So You Tore Your ACL, Now What

So You Torn Your ACL, Now What?

You are reading this article because you want to know about the best way to repair your torn acl. You may or may not have already repaired your acl yourself, but now you need to know whether it’s worth repairing again.

If so, which surgeon would be best for you? Should you get surgery right away or wait until next year when prices will likely drop?

The short answer is, you’ll probably never know. There are too many variables to make any definitive statements. However, there are some things you can do to minimize the risk of having surgery in the future.

What Is A Closure Surgery?

A closure (also called a reconstruction) is basically a second operation performed on someone who had their original ACL repaired. Usually, the second surgery involves replacing the damaged part of the ACL with a new one.

Closures are usually done because the first surgery didn’t fix all of the damage to your ACL. For example, sometimes people have tears in other parts of their knee besides just their ACL. Or they might have injuries from sports like soccer or basketball that cause them to lose control of their leg at times.

These are usually good times to consider a second surgery.

When Should You Have A Closure?

Most people who have a first surgery don’t need another one. Some people are more likely than others to need a second surgery. For example, if you are over 30 and haven’t had any other knee injuries or surgeries, then you are more likely to need another surgery.

There is no way to know for sure whether you’ll need another surgery. That’s why some people have multiple surgeries in their lifetime!

What Are The Risks Of A Second Surgery?

The main risk of a second surgery is the risk that the doctor messes up and doesn’t do it correctly. If this happens then you will be no better off than you were after your first surgery!

What Is The Best Time To Have A Closure?

With advancements in technology, you can have a second surgery at any time after your first one. That means that you can wait years or even decades before having another surgery if you choose.

Usually, the earlier the better. The reason for this is that most people’s knee injuries get worse over time. If you choose to wait many years before having surgery, there is a risk that the surgeon will damage the other parts of your knee while trying to fix your ACL.

What Are My Other Repair Options?

The other major repair option is called an arthroscopic surgery. This is when the doctor cuts your knee open and fixes your ACL with small incisions instead of one big one.

If your knee is already messed up, then this isn’t necessarily a good idea. The reason is that the surgeon will have to look around your knee to see where the damage is. If there is other damage, he might accidentally make it worse.

On the other hand, if you don’t have any other damage and you’re having problems with just your ACL, you might be better off with an arthroscopic surgery.

What Should I Expect Afterward?

After you have surgery, your knee might be stiff and swollen for a while. You will need to use crutches after surgery to help keep the weight off of your knee. It might also be helpful to have someone around to help you out for awhile.

You will probably be able to start putting weight on your knee after a few weeks but you should not resume sports or strenuous activity for at least six weeks.

Most people have their stitches or staples removed from their knee six weeks after surgery. You should then be able to return to all normal activities after that point.

What Are The Risks And Side Effects?

The risks and side effects of the surgery are the same as they were for your first surgery. For example, if you had problems with the incision from your first surgery, you might have problems with the incision from your second.

Other things to be aware of are:

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The knee is at a higher risk for infection after surgery. You may also need to take antibiotics before any dental work.

You should not get your stitches or staples wet (like taking a shower) for two weeks after your surgery.

You will need to put ointment or sterile gauze on your incision daily. Your surgeon will tell you which one.

You might develop a blood clot (thrombosis) after your surgery. You can decrease your risk of this by moving around as soon as possible and keeping your leg elevated as much as you can. You should stop taking aspirin, ibuprofen or other blood thinners before your surgery.

The knee is at higher risk for injury or degeneration after surgery. Your surgeon may give you exercises to do after surgery to decrease this risk.

You might find that your knee does not feel as strong or as flexible after surgery. This is normal and should improve over time.

The doctor will probably provide you with physical therapy guidelines for your knee after surgery. In general, it will be important to keep the muscles around your knee strong to protect it.

In addition to the physical therapy guidelines, you should continue with the strengthening exercises that your surgeon gave you, if any.

You will be given a permanent brace that you should wear anytime you do something that puts a lot of strain on your knee, such as running or jumping.

If you develop any conditions such as arthritis in the knee in later years, the condition is likely to progress faster than it would if your ACL was still in place.

You should always have an annual checkup for your knees to monitor any arthritis that might develop.

Many of these risks can be reduced if you are aware of them and take the necessary precautions.

What If I Decide Not To Have ACL Reconstruction And Continue To Play Sports Without Surgery?

If you decide not to have surgery but still want to participate in sports, you should try to wear a medical grade knee brace at all times. This will give your knee some extra support and protection. It may not be as helpful as an ACL, but it’s better than nothing.

