ACL Reconstructive Surgery
My story, insights and what to expect…
Before an ACL(Anterior Cruciate ligament) tear is a devastating injury and potentially career-ending, but with modern advances in medicine and technology it is now possible to reconstruct a torn ACL.
Professional athletes like Chicago Bulls star point-guard Derrick Rose, Minnesota Timberwolves’ wonder kid Ricky Rubio, and FC Barcelona’s Xavi Hernandez all suffered from an ACL tear. Rose eventually returned but injured his other knee. It was probably because he was relying mostly on his right uninjured knee during his first ACL tear. Rubio is back in top form and is looking to help the Wolves climb up the standings, while Xavi Hernandez is still one of the best midfielders in football history. These prove the fact that an ACL injury chooses no one. But these guys refused to go down and came back in top form.
I tore the ACL of my left knee while playing Frisbee on November 16. It was one of those times that you wish you knew that it would happen to avoid it, but unfortunately it happened without warning. The odds of the injury happening were 1/1750 according to a health website, and the risk increases to 1/33 after having it repaired. But these are just numbers and we do not know what would happen in the future only He knows, but there are some things that we could to minimize the risk of the injury to happen again. But there is no accepted method that would prevent these kind of injuries from happening. There are a lot of factors that contribute to these kind of injuries, thus making it hard to determine a prevention method.
These links direct you to websites on how to reduce risk of initial tear and further ligament tears:
http://drwaltlowe.com/acl-injury-risk-reduction/ http://bjsm.bmj.com/content/39/3/127.long
Anyhow, if you are already suffering from a complete ACL tear you will probably need a reconstructive surgery if you opt to return to the sport you love. I have read an article that an ACL tear may be remote or most of the time other ligaments may also be damaged. In my case, aside from tearing my ACL, I also tore my MCL(Medial Collateral Ligament) and an oblique tear on my meniscus. This is what doctors would call an Unhappy Triad or a busted knee. The MCL would heal in time but the ACL and the meniscus can’t heal on their own so I opted for surgery so that I could get back to my usual active lifestyle. Full recovery would take about 6 — 8 weeks with physical therapy and at home exercises.
So what is an ACL? The ACL is one of the four ligaments that hold your thigh bone(femur) and shin bone(tibia) in place. The other three is the LCL(Lateral Collateral Ligament) which on outer side of the knee, the MCL(Medial Collateral Ligament) which is on the inner side of the knee and the PCL(Posterior Cruciate Ligament) Which intersects with the ACL to form an “X” inside the knee. The MCL and PCL control the sideways motion of your knee and brace it against unusual movement , while the ACL and PCL control the back and forth motion of your knee. Then there are cartilages that act as shock absorbers, called meniscus. This is located between the ball end of your tibia and femur. These protect the bones from arthritis and sudden impact while landing. An awkward landing, a sudden pivoting motion, a sudden deceleration or a blow to the knee may cause one or more of these ligaments to tear.
So, what to expect when you choose to undergo ACL reconstructive surgery?
Day 1 — December 19, 2013
Pre-operation day
Chong Hua Hospital, Cebu City, Philippines, 3 PM — I was admitted on the 7th floor. This floor is exclusive to patients who are about undergo surgery. This just adds to the anxiety that I have been experiencing ever since the orthopedic doctor told me that I need to undergo surgery to return to my normal life. A male nurse entered my room, 731. He then oriented us on the hospital rules and regulations. I banished my mind to the fact that tomorrow I’ll be heading to the OR and the rest will be up to God and the surgeons.
I was having trouble sleeping. Lying down on a hospital bed doesn't feel very welcoming at all, especially when Christmas is right around the corner. So I turned to the television for some form of entertainment because there is no Wi-Fi at all. Eventually I fell asleep.
Day 2- December 20, 2013
Operation Day
A Nurse came in, stuck a needle in my wrist, and hanged the IV beside my bed. The doctor said to prepare at around 7 AM because the operation was supposed to be at around 9 AM. I was so anxious that I can’t help but imagine what the OR would look like. Then finally at around 10 AM the nurse arrived and told me to prepare, she stuck another needle on my arm to check for skin allergies, then I was carried on a hospital bed to the operating room.
Then I met the surgeon, who then explained to me briefly the whole procedure then I lifted to the operating table. They attached a heart rate monitor, a blood pressure monitor, and an oxygen hose or nasal cannula(actually researched the correct medical term on that). Then I was asked to curl up into a fetal position. The anesthesiologist told me that she was going to administer the spinal anesthesia and that I was going to feel numb and would be unable to move the lower half of my body. The anesthetic immediately took effect after about 5 minutes. Then they injected a sedative on my IV, just enough to make me feel drowsy but still conscious.
I can’t remember what actually happened after that because the sedative was quite strong than I expected. I returned to consciousness every once in a while. Then I was able to glance at the monitor beside me. I saw the insides of my knee, they seem to be cleaning the inside with some kind of a mini vacuum cleaner. Then I lost consciousness again after that. Next thing I know I was at the recovery room. Still a bit drowsy because the sedative hasn't quite worn off yet. I was able to look at the heart rate monitor beside me, I saw the number going up and down within the range of 103 — 135. I didn't know back then if that was normal. I only knew that it was not normal when I finally regained back my consciousness at my room. I was already attached with a knee immobilizer. The doctors told me that it was an unusual reading at my age of 19. They told me that they had to call a cardiologist in during the operation to asses my heart rate reading. Eventually the cardiologist told me that it was normal because it was just an adrenaline release.
Day 3- December 21, 2013
Post-Operation Day
A day after the operation I was visited by a physical therapist. He carried a machine with him. He said it was a cryo-therapy machine. based on the word cryo, I assumed it was something cold, and indeed it was. He removed the knee immobilizer and the elastic bandage, then he pointed the nozzle of the cryo-therapy machine over my left knee. Cold air rushed out of the nozzle when he turned it on. It was such a soothing feeling.
Then he took my left leg and started to bend it slowly 20 times. He then instructed me to pump my ankles 50 times so that the inflammation would slowly diminish. After the on-bed exercises he told me if I was ready to start walking with the crutches. I eagerly said yes because lying down for almost 2 days was such a pain in the ass and the back, literally.
I started walking back and forth slowly in the halls, then I took on the stairs. After doing a couple of laps, I went back to bed and rested for the whole afternoon.
The doctors came in and told me that I can go home by Sunday or Monday.I was very eager to go home before Christmas. In the US, an ACL reconstructive surgery is typically an out-patient procedure but in the Philippines doctors advise patients to be admitted for 3-4 days for us to recuperate.
I went home on December 24, just in time for Christmas.
Today is the fifth day since the surgery and things are going well. I will have another appointment with the PT tomorrow and I am hoping to be able to walk without crutches by next week. The doctor told me to come back two weeks after the surgery to remove the sutures.
I had three surgical wounds. two of which are very tiny, about half an inch, and one that is about an inch and a half.
I am currently taking two meds. One called Celebrex, taken once a day after supper, and a pain reliever taken 3 times a day after meals.
The doctor told me that after 3 months I would be able to do cycling and running in a straight path, without pivoting and quick change of pace. Then after 6 months, if everything goes well, I would be cleared to play again.
PS:
Contrary to popular belief, wearing a knee brace or supporter while playing does not prevent or reduce the risk of injury. There is no accurate study to prove that this is true. So always be vigilant when playing your sport, with or without a knee brace.
If you have any questions and other insights feel free to e-mail me at: >idolbordz@gmail.com
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>@iamdale11
