Another ACL Thread

[Ajskier]

Good Afternoon All,

 

It sucks to be starting another one of these threads and I apologize for the length of the post, but I blew my ACL just over a month ago. Drunk snow skier decided he wanted to go to the opposite side of the hill and hung a left into me. I didn't see him until I was hitting him, happened so fast, skis didn't release and I of course twisted hard when I fell.

 

MRI two weeks ago and confirmed that I had a full tear to my ACL. Fortunately everything else is intact and no other damage. Also, have pretty good strength in the injured knee, which happens to be my front foot. Met with a surgeon last week and he is recommending that I have surgery to be able to get back to where I was before the injury. He did clear me to mountain bike and some other activities this summer, but strongly suggested that I do not ski this summer, for fear of causing damage to the rest of the knee. I reluctantly agree with him and have partially resigned myself to the fact that I won't be skiing for the first time in over 35 years. I have an appointment for a second opinion next week, not that I am expecting to hear much different, but the doctor I am seeing does a lot with professional athletes.

 

Few questions I have for the group:

 

1) First doctor is recommending a quadricep graft. I know it is a newer style of ACL reconstruction. Has anyone had it and what has your experience been with it? Have any of the medical professionals on here seen a high relapse rate with that style?

 

2) I am currently wearing a hinged brace that I bought at target to provide stability because my knee does feel a bit unstable when I do not have it one. Doctor said that they could get me a custom brace, they recommended a DonJoy Defiance brace. I told him that whatever brace I get, it needs to be able to hold up in water because I spend a lot of time in the water even when not skiing. He told me that no brace is waterproof, but said the DonJoy does hold up well as long as you take care of it. For those of you that have used that brace what has been your experience with it? If I am plunking down the cost of a new ski for a brace, I want to make sure that I am getting the best. I saw in other threads, people mentioned CTI braces. Is there a brace that skiers would recommend for longevity, durability and support?

 

3) I mentioned above that I am partially resigned to not skiing this year, but for those of you that skied with a torn ACL, what was your experience and did you end up causing additional damage?

 

I really appreciate the feedback in advance and sorry for the long post.

 

Take care,

 

AJ

[ForrestGump]

I completely ruptured my right acl 5 years ago in a bike race. Never had it fixed. Continued riding my road bike, which is probably the best rehab. 5 years later I never even think about my knee. And I'm skiing, albeit it is my back leg so I am running Reflex R. I wouldn't hesitate to ski if I ran a reflex or other positive release front binding.

[The_MS]

How old are u?

[Horton]

I had my ACL done 30 years ago. Now that is my "good" knee. Schedule the surgery asap and get it done.

[lundberg]

I've blown both ACLs. Had the first one fixed (patellar tendon) and did not fix the second. I skied with a brace on my front leg (no ACL leg) for years (custom Townsend design brace) worked okay but had to protect my back knee from running into the brace. I stopped wearing the brace for skiing over 10 years ago and now I don't even think about it while skiing. I kept wearing the brace when I played basketball but at this point the leg is strong and stable and I don't need it. For what it is worth I have more pain in my repaired knee than the one with no ACL. Everyone's anatomy is a little different but for me if my quads are strong my knee is stable.

[BraceMaker]

There is a reason CTi has so much market on active ACL bracing for watersports and such. The full shell over the shin bone (tibia) supports the function of the ACL.

 

The ACL prevents your shin bone from popping out forwards from under your thigh bone. So most knee braces that are discussed with a full frame only have a velcro strap to restrict this motion. The CTi and a few others like the Breg X2K have a frontal frame but the CTi is all graphite/carbon in the frame where as most of the others are aluminum.

 

 

[BraceMaker]

 

you'll note the CTi has a rigid tibial shell and a rigid lateral component to control the rotation of the thigh. Somewhat unique in the world of knee bracing and almost only for ACL control.

 

[RazorRoss3]

Hey, I just came off of the same injury. Age is a big factor in graft style. A lot of docs like the patellar graft, the hamstring is also popular. Schedule surgery and accept the fact that you won’t ski this year. Work really hard during physical therapy and you’ll be back. I just got back from ski school and my post op, post rehab, knee held up great. Good luck

[skibug]

Had mine done in January of 1999, hamstring graft technique, been great ever since. It sucks and rehab is paramount to get back to what you enjoy doing. I skied at about 7 months after surgery.

