors will tell you, your knee will never feel the same. I have also stopped competitive badminton. I only recently started playing badminton again. BUT I do my gym work religiously and when I play I know to not go for all shots that require me to risk it. If I needed to change directions quickly for sure my knee will give way. I also run the risk of hurting the other ligaments in the knees. But I still love badminton and this is the risk I will take.

    It sounds that the doctors you have around you don't seem to know what they are doing. I strongly advise you to seek further advise from orthopedic surgeons who know what they are doing... a complete ACL tear isn't very hard to diagnose, ESPECIALLY with an MRI. The most critical thing they will always ask you is if you heard a POP when you injured your knee, it's a very high chance that you tore your ACL. If you are still young (20-25) and intend to play competitive badminton for many years to come, I would strongly urge you to do a reconstruction. It will also help you in the other sports that you will undertake later in life.

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    I have my ACL reconstructed in year 2001..
    no MRI could check the ACL condition unless if it use the ortoscopy-something

    I understand you pain that you couldnt do Badminton for say a year.. but you wont enjoy if you couldnt move freely..

    Do the surgery/reconstruction.. then train for a year than back to play badminton normaly.. meanwhile train your wrist for a year too lol.. so when you comeback to play you will be super

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    Quote Originally Posted by buffedupboy View Post

    It sounds that the doctors you have around you don't seem to know what they are doing. I strongly advise you to seek further advise from orthopedic surgeons who know what they are doing... a complete ACL tear isn't very hard to diagnose, ESPECIALLY with an MRI. The most critical thing they will always ask you is if you heard a POP when you injured your knee, it's a very high chance that you tore your ACL.
    When I injured my knee from badminton, the gym was quite noisy. I wasn't able to hear anything, not even a pop. I have 2 doctors. They work together. One of them is the one that's doing the surgery. The doctor that thought my acl was still intact diagnose that because when he did my knee test, he thought it is still there. I was able to walk and jog after the incident. I was even able to play badminton for a certain amount of time before it gives out. People said I have pretty strong legs compared to them when they injured their knee. I guess everyone is just different. Some of you here say you guys weren't able to walk or jog at all for a couple of months.

    My doctor e-mailed me back saying that if I want to return to badminton then he recommend me doing the reconstruction. It's not just about going back to play badminton again but also about whether I'll be able to run like normal without the acl. People need to be able to run from danger like an incoming car or simply if someone is chasing after you. I aggravate my knee again because I was running from an incoming car and end up hurting it. I don't want that to happen. If I can not run simply a very short distance, how can i be able to run if someone is chasing after me? I don't know what the chance of that is going to happen but it might happen. I'm only 20 right now, I don't want to think about these bad incidence yet. I really enjoyed playing badminton. I know when I return again, i'll still have to wear a knee brace but that's fine with me. I just want to play like i normally do without it giving out. One year is a pretty long time.

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