ACL Reconstruction — Take II

Tomorrow is the big day…October 16th 2017. I will undergo anterior cruciate ligament reconstruction surgery on my right knee at the Hospital for Special Surgery in NYC. This time it’s different though as it’s a revision from a prior procedure. The first surgery was conducted on July 18, 2013 — that’s 1,552 days ago. This time around, I wanted to document the road to recovery…but first, a brief history of how I ended up in this situation.

Spring and Summer 2013

Since about 2007, I would play basketball with a group of friends pretty religiously. This was my Saturday morning routine — basketball with the guys and food afterwards. We played a lot of basketball! In early 2013, one of my friends had the brilliant idea of enrolling in a rec league. Despite the subpar play, we made it pretty deep in the playoffs…until things went south quickly.

We didn’t have many people coming off the bench and were playing tired. It was the 4th quarter in our second game. I jumped to grab a rebound and landed funny. I didn’t hear the proverbial “pop” but my knee felt strange. I thought it was just a sprain and tried to stay in the game — but I couldn’t cut. My knee buckled and I had no lateral stability in my right knee. I came out and didn’t play a game of basketball for a very, very, long time.

There was no pain — not even a bit of swelling, or any discomfort. I knew that there was something wrong though and I needed to see an orthopedic surgeon. I fired up zocdoc and browsed the various doctors that accepted my insurance plan. I wanted someone with stellar qualifications. I found someone that went to an ivy league college. He ordered an MRI and a few days later, my suspicions were confirmed: complete tear of the ACL. He recommended surgery with PRP therapy during rehab.

He also started talking to me about graft choices…autograft, allograft, BTB, hamstring, etc. nothing made much sense to me. What worried me most was that he said he would do whichever procedure I preferred. Isn’t he the doctor and shouldn’t he recommend the best procedure for me?! I ran from this place and never looked back. I started doing research on google and stumbled on HSS — a world renown facility specializing in orthopedic surgery.

I browsed dozens and dozens of profiles of the surgeons. Some performed surgeries for famous athletes like Kobe Bryant. This place was legit. I narrowed the list down to a few candidates and made appointments immediately. The first surgeon recommended the BTB procedure but warned that there could be some lifelong pain in the knee afterwards. Not gonna lie, it scared me and I wanted to get a second opinion (I also didn’t “jive” with the surgeon).

The next surgeon was Dr. DiFelice — his resume was solid and we immediately clicked. He advocated a much more conservative approach to surgery. Instead of completely removing the damaged ligament, he said he would try to salvage the ligament and repair it. Apparently, techniques have evolved quite a bit and he was seeing a lot of success using this approach. The strategy was to try to salvage if possible — if during the procedure he decided that this was not possible, he would use a hamstring autograft tissue.

July 18th, 2013: The day of the surgery arrived. The game plan was set. I was sedated and slept during the procedure. When I regained consciousness, I woke up with my leg bandaged up in a locked brace. I met the surgeon and he said he had some good news. My native ligament was in good shape. It was apparently tearing from the point of attachment not in the middle. He used an achilles tendon allograft (from donor tissue) to augment my native tissue. Because of this, the recovery should be pretty straightforward and quick.

The Road to Recovery

I started rehab almost immediately. I would go 3x a week and wanted to get healthy ASAP. Because of my aggressive rehab and PT regimen, I used up the # of allotted appointments pretty quickly. I regained range of motion, but my quadricep muscle had atrophied pretty significantly.

I had to continue doing PT on my own and by early 2014 I decided that it was time to join a gym (thanks for convincing me Jared!)

The rehab was slow and my quad didn’t want to “wake” up. I pushed through and by June of 2014 (almost a year since the surgery), I started taking some bootcamp style classes at Equinox. I was fortunate to have accidentally taken a class taught by Greg James — I was hooked and felt I was finally getting stronger.

Return to Basketball — June 2017

I felt confident that my knee was back. I didn’t have any issues with the 100s of jump squats, burpees, or any of the other crazy things I was doing multiple times a week. I decided that I was ready to play.

June 3, 2017: On this day, 1,417 days since my surgery, I picked up a basketball again. This is the first time I played in a game since my first injury. Things were going well. My knee felt strong — until I jumped and landed funny. I immediately knew something was wrong. I tried to stay in but the lateral stability in my knee was gone. Everything felt like the first time except my knee actually hurt. I had trouble straightening it.

I immediately made an appointment with Dr. DiFelice and got an MRI. My worst fears were confirmed, only this time I had also torn my meniscus. He recommended the same procedure — allograft again. I wasn’t satisfied with his suggestion and made an appointment with the Brooklyn Nets team doc…also at HSS. He gave me some sobering news — that I had the wrong procedure back in 2013 and should have gone with the gold-standard BTB autograft. I liked him and got a good vibe but wanted to see one last doctor, Dr. Robert Marx.

This guy is literally an expert in ACL surgeries and more specifically, more complex revision procedures. He took the time to explain everything, my options, and what the outcomes would be. The thing I liked most is that he didn’t say I absolutely had to get surgery (you can actually live without an ACL). I was sold — it didn’t hurt that this guy is Quebecois like my girlfriend!

The Surgery

The surgery is all set. I found out that I will be Dr. Marx’s third patient of the day. Recovery is going to be hard but my girlfriend has already prepped the apartment for my lack of mobility — I’m also lucky because I am going to have her amazing food for the next few weeks! My mom is also coming to make sure I have everything I need. I guess I’m a pretty lucky guy…to be continued.

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