[Closed] ACL reconstruction

I think you are scaring yourself about it.

i had anterior and posterior reconstructive surgery done about 10 years ago; tore lots of other things in knee too including meniscus.

Was off work for a month, but I did a very manual active job ... so office type job wouldn’t have been a problem after 2 weeks I reckon.

Walking up stairs (or carefully lifting leg up stairs) was easy manageable first night.

knee didn’t feel secure for a longtime afterwards; but I have got fitter and stronger on a bike every year since then ... so no problems.

Thanks @mooman for the reality check. Think with all the NHS delays I've had too long to think about it! Glad your back in shape. Good news.

Hi I’m 3 weeks post revision surgery. I first snapped it about 12 years ago and returned to full snowboarding and started mountain biking in that time. It took 1 year before I felt comfortable snowboarding and about 2-3 seasons before I took knee brace off during those seasons I had about 10 - 15 day trips and week in the alps each season. I also went back and flew power kites which initially caused the problems in the first place. I took up biking during the last 10 years and was riding doubles/drops/ with plenty of crashes and had zero issues with the repair. Then a stupid night out last August and I fell off a chair and snapped it again! The re over this time has been much slower they used hamstring first time and patella tendon graft this time, which was a bit sorer with a bigger scar. Rehab is key get on it ASAP and treat it like a job and do it constantly throughout the day and you will recover back to way you were pre op. Even when you feel your getting stronger keep going till you finish the full programme and then after keep building strength and maintaining mobility.

I live in a first floor flat and the stairs have been totally fine. Take the painkillers and don’t try to be a hero and you’ll be back on it before you know. Im terms of work I took 3 months off last time as i worked in kitchens at the time and couldn’t stand for long periods of time, I’m now own a bakery so am able to step back and will take off as long as I need to. It’s a pretty successful procedure so you should be totally fine post op. I’ve just tuned 40 last November to give you and idea of my age and I’m of average fitness, the one thing I do regret is I’ve been  dormant since last Aug due to the knee instability and 2 young kids under 3 and work, so haven’t really done any leg exercise and i could feel it post op my legs are so weak, but the rehab will get me strong again. I think by being in a good shape pre op it helps speed up rehab. Hope it all goes well!

The odds are heavily stacked in your favour with this one, there shouldn't be any reason why you can't make a total return to your previous baseline. (Word to the wise: Smoking will greatly increase the risk of a poor outcome).

It will take a long time to rehab, although the bulk of that would be as a result of the 22 weeks of taking it easy rather than the operation itself. You will be either referred to a physio or given an exercise protocol to follow, this will load the ACL sufficiently to expedite the healing process as efficiently as possible, it is important that you follow it (although it sounds like you are the sort of person who probably would anyway!). If they don't, ask!!! After that you can treat it as you would any return to fitness after a long period of inactivity- no diving straight in at the deep end but a measured, gradual increase in exercise level (time or distance and intensity)

Good luck and enjoy the journey back to your former level of fitness. It takes time but it will happen!!!

Every patient is different but expect around 12 weeks of following the post surgery protocol and then at least that long again to return to your previous fitness level.

I've had it
Couple weeks off work.
You'll be on crutches - they'll teach you how to do stairs before you leave.
First couple of weeks you may have to get taxis a few times.
It's sore but not unbearable. Take the codeine!

As the guys said, do the rehab. Swimming is good for it, and if you can get to a gym try the recumbent bikes.

Anything non-impact really.

Long term, don't get overweight and keep your leg muscles strong - cycling, swimming, walking and maybe the weights machines at the gym since they're quite controlled (i'm not much of a gym person so I might be wrong there!)

monkeyninja's comments ring true with me also, especially about the importance of following your rehab schedule and the benefits of 'prehab' (pre-op conditioning)

Long term, don’t get overweight and keep your leg muscles strong – cycling, swimming, walking and maybe the weights machines at the gym since they’re quite controlled (i’m not much of a gym person so I might be wrong there!)

This is all very good advice, especially the weights! Wait until you've completed your rehab protocol and then start small and build up gradually!! 🙂

Thanks all. Really really appreciate the replies. If I could get back to work after a couple of weeks, even remotely and part time for a bit, part of me would be happy with that, as academics are awful at not working!

So I should add that I have been doing prehab physio for the last 6 months (lazy compared to normal because both the surgeon and physio were concerned about me doing further damage, but having had previous injuries which required a lot of physio I have been reasonably motivated). I have managed to get my full hyperextension range back in the bad knee.