[Zman]

I started skiing about 6 months post surgery. And, for about 5 months I wore the DonJoy Defiance while skiing. Worked great, no hindrance to skiing, and held up very well to all the water use. Just had to replace some of the velcro attached pads once.

As others have said, get your surgery ASAP. Until then, keep bike riding, and schedule some "prehab" with the same PT you will use post surgery.

I had the two hamstring tendon graft. I was 61 at the time.

Good luck! Rehab after surgery is your new sport for a while. Embrace your steady improvements.

[vtjc]

Sorry to learn of your ACL injury.

 

As the spouse of someone who had an ACL replaced at age 18 and 36, I would encourage you to get your ACL replace soon. My wife is now battling multiple areas of deterioration in her knee some possibly attributed to the year she competed alpine skiing without an ACL.

 

It is important to consider the ACL graft used in the procedure, also think of the surgeon, procedure, hospital and physical therapy as a system. The type of graft is just one factor in the outcome.

 

[slow]

Blew my ACL snow skiing in February 2020. Had my ACL replaced with a hamstring graft a month later in March. It was in great shape for snow skiing this year. 35 days and no brace the last 20 days. Knee is perfect. Took a full year to get hamstring to full strength. Had great insurance so did pt twice a week for 40 weeks. No water skiing last summer however.

[ral]

I had my ACL redone, hamstring graft. Done by my brother, who is a knee surgeon.

 

Some say here that you can function withouth surgery, that is totally dependent on your particular anatomy. My knee was unstable to the point of not being functional after the injury. I know people that could snow ski 2 weeks after blowing theirs, almost no unstability. If your knee feels unstable, you are damaging your cartilage.

 

Get your ROM back ASAP after surgery. Going back to skiing before 6 months post surgery is nosense, as the body needs to replace all tissue in the graft. It is not a matter of rehab or recover/improve muscular strenght.

[markn]

So sorry to hear of your injury..that sucks. I ruptured my ACL in my right leg at the age of 17. Never had it repaired. Granted have had stability issues playing basketball and other sports, but have run marathons, raced bicycles, done triathlons, snow skied and water ski ski and barefoot. Due to either over-use or lack of ACL, I have had 2 surgeries on slightly torn MMC and LMC . I am now 65 and do not give my knee a thought. Whatever your decision, best wishes for a full and rapid recovery so you can go back to doing all the sports your enjoy.

[Ajskier]

Thank you all for your feedback, I really appreciate it. I am reading all of this after a couple bourbons and hearing that my friends are putting in the course next week.

 

@The_MS, I am 43, I am a 34 mph 22-32 off skier. I used to jump, but don't think that is going to be in the cards anymore.

 

@Horton, that is good to hear that a repaired leg can be as strong if not stronger than the uninjured leg. Unfortunately, I have to push surgery until fall, we are getting ready to start a major home renovation, and I am doing a bunch of the work to save us a substantial amount of money. Right now, my knee feels really good, almost normal, but I am wearing a brace daily and haven't pushed it much, but what I have done it feels ok.

 

@BraceMaker how does the CTI brace hold up in the water? That brace looks like a much stronger brace than the DonJoy Defiance that the doctor is recommending.

 

@RazorRoss3 what style of graft did you have?

 

@Zman I start prehab next week and I am looking forward to it. I am looking at the prehab and the rehab as my new extreme sports for the next year.

 

@vtjc the graft style, surgeon, procedure and everything along those lines have been at the forefront of my mind. The first doctor I meet with, I described what I do with water and snow skiing and I don't think he really grasped it. Which is way I am getting a second opinion from a doctor that I got in with that does a lot of work with professional athletes in my area.

 

@slow I like to hear that, I am hoping to catch of the end of snow ski season in 2022 and then be able to ski that summer.

 

@ral I haven't given my knee much of a chance to be unstable since my injury, I have been wearing a brace almost all day everyday, but if I take the brace off, my knee feels loose, it probably wouldn't give out, but I am not taking any chances.

