# Anterior cruciate tear



## Pumpkin the robot (14 Aug 2021)

It looks like I have torn my ACL. I was hit on my left side by a red light jumping taxi (funny how everyone seems to think it is only cyclists that jump red lights!) whilst on my motorbike. I was taken to hospital and had a few x rays and sent home with no broken bones. A few months later I started physio as both knees were still swollen and I had limited movement in them, especially the left one. The physio thought I may have torn my acl and I was referred to the NHS. A month ago I saw a musculoskeletal specialist and she also thinks the ACL has been torn and I have an MRI to confirm it next week.

I have been doing some reading up on this and it seems that opinion is divided on whether to have surgery or not. I am seeing 2 physios now, a private one I have used before and one assigned by the taxi drivers insurance. One says to have it if offered and the other is on the fence. Cycling and running I could probably get away without surgery, but I also go skiing and play table tennis, so have side movement which would cause problems. The knee is unstable. I pivot around on the spot at work and this is where I notice it the most. I have started to try and avoid that movement, but it still catches me out a few times a day. I am 50 next year and do not really want to give up the sports I do.

It is now 4 months since the crash and I have been doing strength building exercises but the knee is still slightly swollen and numb to touch across the joint. I have lost about 20% range of movement. I have recently tried some walk/run and that lasted about 5 steps! I have done a couple of bike rides up to 15 miles but the knee swells up after the ride and causes me pain for a few days after. I am going to try doing shorter distances on the bike and see if I can do less, but more often.
I am inclined to take the surgery if offered, it seems there is a smaller chance of osteoarthritis in the long term. The rehab looks to be painful, but I would rather do that and have a better long term prognosis.

So what are people's experiences of acl injuries?


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## shep (14 Aug 2021)

My lad had an ACL re-construction at 17 following a nasty Rugby tackle, never played again and it still plays him up now, he's 22.

I'm sure plenty have better luck.


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## Sharky (15 Aug 2021)

No experience of ACL, buts lots of TT experience and playing after injuries (broken ankles, collarbone, pelvis) and the sudden /reflex movements of table tennis can be painful. I play in the NWK and Bromley leagues, but have hardly played in ages because of the lockdown.


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## vickster (15 Aug 2021)

@PK99


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## PK99 (15 Aug 2021)

Pumpkin the robot said:


> It looks like I have torn my ACL. I was hit on my left side by a red light jumping taxi (funny how everyone seems to think it is only cyclists that jump red lights!) whilst on my motorbike. I was taken to hospital and had a few x rays and sent home with no broken bones. A few months later I started physio as both knees were still swollen and I had limited movement in them, especially the left one. The physio thought I may have torn my acl and I was referred to the NHS. A month ago I saw a musculoskeletal specialist and she also thinks the ACL has been torn and I have an MRI to confirm it next week.
> 
> I have been doing some reading up on this and it seems that opinion is divided on whether to have surgery or not. I am seeing 2 physios now, a private one I have used before and one assigned by the taxi drivers insurance. One says to have it if offered and the other is on the fence. Cycling and running I could probably get away without surgery, but I also go skiing and play table tennis, so have side movement which would cause problems. The knee is unstable. I pivot around on the spot at work and this is where I notice it the most. I have started to try and avoid that movement, but it still catches me out a few times a day. I am 50 next year and do not really want to give up the sports I do.
> 
> ...



Lots of experience!

Mine in Feb 2016 with repair October - as I wanted to cycle up Ventoux in the September
Daughter Feb 2017
Wife Feb 2019

All repaired by the same Surgeon! All now fully mobile. Wife and I have foresworn skiing but all other activities as normal D2 had taken to Snowboarding

Mine was straightforward: No meniscus involvement just a simple snap of ACL. Hence ability to cycle up Ventoux with a missing ACL! But I had lateral instability so needed repair for long-term activities. The surgeon gave me the choice.

Daughter similar. But 23 not 60 so repair was an automatic choice.

Wife's meniscus damage that meant significant op just to regain walking ability.

From your description, it sounds like you are at the more complicated end of the scale. By your stage post-injury pre-op I was more or less back to normal for most things but needed to be careful wrt twisting and turning and the thought of kicking a ball was terrifying.

So, you can probably guess what my advice would be. But note, I am a _Random Bloke-on-the-Interweb,_* not* a doctor!

Whichever route you go, I heartily recommend hiring one of these. Not cheap but worth every £!
https://gameready.com/

Happy to discuss further either on the forum or by PM

EDIT: Search the forum for ACL - there have been a number of threads all with different info.


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## Pumpkin the robot (15 Aug 2021)

Thanks for the replies.
@PK99 I had not thought about boarding instead of skiing, good call. I could give that a try. I used to work with a guy that did his ACL skiing and he nevere did it again after that. 
The game ready would probably be a good thing for me, I try to avoid opiate pain relief, I was on tramadol for 4 years and got addicted after a previous accident.
Anyone tried a brace? Advice on them seems to be split.