Know I haven't been on the turbo as much as I should have been but the hospital physio was happy enough to discharge me last time I was there. I am about to go and do another 20 mins on the turbo this morning. I did try one round of swimming but I could only manage 20 mins due to not being able to do breast stroke (I'm not a v strong swimmer) so really lacked motivation as it took longer to get changed than I spent in the pool! Rubbish excuse I know. However I have kept walking quite a bit so legs aren't what they were when I was riding but there is still some muscle tone (for a 33 year old women!).

I've probably put half a stone on (too much wine!) and never smoked.

Thanks for the comments. Laid in bed at 4 am thinking about it. Stupid. Was home alone, so ended up listening to my brother reading the news on the BBC World Service (because obviously at the moment that is more relaxing 🙈)

Good luck with your recovery too @monkeyninja

All operations in the knee tend to have different after care protocols. I had a reconstruction of meniscus and acl but mine was complicated by a depressed fracture of the tibia plateau. I was on crutches for over 8 months in total but the first few was to let my tibia heal. I then had 18 months of rehab which also included a knee abridement which delayed the rehab. It sounds awful but i can safely say there was no pain involved at all, just take things at a snails pace to avoid risking any damage. Follow the physio to the letter and you will be back to full fitness no problem.

so really lacked motivation as it took longer to get changed than I spent in the pool! Rubbish excuse I know.

You made it into the pool, no excuse needed!! Sounds like you have been (and will be!) doing all of the right things, there is no reason why you shouldn't be looking forward to the optimal recovery time. Instead of worrying at 4am you should be giving yourself a pat on the back. Seriously!! 🙂

It's a marathon not a sprint, so make sure you motivate yourself by comparing your progress to how you were doing last day/week/month. Don't dishearten yourself by comparing your progress with how you were at your peak fitness, sounds obvious I know but you will find yourself doing it anyway! Everybody does, it's just one of those quirks of human nature 🙂

Had mine done a few years ago. Tore miniscus, leg was locked for a few weeks had op on that and they found my acl had gone too. Had it done a few months later. Couple of weeks on crutches 6 months of physio. Was back on bike after 3 or 4 months I think gets a bjt sore when its cold now but generally ok.

Make sure you go through with it, I had to turn it down 20 years ago as they were telling me around 6 months off work, fast forward 20 years and the surgeons wont do it as my knee is starting to wear out

Instead of worrying at 4am you should be giving yourself a pat on the back. Seriously!!

🤗 Ok, noted and thank you. Did another hour of physio this morning trying to make sure hamstrings aren't tight.

Make sure you go through with it

Ok @deserter - think that's what I needed, as you can't ever see into the future, but sounds like you have just provided it for me. Sorry to hear of your problems.

Honestly the op isnt that bad and I was back at work in two weeks I think. The hard part is getting through the physio to get back to full activity. I kind of gave up on it a bit once I was riding my bike again so full recovery took a bit longer.

I’ve had it . I was instructed to have two weeks STRICTLY non weight bearing & little movement ,bar the initially uncomfortable physio .Full crutch action for about four weeks for me. Gentle pedalling after 6 and I was up Dash falls bang on 12 weeks.

My advice is do as much physio as possible. Lots of squats helped rebuild my hamstring. &Take as many pain killers as possible for the first week ! I thought I was fine after three days and stopped taking them- crikey that was a mistake.

best of luck

🙂

I’ve had it . I was instructed to have two weeks STRICTLY non weight bearing & little movement ,bar the initially uncomfortable physio .

Yep, as a physio ACL reconstruction is one of the few times that you follow a fairly rigid protocol, and the reason why is because we know it works. So it's a good idea to follow it!! 🙂

I'm really fortunate that the hospital in Leeds is a center of excellence for othopedics and I have ACL specialist surgeon.

@Shermer75 in some respects there being a strict protocol totally fulfills my needs for structure and a plan. I don't function very well without a plan. Thank you for your input today, you've certainly put my mind at rest that (without seeing me of course) that I'm on the right lines ahead of Tuesday.

Thanks everyone for the input. Just last day at work to get through tomorrow!

Thank you all for helping with my wobble at the weekend. I went ahead with the surgery yesterday and all seems to have gone well and I'm home. Had a femeral block on top of the general, which made trying to walk with a dead leg very tricky, but hoping it's easier today. Certainly glad for the prehab I've done as so reliant on my quads etc, and it looks I am already a good way towards being able to get it straight (though hard to tell with the bandage on).

