Hi all this is my first post and I hope someone can give me some insight on this......
It is a bit of history but here goes…..
4 years ago while on a camping trip I injured my right knee. I am not exactly sure how I injured it but believe it was due to hyper-extending my leg. The knee was bruised and swollen, I was not able to do weight bearing and the knee would periodically just give out from under me. I have an HMO so you can imagine the nightmare of going to my primary to make an appointment then getting sent to urgent care because it was an injury less than 72 hours old. At urgent care the knee was x-rayed and I was put in a brace and sent home to wait for the referral that was being sent to orthopedics. Approximately 3 weeks later I have my Ortho appointment, by this time almost all the swelling and bruising was gone. I still was having problems with pain in my knee though. I could bear weight but I could not kneel without a lot of pain and anytime the leg was put in a position that caused the leg to “dangle” stepping up into a high truck or on a step etc I would have horrible pain in the back of my knee and the bottom part of my leg felt as though it was separating from the top portion of my leg.
At my ortho appointment I was basically told that I would not have a knee injury if I was not so “fat” and the knee would get better if I lost the weight since they saw no injury on the x-ray. I was told I should go home and lose the weight and the knee would get better I was also told I could have a partial ACL tear or meniscus injury but that losing the weight would be the answer to my problem. Giving credit where credit is due I was in fact obese. I am 5 ft 8 inches tall and I weighed almost 245 lbs. I honestly felt I was being denied health care because I was fat. I sucked it up went home and of course did not lose the weight. However over the next two years the knee slowly got better and in the last 2 years I had no incidents of the knee being unstable. In fact in the last year I got my act together and I am now 177 lbs and very fit once again as obesity was never something I suffered with all my life but just in the last 12 years while having children, being less active and always putting myself last. I still need to lose about 10 more lbs to be considered in a healthy BMI but I now run 5 miles or more at a time, I cycle 30-40 miles at a time, I hike 10+ miles while carrying a 50+ lbs pack. I get activity in at least 3 times a week and a lot of times I can get 4-5 days of activity in a week. I am so in love with my new lifestyle. With all this activity I have not once had my knee give out or give me problems.
This is where things went a little off track. Last Monday I cycled 12 miles…something I can do with very minimal effort but still burn and extra 500 calories doing it. Also that evening I attending my martial arts class. This is where the injury happened. While sparring I performed a spin-jump-front kick and all the movements felt just fine but when my food landed on the floor there was a very loud “pop” so loud that the person I was sparring heard it too. I had instant pain and the knee bent backward and I fell to the floor. At first I could bear no weight on it. I tried to continue the sparring while hopping on one foot but while letting the other foot dangle I felt the same leg-coming-apart-at-the-knee-sensation.
After class I came home did the whole RICE thing I had to do the first time. Took some anti-inflammatory and went to sleep. Next day the knee had no bruising and very little swelling other than not being able to kneel on it and it feeling a little “loose” I felt I dodged a bullet. (so not looking forward to another ortho appointment or 2 year recovery) I kept my old “bendable” knee brace on for the day just to be safe and things were looking good. However that evening even with the knee brace on as I turned to step off a very high step and as my foot landed on the ground my knee bent backward and gave out again. I fortunately had a Dr. apt the next morning and he was able to look at my knee. However, they took no x-ray but put me in a straight leg brace told me to keep it on until I get to see the orthopedic Dr. Again that is taking 3 weeks to get in and my appointment is next Monday the 18th.
First I am amazed as bad as my knee hurt at the time of the injury and the sound it made that I had very little swelling and no bruising. Second the knee seems to be healing quickly but everytime I think I am in the clear a little step or turn can find me on the floor. I am keeping the brace on now (after the 3-4 fall) until I see Ortho. Honestly though from all I have read it seems I my have torn my ACL also from all that I have read I am afraid due to my age (43) I again will not get the care I need to repair my knee. I am frustrated as I can’t help but feel that if they had taken care of the original knee injury I would not be facing it today. I felt I was discriminated against and not given proper health care due to my weight and now I fear the same thing will happen now due to my age.
Thank you for letting me share this with you and I look forward to any advice you can offer.
I, too, was also discriminated against when I injured my knee but because I was female. It was believed, many years ago, that females could not do major injuries to the knee unless they were professional athletes. At age 14, I was caught in a rock slide hiking in the Rockies and that wasn't sufficient(so they said). I tore the ACL, the medial meniscus and the medial collateral ligaments. As a result of being ignored, I have now undergone 14 knee surgeries and bi-lateral replacements(at 47). I hear you, loud and clear. And yes, you were discriminated against.
I would suspect that you may have now completed what you started back then. It sounds suspiciously like my knee and you may have torn the ACL and medial meniscus.....that makes the instability that causes you to go backward so easily. A torn ACL may have very few symptoms except for the instability but the hyperextension, I found, was worse with the meniscus tear. Have torn not only the medial but tore the lateral meniscus 3 times and then tore the medial in the other knee so I've had that problem a few times. and a torn meniscus may not have any knee joint swelling....I didn't with any of my tears.