 

@markn when I hear stories like yours and @ForrestGump and some of the others, it makes me think twice about have it repaired, but on the other hand I have two small kids at home and worry about not being able to do things down the road with them because I screwed up my knee more.

 

Honestly, I am shocked with 35 years of snow skiing and water skiing, plus all of the other stuff that I do that I haven't had a significant injury like this before, so I guess I was playing with house money.

 

Again, I really appreciate everyone's feedback.

[RazorRoss3]

@Ajskier I had a patellar graft, it was recommended for someone my age as the best option. My surgery leg is my back leg which was lucky, but as I said I just got done putting it through a week at the boarding school after 18 months off (6 month MN winter + 1 year ACL recovery) and it held up great. Little bit of inflammation little bit of tenderness the week after.

[moski]

@Ajskier ——- I’m 43. Never been in hospital etc... grew up on farm, motorcycles, waterskiing (snow skiing later in life with my wife and kids), etc.... i tore my left ACL back when i was 34, October/November 2012 I think. (left acl is my front ski foot). I tore it playing in flag football league with a bunch of early 20 year olds. Ugh. I was pissed off at myself, the dr that did the surgery tried to be positive and was like 34 yrs old and this is your first issue in hospital, much better situation then others, and acl tear is not a big deal.

I saw 3 doctors. First dr the oldest and said “leave it be and see what its like”. Second dr was the youngest and said i have a high activity rate and wanted to use my own patella tendon. The third doctor was middle aged and recommended by few folks who just moved to my area, and he had been practicing out in CO (avalanche hockey team, and broncos team dr too) for long time. He said yes i have a high activity for my age but felt a cadaver was best to use and did few other things. The dr’s PA prior to surgery came into room and going thru check list, i asked him to please make it a runners cadaver. He’s like well sir a cadaver is a cadaver (he thought i was serious), i stopped him, and I’m like I’m joking dude. Lol. Surgery was around December 2012. I did everything the Dr, PA, and PT told me to do. The PT was like a drill instructor, she pushed me hard.

But I’m back to slalom skiing, barefooting, trail running, running , mtn bike, and road bike. Summer of 2013 just did 2 skis since dr and PT told me too. So back to slalom and bare footing in summer 2014. My knee is strong.

 

I still think. Since i tore my left ACL and its my front ski leg. I still wonder if i should do front release boot. My back foot is a RTP. I’m on Wiley’s front rubber bindings which i really like. I might get a Wileys rear boot and see how that feels over my RTP.

But someone on here on BOS site ( I chatted with over the phone) said release bindings can good but also sometimes a headache and need maintenance. There advice over the phone to me was just let go of the slalom handle prior to hard crash, don’t need to go all out. Lol. I’m not hard core. I do want to improve in the course and just my ski technique. I’m mainly open water. But sometimes hit the course if its set up on lake. I’m a 30 mph 15’ off. I would love to hit 22’ off, and be able get to 28’ off.

 

Hope this helps. Good luck.

Moski

[ral]

@Ajskier , good choice on asking an athletes’ doctor that understands competitive skiing.

[The_MS]

@Ajskier I would fix it. I was your age and went for the cadaver replacement and it was great. Had surgery Jan 21 and skied Nationals in aug. Need to be real careful for 8 months but doing everything normal 4 weeks.

At 57 I blew my other ACL but only cleaned up my meniscus. I don’t even know my ACL is gone but I don’t snow ski any more.

[ral]

@The_MS , how did you blew your other ACL?

[Deanoski]

Cadaver get it fixed

[The_MS]

@ral I left the judges tower to go replace a buoy and slipped on the clay on the way into the lake

[ral]

Thanks @The_MS . As you mentioned you do not snow ski anymore, was wondering if it was waterski (slalom) related. I have seen/heard my share of ACL blown out jumping, and the occasional trick one because of late-release, but no slalom-related ones.

 

Anyone blown their ACL while slaloming?

[Zman]

@ral Yes. Running late, hit a turn buoy that was sitting too high. My bad, it was only practice, should have let go. More importantly, when skiing a new course, check the turn buoys.

When the ski hit the buoy, it felt like I hit a curb.

I think the knee hyperextended, pop.

Thankfully, all good now.