ACL Reconstruction Experience

Posted as a contribution to sgrunners forum:

I had a complete tear of my right ACL in 1999, confirmed on MRI and clinical examination. Injury incurred during a soccer game. Reconstruction done 8 months later, and during arthroscope, was confirmed that ligament was completely torn

A few points;

1) Knee stability with ACL tear.

The ACL is one of the ligaments of the knee that stabilises the joint. Specifically, it restrains the femur (thigh bone) from sliding backwards on top of the tibia (shin bone), and vice-versa. It is [u]actually POSSIBLE to continue running safely [/u]with a completely torn ACL. My ortho surgeon suggested as much, and 2 weeks after the injury, I was back to normal running >5K with little problem. The point is that if you have decent muscle strength, sub-sprint running on an even surface does not stress knee stability that much. If you do want to play sports, however, it is a different story. For games like soccer, tennis, and the like, changes in direction are the norm. If your ACL is torn, the instability could lead to further knee injury.

2) Further and associated injuries with ACL tear.

Very often, the force required to cause an ACL to rupture is huge, and other knee structures get injured as well, most commonly, the meniscus. Do check out if you have associate meniscal injuries, the MRI should help. Fortunately, I did not. With increased instability, the risk of incurring a meniscal injury, even if you did not originally have one, is now quite great. This was the main reason I decided to go for a recon, because I had wished to continue with other sports. If all the exercise you did were swimming, biking and running on a flat surface, I'd say you could get away WITHOUT doing a recon, provided you had good muscles already providing ancillary stability.

3) Cause of the tear.

Fatigue Fatigue Fatigue. As you get tired, your start losing attention and your muscles are less able to cope with stress and loads. The injury occurred during a competition and I was playing my 3rd game of the morning, about 100 minutes of game time. As I leapt to evade a tackle, when I landed standing there was a loud crack and my knee gave way. Basically the hamstrings were just too tired to help take the force of the landing and the entire weight bore down on the ACL, causing the rupture. Take care of the body and don't overexercise!

4) Consequences of an ACL recon.

Not nice! You could be walking in about 3-4 days, but muscles withered away and fully took me 6 months to get the bulk up. But there would always be a deficit compared to the normal side, up to 10% less strength or more. Definitely lost explosive strength on that leg. However, got good stability and now back to racquet sports, but no serious soccer, just kick-about with kids.