FYI, they remove the ACL when they replace a knee yet no one worries about instability with them....why? Weird.
Anyhow, I have known people who have had the ACL repaired at your age but they may not do it due to your age too. But if there is a torn meniscus, then fixing that will help the instability tremendously. Don't jump ahead until you know what the problem is. It may not be all ACL.
Sorry you have joined the bad knee club. It is one huge club!
Jenny thanks so much for your feedback and sorry to hear all the knee injuries you have had. I do fear they will not want to "fix" my knee due to my age also...see that would be fine if I was content to have my old lifestyle but now that I have been able to work so hard and become a healthy weight again I do not want to give up my lifestyle. ( I have always enjoyed outdoor activities but now I have an even deeper appreciation for them). I do not want to give up my hiking, camping, cycling....I can give up the martial arts but I am NOT willing to give up the other. Fortunately I do not have the same Ortho Dr I had before so I hope it will be someone with compassion and understanding.
I had my ortho appointment with a Sports Med Dr. that had a wonderful beside manner. After hearing my history he examined my knee. He told me that by the movement of my knee he knew that the ACL is completely ruptured. He scheduled me for an MRI (thanks to HMO could take up to 3 weeks) but he said that I should have surgery to repair and sent me home to do PT exercises and decide what type of graft I would like.
Wow...I had no idea the amount of conflicting information out there regarding the 3 types of grafts. I would like to hear from everyone, What option did you chose and how is it working for you? Whould you chose a different one now knowing what you know. Thanks so much for the feedback.
He also said he suspects there is aditional damage in the knee but we will not know until the MRI.
Last edited by PCThiker; 04-20-2011 at 04:24 PM.
Reason: left out information
Hi....Your story is very similar to mine...I could not put any pressure on my knee for 24 hours and then i was able to slowly walk. After seeing a sports specailist..i was able to run and play soccer again with certain limits. My knee gave out on me a couple times, but i blew it off. All the doctors I saw said that it was just a sprain but the MRI came back with an ACL tear. i then went to another doctor and he agreed. We have decided to go with surgery so i can play again without limits. I don't know what graft to go with and was also wondering about the type i should go with based on my personal factors: 14 girl who plays at a high level competitive soccer. All i want is to be able to play soccer again 100% as quickly as i can. Thankyou all!!
So sorry you have joined the bad knee club at this young age.
As I stated in another thread. Which type of graft to choose seems to be one of the most difficult decisions to make besides picking your surgeon.
I have done an extreme amount of research on this in the last 3 weeks and I will tell you the pros and cons I have gleened from this research.
I AM NOT A MEDICAL PROFESSIONAL AND THIS INFORMATION IS JUST MY NON MEDICAL OPINION BASE ON MY OWN RESEARCH. ALWAYS CONSULT A MEDICAL PROFESSIONAL.
First besides the type of graft you choose in my opinion of studies and reseach I have read about will be the correct placement of the graft, the skill of your surgeon and your willingness to do your PT and having a PT that specializes in knee rehab. It seems these factors go far in the long term out come of your recovery.
Cadavar allograft: Low risk of rejection but a risk, low risk of disease, higer risk of graft fail but less pain and faster recovery (I vetoed this one fairly quickly but many have had it done)
I have read over and over that the Patellar graft seems to be the gold standard for professional athletes. It seems this graft has a slight advantage in its strength due to the fact the tendon is taken out with a piece of the bone on each end and then plugged in bone on bone this seems to give this particular graft an advantage. On the con side, many have complained about long term knee pain. Inability to ever kneel on that knee for a long time and sometimes never again, knee cap having tracking issues and feeling like it is popping out of place and knee pain while doing a climbing up motion.
Hamstring graft: This one had a reputation in the past for gaft failure because the tendon had a tendency to stretch. However with new techniques of the double and quad bundle it is 2x as strong as your original acl tendon. Many Drs are opting to do this one over the Patellar now, It has longer recovery time because it is grafted from your body and you have extra healing and recovery to do. Some have complained of longer time frame to get their hamstring muscle built back up to full strength. (This is the option Tiger Woods chose when he had his done)
I thought seriously regarding the patellar vs hamstring graft, they both seem to be so close in the running in their pros and cons and even though the patellar tendon will grow back and the hamstring does not (however you can rebuild the muscle around it to make up for it) I really do not want to take the risk of knee pain everytime I kneel or do a climbing up motion or have a risk of my knee cap not tracking properly, I have decided to go with the hamstring. Now I do a lot of pivoting, and direction change with martial arts and I do wonder if the patellar would not be better for that but I just do not want to deal with the risk of the long term knee pain.
Again this is just my opinion based on the research I have done ( and will continue to do right up to the day of surgery I am sure). Make sure you do your own research too! I hope this helps a little and I wish you the very best of luck! Come back and let us know which you decided to do and how things went.
thankyou...yes i need to decided by tommorow and i dont want the knee pain either with the patella. so i am most likely going to go with the hamstring or cadaver. I am currently going to the gym 3 times a week to build up my hamstrings so i dont lose as much muscle.