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## vickster (15 Aug 2021)

Pumpkin the robot said:


> Thanks for the replies.
> @PK99 I had not thought about boarding instead of skiing, good call. I could give that a try. I used to work with a guy that did his ACL skiing and he nevere did it again after that.
> The game ready would probably be a good thing for me, I try to avoid opiate pain relief, I was on tramadol for 4 years and got addicted after a previous accident.
> Anyone tried a brace? Advice on them seems to be split.


Discuss bracing with a Donjoy fitting physio, they’re more expert than peeps on t’interweb. It‘s the instability that can lead to articular cartilage damage and risk the meniscus (all assuming you don’t already have wear and tear to both given your age, wouldn’t be unusual at all, MRI should show).

https://www.djoglobal.eu/en_UK/Find_a_Clinic.html


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## PK99 (15 Aug 2021)

vickster said:


> Discuss bracing with a Donjoy fitting physio, they’re more expert than peeps on t’interweb. It‘s the instability that can lead to articular cartilage damage and risk the meniscus (all assuming you don’t already have wear and tear to both given your age, wouldn’t be unusual at all, MRI should show).
> 
> https://www.djoglobal.eu/en_UK/Find_a_Clinic.html



Just followed your link and found this:

https://www.djoglobal.eu/en_UK/Rehab_Muscle_Stimulator.html

I used a similar device on loan from lo local physio and in turn DW & DD2 did also - fantastic piece of kit to rehab muscles without using the joint


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## Pumpkin the robot (15 Aug 2021)

vickster said:


> Discuss bracing with a Donjoy fitting physio, they’re more expert than peeps on t’interweb. It‘s the instability that can lead to articular cartilage damage and risk the meniscus (all assuming you don’t already have wear and tear to both given your age, wouldn’t be unusual at all, MRI should show).
> 
> https://www.djoglobal.eu/en_UK/Find_a_Clinic.html


 
One of the physios has basically said that most people my age would have significant wear and tear to the cartlidge and ligaments, especially people that are active. I had a frozen patella when I was in my 20s, but that was in the other knee.

I guess it is best to wait and see what the MRI turns up next week and go from there.


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## PK99 (15 Aug 2021)

This is worth watching:

https://www.physiorehab.com/you-tube-videos/acl-reconstruction-rehab-program-essentials-seminar

I also bought and worked to his online rehab programme, checking in with my physio from time to time


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## Pumpkin the robot (23 Aug 2021)

I had the MRI yesterday (18.55, the hospital was empty. I guess they are trying to clear the back log)
I asked what the problem was, but they just told me I will hear in a few weeks.


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## vickster (23 Aug 2021)

Radiographers are techs, they don’t read MRIs, you’ll need to wait for the radiologist to report after going through dozens of slices


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## rivers (23 Aug 2021)

I tore my ACL and meniscus in October 2001, playing rugby when I was 18. Surgery in January 2002 to repair both (hamstring repair on the ACL), followed by about 9 months of physical therapy. I regained most of my range of movement, but can't bend my knee on past around 100°. No major issues these days, although I most likely do have some minor osteoarthritis. About once every 18 months my knee will just get swollen and sore for no apparent reason for a couple of days.
I did play rugby again for a short time in my early 20s, but I kept getting injured and decided rugby wasn't for me. I snowboard, and have done since I was 19, cycle (including TTing), and scuba dive to a decently high level.
My knee prior to the surgery was massively unstable. It would give out randomly several times a day, I couldn't run, barely walk some days. The doctor operating on my knee commented to my parents about how much of a mess it was. If you have any instability, I would probably opt for the surgery.

Edited to add: I did have a brace specially made to fit my knee. I had to wear it during "sporting activities" for about 18 months after my surgery. That amounted to a few months of snowboarding in reality. I'm sure it's probably in my dad's basement somewhere.


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## Pumpkin the robot (10 Sep 2021)

I got the results of the mri back today. The acl is fine  but I have a fracture in my knee and a partial pcl tear. I have been referred to the orthopaedic surgeon to see what can be done, but it sounds as though there will not be any surgery.


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## PK99 (10 Sep 2021)

Pumpkin the robot said:


> I got the results of the mri back today. The acl is fine  but I have a fracture in my knee and a partial pcl tear. I have been referred to the orthopaedic surgeon to see what can be done, but it sounds as though there will not be any surgery.



That is good news. 

Now find a Physio experienced in knee rehab - I had a guy who worked with the FA so knee were his stock in trade.

No slacking
No shortcuts 
No what they tell you to do. No more. No less.

Good luck


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## vickster (10 Sep 2021)

As above, good news 

Nothing much is done for partial PCL tears, just time and keep the quads and other muscles strong (I had one too, my surgeon was supremely disinterested in that bit of the report, common in worn knees, my ACL is attenuated too for the same reason).