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You may also need to change the sports you participate in if you want to continue with your active lifestyle. For example, you might be able to play football or soccer without ACL surgery but you would not be able to play basketball or tennis because of the twisting and turning involved.

Your parents may or may not agree with your decision if you’re under 18. You may need to discuss the risks and benefits with them before coming to a decision.

Regardless of whether or not you have ACL reconstruction, it is important to remember that your physical health is the most important thing.

If you feel that you are not old enough, strong enough or in good enough shape to continue an active lifestyle without ACL surgery, maybe you should take a break and try something else.

If you do choose to have the procedure, you can be one of the many people who return to active lifestyles after ACL surgery.

You can also look into your options for ACL surgery and resources to help you make your decision.

What Are My Options For ACL Surgery?

So you’ve decided to have ACL surgery.

Now what? Should you go through with the more traditional surgery method or consider a newer procedure called an ACL reconstruction-transfer?

Here’s some information that can help you make your decision.

What Is An ACL Reconstruction-Transfer Procedure?

An ACL reconstruction-transfer, also known as an anatomic ACL reconstruction or patellar tendon transfer, is a procedure to replace your torn anterior cruciate ligament with a new one. It is becoming more widely accepted for use among adults who have suffered an ACL injury, but it is still only considered experimental for young, active patients.

The procedure involves replacing your torn ACL with a tendon from either your patellar tendon (the tendon in your knee that connects your thigh to your shin) or a tendon from a cadaver. The replacement tendon is stitched into place, taking the place of your original ACL. Over time it is hoped that the body will accept the replacement and the repair will be as strong as a normal ACL.

What Are The Advantages Of This Procedure?

The advantage of this procedure over the traditional ACL reconstruction is the replacement tendon can be used in a variety of ways to reconstruct the ligament.

For instance, a piece of the patellar tendon can be taken and tied to the bone through the flesh in your knee, without having to take any muscle from your leg. The new ACL is not taken from anywhere near your leg, so there is less of a chance of muscle atrophy and disuse osteoporosis.

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Some studies have shown that the amount of time you are required to take off from physical activity following an ACL-transfer is about half that of a traditional ACL reconstruction.

What Are The Disadvantages Of This Procedure?

As the procedure is still considered experimental, not enough long-term data is available on patients who have had the procedure. But what is available indicates that because a piece of donor tissue is used in the place of your original ACL, most patients who have undergone this procedure experience some degree of arthritis in their knee later in life.

Another disadvantage is that you are required to take a break from physical activity for three to six months to allow the new tendon to heal in place and your knee to regain full strength.

Because of the use of a cadaver in the procedure, there is also a small risk that the tissue could be infected or contaminated. Plus, there’s always the possibility that your body won’t accept the new tendon and it will be reabsorbed by your body.

How Much Does This Procedure Cost?

One of the main advantages of undergoing this procedure is that it is less expensive than a traditional ACL reconstruction. The use of a cadaver to create the new tendon opens up the possibility for a lower cost surgery. If you have health insurance, the cost of an ACL reconstruction-transfer would most likely be covered, although you will still most likely have to pay some out-of-pocket expenses associated with deductibles and co-pays.

ACL Reconstruction-Transfer: Discussion Questions

If you tear your ACL, do you prefer to have a traditional ACL reconstruction or an ACL reconstruction-transfer? Why?

Acquired flat foot is a condition that results in the arch of your foot collapsing and settling downward into the bottom of your foot. This condition develops in people who have overly flexible feet and weak arches. The condition can occur from an injury or trauma to the foot, after extended periods of standing or performing activities that require you to put your foot into a fixed position with little movement, or by some people being naturally “flattened footed” due to their skeletal structure.

What Are The Symptoms Of A Acquired Flat Foot?

If you have acquired flat foot, you may or may not have symptoms related to this condition.

Some people with acquired flat foot suffer pain in the bottom of their feet and experience a grating sensation when they walk across hard surfaces such as tile or wood. Others notice a visible indentation at the bottom of their foot when standing barefoot on hard surfaces.

The most common symptom is pain.

Where Is The Plantar Fascia Located?

The plantar fascia is located on the bottom of your foot. It is a thick band of tissue that connects your heel to your toes, and when it develops tears or other damage, it can cause pain in the arch of your foot.

What Causes The Fascia To Tear?

Anything that puts unusual stress on the plantar fascia can lead to tears or other forms of damage.

If you have weak or damaged arches, this can lead to tears in the plantar fascia. People who have flat feet are susceptible to this condition, as well as people who participate in sports that require them to be on their feet for long periods of time or people who stand for their occupation.

Other causes can a sudden twist or turn or even a direct blow to the foot. This can damage the plantar fascia leading to tears and inflammation.