Turns out I didn't have mensicus damage but rather patella cartilage damage which explains why my knee cracks so much. Bit like @deserter I think this is damage from not being offered the op several years ago (I didn't know what I had done). But annoying as it sort of suggests I have early onset arthritis in that knee as a result. I'll chat with the surgeon more when I return for my follow up, but it's made me glad I've had it now.

It's uncomfortable, but they have put me on Tramadol due to some underlying medical complications, and I feel reasonably spaced out to not worry about it. Here is to the recovery and sweeping singletrack. Thank you all, and good luck to those also recovering.

Osteoarthritis (OA) is something everyone will have from the age of around 35 onwards. It is very different form rheumatoid arthritis (RA) which is a degenerative autoimmune condition caused by the body's immune system attacking the joints. OA also affects the joints (although it tends to be the big ones, like knee and hip, as opposed to RA which attacks the smaller ones like the fingers) but is caused by either joint instability, overload or lack of use. It is something that is possible to manage and there is evidence to support that moderate loading of the joint will encourage regrowth of the cartilage. Make sure you mention it to your physio! 🙂

Thanks Shermer - that's useful. I'm thinking that like my disc proplases, with careful management, physio and watching my weight, it will be manageable. At least cycling is joint friendly. Not going to worry to much about it today. Main job is trying to eat without feeling very sick!

Slightly late but ...

A friend tore her ACL skiing (typical - get one last run in before the end of the holiday), she's not the most patient of people and didn't stick exactly to the recovery timescale. A year later she did the Bob Graham Round (66 miles and 28,000ft of ascent fell running in the Lakes) so it's not something that automatically consigns you to a sedentary lifestyle.

OA? Had that in my hip, started becoming noticeably uncomfortable when I was in my mid 40s, certain leg actions caused discomfort. It got worse over the next decade to the point the pain had me in tears and nearly passing out. Had a total hip replacement four and a bit years ago and it's been a life changer.

Anyway, get well soon! 🙂

Had ACL reconstruction on both knees (10 years apart) - and although daunting at first, feeling all the emotions that you mentioned, you should soon get back to the level of mobility that you once had.

As other have said though, you need to put the effort in early doors with physio and rehab. Be guided by your physio though, rather than other on a biking forum, as everyones knees, body, mental state and attitude to hard work is different.

What shocked me was how much different the second op was to the first - completely different cuts, and wounds considering the ops were 10 years apart. When i asked the surgeon he said that techniques had changed and that different surgeon have different styles. I felt i recovered quicker after the second op, but i wonder how much of that was down to knowing that things do improve if you put in the effort. Don't under estimate the mental side to pre and post surgery - i think you have experienced already, that it can be quite a challenge time mentally.

Static spinning on a bike in a turbo/gym was really good for me on the left knee, as was having a physio who was geared up to really pushing me to work hard, rather than the softly softly approach.

Good luck with the recovery.

Thanks @latham2104

Fully agree that everyone responds differently. Good to hear some good news stories though. Have to say I was expecting a large cut on my hamstring but nothing there so just feels bruised rather than sore. Already managed a few short walks up and down the lane today. Sure some tough times ahead, but have to say feeling a bit more optimistic today.

Good to hear your up and about already.

I had my ACL done 3.5 years ago, snapped it playing ice hockey, it dislocated the knee aswell and also damaged the medial collateral ligament. I can still remember the pain of it happening now.

I had the operation in September 2014 and remember being hauled out of bed about 2 hours after I had woken up by the physio saying the best thing to do is get up and about ASAP.. on crutches obviously.

I had about 3 weeks on crutches if I remember right and I was back to work in 2 weeks. I remember falling down the stairs when my crutches slipped and buckling the knee underneath me. Didn’t know I was that flexible. All good though and they said it was a good sign it was so strong so early on.

I had a great physio who understood I wanted to play hockey again (even though surgeon suggested I stop), he gave me loads of exercises to do which I followed to the letter as I knew the importance of them. I was doing gentle running on it within 6 or 7 weeks and was able to weight bare on it with 4 weeks if I remember correctly. After the initial speedy progress I made I remember it slowed down a bit after that and I wasn’t able to put much power through it when cycling. Took me a good 7 months to pluck up the courage to get back on the ice and a further 8 months to start playing hockey confidently again, every hit it took or tight turn I made made me nervous for a while. It’s all good now though, gets a bit achy in the cold weather or if I sit for too long, still can’t fully bend it to tie my shoe lace but it’s as strong if not stronger than it was and I’m back playing hockey, running (but not cycling as I have fallen out of love with it) and generally not being restricted by it. Just waiting for the other knee to go now and I’ll feel 20 years younger.