The fracture will also just need time if small, non weight bearing, no loose bits 

Get some vitamin D down you if you don't already supplement


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## tinywheels (17 Oct 2021)

vickster said:


> Radiographers are techs, they don’t read MRIs, you’ll need to wait for the radiologist to report after going through dozens of slices


wrong,I suggest you look further into this field. Unless your American, then you would be correct. 
Radiographer reporting is now well established in the UK.


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## vickster (17 Oct 2021)

tinywheels said:


> wrong,I suggest you look further into this field. Unless your American, then you would be correct.
> Radiographer reporting is now well established in the UK.


Fair enough, if that’s the case in the NHS. My numerous MRI scans have all been done and reported privately by a Consultant radiologist in the UK.

My American what?


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## tinywheels (17 Oct 2021)

vickster said:


> Fair enough, if that’s the case in the NHS. My numerous MRI scans have all been done and reported privately by a Consultant radiologist in the UK.
> 
> My American what?


Private consultants, that's the guys who work in the NHS,and supplement their income by working elsewhere to fill their boots. 
Nice work if you can get it.

American radiographers are a different profession to the UK. Techs,they aren't trained nor capable of reporting. The money is in the reporting, so Private medicine won't allow it. They are not autonomous professionals, they do as their told.


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## vickster (17 Oct 2021)

tinywheels said:


> Private consultants, that's the guys who work in the NHS,and supplement their income by working elsewhere to fill their boots.
> Nice work if you can get it.
> 
> American radiographers are a different profession to the UK. Techs,they aren't trained nor capable of reporting. The money is in the reporting, so Private medicine won't allow it. They are not autonomous professionals, they do as their told.


If you say so


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## tinywheels (17 Oct 2021)

vickster said:


> If you say so


I know so,work beside them daily. 
google your consultant and find out what else he gets up to.
More than three quarters of the consultants in my department work in the private sector also. It's wot they do!
You can hardly make ends meet on the paltry salary an NHS consultant gets.
Private schools and holiday homes in the Bahamas ain't cheap bro.


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## vickster (17 Oct 2021)

The Consultants I see work in both? That’s pretty normal no as you said?
Anyhow what’s this got to do with the OPs ACL tear?🤷‍♀️
You can go debate healthcare provision in NACA if you want


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## PaulSB (18 Oct 2021)

vickster said:


> Radiographers are techs, they don’t read MRIs, you’ll need to wait for the radiologist to report after going through dozens of slices


I just happened on this and I have a suspicion within the NHS there are radiographers, who would be qualified, probably highly, technicians and consultant radiologists who I presume to be at a higher level. I couldn't give you a precise definition. I think most people's view would be the radiographer takes images but a doctor provides the diagnosis though I'd imagine the radiographer knows exactly what he/she has seen.

I'm only basing this on personal experience. I've been for X-ray on minor injuries either for myself or the kids on many occasions. The radiographer has never given an opinion in these instances.

In 2019 I suffered a brain haemorrhage, the will he wake up sort, and in the months following saw a consultant radiologist three times. The first two as part of routine follow up. The third time I went for a scan nine months after the event to assess the success or otherwise of the surgery.

On this third occasion while I was still laying on the table with the equipment over me the person who performed the scan walked over and said "The result is excellent. The repair has been 100% successful"

It turned out this man was a consultant radiologist and not a technician carrying out routine work. My belief is within the NHS there are both technicians and consultants working in this area.

The best few words I've ever heard. I cried!


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## Pumpkin the robot (22 Oct 2021)

The orthopaedic/knee surgeon sent me a letter. He wants to see me for a face to face appointment and an assessmet.

It is nearly 6 months after the crash, the knee is still painful at times. I struggle to walk down stairs on it and I can do about 15 miles cycling before it hurts and swells up/sesative to touch. Steep hills bring the pain on and I cannot do any running without pain. Movement is still a little restricted but improving.

I have the last physio session that is paid for by the insurance company next week, although the physio is going to ask for more sessions. He has diagnosed tenosynavitus in my right hand (I am taking some naproxen for that, but go for a steroid injection from my doctor next week) Hopefully that will help with that issue. Just the knee, my neck and a pain I get in my groin from the crash and everything will be fine!


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## tinywheels (26 Oct 2021)

Clearly I am surrounded by experts in this field. My decades of practice count for nothing. If you are unable to differentiate between a tech and a UK trained radiographer then I can't help you. All those reporting radiographers and radiographer consultants must be an illusion. I no longer know what I do for a living.


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## vickster (27 Oct 2021)

tinywheels said:


> Clearly I am surrounded by experts in this field. My decades of practice count for nothing. If you are unable to differentiate between a tech and a UK trained radiographer then I can't help you. All those *reporting radiographers and radiographer consultants *must be an illusion. I no longer know what I do for a living.


Which are you out of interest?
People are only citing from their own experience or observation.
Not claiming expertise which given you are presumably in one of the roles bolded gives you that 
There’s no need to be snarky


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