ACL questions

Axis · 03-16-2005, 02:13 PM

Please forgive the length of this post. I'll post my questions in bold to make it more clear.

I just got my MRI results and I have a ton of questions. I'm also actively googling and searching this and other sites for my answers. I'm posting this, because I have more trust in the cabal of experts here than random google hits.

First, here's the summary of my MRI:

1. Complete tear ACL proximally
2. Low-grade MCL sprain
3. Peripheral vertical tear of the posterior horn medial meniscus
4. Small radial tear inner margin of lateral meniscus at junction anterior horn and body
5. Focal chondral defect medial femoral condyle
6. Knee joint effusion
7. Bony contusions medial lateral tibial plateaus posteriorly, and medial and lateral femoral condyles. There is a slight impaction deformity of the lateral femoral condyle centrally.
8. Partial tearing popliteus muscle.

The doctor recommends ACL reconstruction, which I plan to pursue after my wedding in May, or perhaps early next year when I can allocate more money to my cafeteria plan to pay for it tax-free.

Right now, I can walk relatively pain free and it seems to be improving daily (injury occurred two weeks ago). The doctor recommended that I do low-impact exercise (biking, elliptical, etc.) to stay/get in shape, and he encouraged strength training as well. He gave no specifics, though, about the training and said to ask the physical therapist.

Questions:
Can you recommend any good websites that discuss rehab/recovery after a knee reconstruction?
I've found plenty of sites that describe the procedure, itself, but what I'm more interested in is kind of a timeline of recovery, just so I can have an idea what to expect.

As I said, my doctor recommended I do some strength training. Are there exercises I should avoid in the time before I actually have the surgery?
I'm planning, of course, to start out very light, but I'm wondering if there is anything I should specifically avoid (I plan to ask the PT the same question).

My doctor mentioned that I can probably expect some arthritis in the future. Is there anything I can do now and going forward to minimize the extent of the arthritis?

I guess that's all I have for now. I appreciate any help you can give me.

Thanks.

bryanc · 03-16-2005, 08:24 PM

I'm partial to this site, which explains pre and post surgery rehab and a bit on the actual procedure. It is however, the Calgary protocol, so it might not be the same where you are--though I'd have to ask why the hell not =P.

http://www.sportmed.ucalgary.ca/patntsec/default.htm

It should also address your second question for the most part. Avoiding leg extensions would be a good start though.

With respect to developing osteoarthritis (OA), it is going to come down to keeping your quads and hamstrings healthy and strong. The reason why ACL injured individuals develop OA is because there's no structure to prevent shear forces of the femur on the tibia. Cartilage is great at withstanding pressure loads, but horrible at shear ones. The more you can minimize those shear forces, the less at risk you are of developing significant OA. Even with an ACL repair, there's nothing nearly as good as the ACL you were born with--which has remodelled specifically to you for your whole life. So is OA inevitable? Probably. Will your OA have a significant impact on your activities? That seems to be up to you, according to the literature.

Axis · 03-17-2005, 01:14 PM

Thanks, bryanc. That was very helpful.