Long story short.. listen to your physio and don’t overdo it. I tried to chap on with my crutches the day after surgery because I felt ok and it knocked me for 6 for a good few days, trying to sleep was hard aswell but I found packing plenty pillows round me and the knee really helped support where it needed it.

Good luck and get well soon.

Thank you for all the good vibes. Had a tricky day yesterday...tried to get up without pain killers but was really sore and clunky. Painkillers then wipped me out for the rest of the day, feeling tired and quite sick.

Anyway new day today. Knee is looking quite tidy and less swollen today. Surrounding brusing coming out. Going to try and walk a little bit further today (have managed up and down the lane and all the stairs yesterday). Going to try and balance the pain, drugs and feeling naff and keep positive. Certainly making progress getting it straight. Bending is more tricky.

Starting to think I might give in to the 6 weeks they have signed me off for. Will see in 10 days time when I get to physio and the clinic.

I found mine was fine on the day of the op and the day after and then got worse for a few days before the recovery started, just take it easy until you see a physio.

So 3 weeks on from my op, felt an update was justified.  Making progress - can manage 10 mins very easy spinning on the turbo (though getting on and off the bike is quite an exercise, but it really helps loosen up my knee) - and walking regularly with only one crutch.  Operated leg is starting to feel stronger (I did give myself a bit of a step back by slightly tearing another bit of my hamstring doing some physio!) and I can walk for ~50 m on the flat without crutches if the leg feels good.  Extension and flexion is increasing each day - leg is straight but now trying to work on my hyperextension.  My Mum took to measuring my progress on my heel lifts in number of Singletracks - we have quite a few lying around the living room -  I am up to 4!  Lol!

Back to the consultant tomorrow and the physio next week. I am glad I have accepted the 6 week sick leave - having just done an hour of emails my brain feels like total mush; and I know I wouldn't be able to manage the swelling in my knee if I had to do 2 hours of commuting and sat at a desk/walking round the campus all day.  Total respect to people getting back to work after 2 weeks - you are a far better person than me!

Got mine done in October 2004 but it's gone again at some stage between then and now. When I got my op my flat mate got both done at the same time 😦

ahsat............just seen this love, never realised you were getting it mended.

hope all has gone and keeps going well.  be strict with your physio, as you know it works wonders.

and keep on keeping on, you will be back at it in no time.

good luck and heal well.

Glad too hear its going well.

Don’t go back to work before you are ready. I went to the doc to get an extension on my sick note. Just ask.

No one will ever thank you for coming back early.

The hamstring was the biggest deal for my rehab. Apparently the reason it’s so sore after ,is because they pull it out of the slit before they take a slice for the ligament!

ouchy.

Thanks all. Managed to walk a very slow mile on the canal with walking poles today so certainly heading the right direction. @ton, yes you are totally right, good physio is the way forward. Hope that you are starting to find the right cycling for you.

Ouch @Albanach - that is not cool. Feeling for you.

Good to hear you’re doing well ahsat.

Not quite ACL surgery, but just had my first medial plica excision on Wednesday along with a tidy up of a split they found whilst in there along with a good clear out.

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Pics 1, 2, 3 & 4 below show the band of tissue removed (it was a fair lump, best seen between 5 o’clock and 9 o’clock on pic 2).

The split can be seen best seen at 9 o’clock on pic 6 which they sorted whilst in there.

14 & 15 are the finished article. Not too bad hobbling round the house but on crutches for anything more. I’m slowly going insane being stuck round the house, trying to keep myself busy but take it easy at the same time.

Previous ACL folk, and Shermer, how long do things hurt after the op? I'm now at week 5 and the last week has been really tricky - pains around the op site at the shin (eased up after 2.5 days), then then warm swelling stuck all around the joint (ended up back on crutches for a couple of days as weight bearing was painful), and just after I got over that, I've got pain around the top of the shin again (I've got brusing there that just won't go away) and spikey pains round my knee cap? Is this all just part of the process? It's wearing me down!

All that said, I can get my knee fully flat and probably to about 125 degrees bent. On the turbo spinning for 10 mins morning and night as helps free the stiffness up (though cant do it pain free with the ball of my foot on the pedal, have to have it in the middle of my foot). Haven't really been able to get on with the basic strengthening the physio gave me this time last week due to the pains. Keeping up with paracetamol to try and keep on it (really don't want to go back to the Tramadol).