What Are The Symptoms Of A Torn Fascia?

You may not experience any pain when you initially damage the plantar fascia. But, as time passes you will begin to experience pain in the bottom of your foot when you walk or stand for extended periods of time.

The pain is typically most severe when you first wake up or after long periods of inactivity during which the plantar fascia has had a chance to tighten up. As the day progresses, the pain will usually go away, but you may experience a grating or grinding sensation when walking.

As the condition worsens, you may notice a visible bump on the bottom of your foot and the top of your foot when standing barefoot. If left untreated, acquired flat foot can lead to a condition known as bone spurs.

What Are Bone Spurs?

While the name suggests that bone spurs are caused by actual bone growth, they are in fact bone fragments that have begun to grow and protrude through the skin as a result of damaged or weakened connective tissue such as tendons and ligaments.

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Bone spurs can occur at any site in the body where there is damaged or weakened connective tissue, but are most common in areas such as the spine, shoulders and ankles.

Bone spurs are common in people with flat feet who experience a lot of stress on the feet such as runners or athletes who engage in activities that require them to be on their feet for extended periods of time, such as dancers or runners.

What Are The Symptoms Of Bone Spurs?

Bone spurs can cause pain in the bottom of your feet, particularly when you first wake up in the morning. This is caused by the bone spur rubbing against the underside of your foot as you move it.

As time goes on, the pain can become more severe and you may also experience a grating or grinding sensation that becomes more noticeable when you walk.

In addition to pain, bone spurs can lead to other complications such as:

Reduced range of motion

Swelling

Bump or prominence just below the skin on the bottom of your foot.

How Are Tendon Injuries Diagnosed?

A physical therapist or podiatrist can make a diagnosis of a torn or damaged tendon in your foot after taking a complete history of your injury and performing a physical examination.

Your foot may be X-rayed to look for fractures or other types of damage that can occur in the same area. If you have had the injury for more than a few days, you will most likely have to have an MRI or CT scan to look for tendon damage.

How Are Tendon Injuries Treated?

The treatment of a torn or damaged tendon in your foot will depend on the severity of the injury and what type of tendon is damaged. Your doctor or physical therapist will develop a treatment plan that is specific to your injury.

Most tendon damage can be treated effectively through physical therapy and the use of braces or special shoes. You may have to use crutches initially as you begin a strengthening exercise program.

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If you have bone spurs, you will most likely be placed on a course of anti-inflammatory drugs to reduce the swelling around the affected area. In more severe cases, your physician may recommend surgery to remove the bone spur.

What Can I Expect With Treatment?

Most patients can return to full strength within three to six months with proper treatment and exercise. Your final recovery time can be anywhere from three months to a year.

In some cases, physical damage is so severe that a patient never fully recovers and must live with permanent weakness or pain. This is uncommon though and most patients make a full recovery.

Prevention

There is no way to prevent a torn or damaged tendon since the injury is caused by an accident or unexpected trauma. You can reduce your risk of suffering from a bone spur though by ensuring that you have adequate calcium, vitamin D and phosphorus in your diet to help your bones develop and grow properly.

If you have experienced a severe bone or joint injury in the past, you may be prone to suffer from bone spurs. Wearing properly fitted shoes with good arch supports and avoiding activities such as running or jumping that put pressure on the bottom of your feet can help reduce your chances of developing bone spurs.

When To seek Medical Attention

You should seek medical attention if you have pain or tenderness in your foot that will not go away, as this could be a sign of a bone spur or other type of injury.

You should also seek medical attention if you are not feeling any improvement in the strength or sensation of your foot after two months of treatment. This could mean that you have an infection or another type of complication.

Outlook

A torn or damaged tendon can have a significant impact on your life, both in the short and long term. Not only will it prevent you from enjoying your normal activities, it can also have an affect on your work and your mental outlook.

With treatment and time, most people are able to make a full recovery. However, you will need to take steps to ensure that your foot receives proper support and that you do not put any additional pressure on your foot while it heals.

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Fortunately, most people are able to make a full recovery from a torn or damaged tendon and can return to normal activity within a few months. In severe cases, surgery may be needed to treat complications.

Sources & references used in this article:

ACL reconstruction by PM Bill – wakehealthse3.adam.com

Don’t Let Physical Therapy School Tear You Down Like My ACL by P Staff – 2019 – apta.org

All About ACL Injuries by K Morris – girlsgonestrong.com

So You’ve Busted Your Knee: An Introduction to Physical Therapy for the New ACL Patient by A Ramos Jr – 2011 – commons.lib.niu.edu

Is an ACL tear more common on artificial turf or grass? by HD Geier – drdavidgeier.com