I've got to go back to work next week and then to a very important presentation in Brussels in 2.5 weeks time. Can't say I'm particularly looking forward to it, as get so stiff if I am doing anything for too long. Oh well.

@bluearsedfly how are you getting on?

So nearly 11 months on, i know there will be other people searching the forum looking for similar stories, so thought I’d complete the circle.

The first 4 months were pretty awful. I had issues with NHS physio, which after 2 months meant I moved to private but we then had to spend ages undoing an awful limp. Also as my injury was old, I have arthritis behind my knee cap I had a lot of pain. I was very low at times. I was back and forward to the hospital as I wasn’t making much progress.

Suddenly at month 5 we turned a corner. I was able to walk several miles and my physio was able to increase. I was still limited by single leg dips due to a lot of knee pain, but at about month 7 I moved to working with a PT and my muscle significantly increased with quite a bit of hard work. I was signed off by the surgeon (with a cautious note re mtb!) after 9.5 months (after the first 4 months, it looked like it was going to take 12). I’m still in the gym 2-3 times a week, but I’ve done a 40 mile road ride in the last month, and 3-day 32 mile walk in the Yorkshire Dales. I have done some classic xc, but not yet returned to full mtb - that is just a mental thing of avoiding it until I feel absolutely ready, but I think Hamsterley will soon be on the cards.

Forums like this have been really useful, but most of all the ACL-family on Instagram. I know it sounds cheesy but it really has been social media for the good.

Last May was one of my lowest points of my life due to the physical and mental strain; however I am now both physically and mentally stronger and looking forward to more adventures.

View this post on Instagram

Yep, it’s a tough one, and trying to loose weight whilst gain muscle an interesting challenge.

Glad to hear things are getting better, albeit slower than you would like.
I'm looking at fairly major knee surgery in six months, involving some bony procedures as well as ligament reconstructions.
In terms of losing weight, my consultant said 80 percent of it comes down to calorie control, and 20 percent is exercise. But easier said than done!
It's good to have a "dream" to aim for - mine is to be able to do a mountain biking holiday in Spain in late 2019.

My advice is get a good physio, work hard and trust the process. It is a long road, but I think I am proof you get there in the end. If your op isn’t for 6 months, I am going to be difficult and suggest a mtb holiday in late 2019 might be pushing it based upon what sounds to be a major op?!

I agree re calorie control - I’ve now lost nearly a stone despite the muscle gain. I ate too many Kitkats whilst immobile but hohumm. You do what seems right at the time.

Very best of luck @handybar

Thanks for this.

I have a torn medial meniscus which just isn't going away. I'm sure there are other issues in there too.

Waiting for another mri and hopefully getting it sorted.

Cycling is okay, but just walking around isn't.

Feel a bit low sometimes as I'm a triathlete at heart, done Ironmans, ultra marathon etc and just want to get back out in the hills.

Mid fifties too so expecting a slower recovery.

Sorry I meant mountain biking holiday in late 2020

Actually a question I have is this - what is the pain like after a knee operation (obviously there is some range). Im having the operation done about two hour drive from where I live. I will stay in the hospital for one night, but then the plan is for my dad to drive me home. But I'm wondering whether that could be an excruciating journey? Should I book in to a hotel instead for a couple of nights?

@Mary_Hinge - I feel for you. Fingers crossed it is 'just' a meniscus repair and I know people who have been back to lifting some significant weights within 3 months. I know that is still a long time if you are an active person. I have ended up using it is a very good excuse to develop a structure program with a clear goal; and with you background it sounds like this is something which might work for you too.

Sorry I meant mountain biking holiday in late 2020

Phew!

what is the pain like after a knee operation

So personally I found that evening it was fine as I was still getting rid of the anesthetic, had a femoral nerve block (so actually couldnt really feel my leg at all - did make standing up very interesting!) and full of morphine! It was the following day once all that wore off that things got really quite sore. The 40 min drive home (in a van, so without the luxury of putting seats back or stretching out across the back seats) was actually ok - I just felt really quite sick from the drug cocktail. I was glad I was home and all I had to do was work out how to get to the toilet, sofa and pain killers the following day. I personally think getting home the same day would be for the best; and they will be able to give you some morphine to help you if needed.

I had mine done around 9 years ago, don't recall it being too painful tbh, although you do get some reasonably strong pain killers. That said I didn't take them for too long as they spaced me out....

Had no issues with the knee since, ski'd every year since & still race XC.