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Old 10-10-2012, 06:53 AM   #1
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Fraps86 HB User
ACL protruding screw pain.

Hi, I ruptured my ACL 18 months and had an Hamstring Tendon Graft Reconstruction of the ACL exactly a year ago.

I am still really struggling with this injury and to be honest feel a little let down my the NHS. (This is another story)

Anyway, I still get alot of pain from the area where the hamstring was harvested and where the lower screw is. Recently (after suspecting for a while) had it confirmed that the screw is protruding and this seems to be one of the main sources of pain. (Although not the only)

In recent months the pain seems to be getting worse and really affecting my motivation to work out.

I have read a bit about people getting the screw removed and that it is apparantly a relatively minor surgery, but when I suggested this to the doctor he said it's almost unheard of and he wouldn't even entertain the idea until 2 years post op, because of the risk of the "graft falling to pieces". (In his words)

Its difficult to find information on the net, but from what I've read alot of people have it actually done after about a year?

I was just wondering if anyone had been through a similar experience. Either had it removed and the graft failed or didn't have it removed and the pain went or just generally any advice.

He has sent me back to my pt for some more work, but quite frankly I'm not sure how this will help as it feels like this foregin object is causing the pain.

 
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Old 10-20-2012, 10:56 PM   #2
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msemily86 HB User
Re: ACL protruding screw pain.

I am going through something like this now. I just had my fourth knee surgery and I have had metal screws in since my first one and with my last one my doctor used plastic screws. But I feel like the metal ones are starting to cause pain. My doctor said that they shouldn't give you any pain but he is taking it into consideration that I have metal ones and plastic ones. My last surgery in March of this year and the dr added a ligament and i had an aci. I hope things get better for you and my 2 cnd surgery was to have bigger screws put in because the original ones were bending and too small.

Back story:
dislocated my knee cap about 12 yrs ago went to doctor #1- nothing wrong and just took x rays. Played sports until senior yr of high school, about 4 yrs after initial injury. Went to doctor #2 took an mri, told I need surgery to fix it and he moved the bone over and put two screws in. I think it is called a release. 3 years later, still in pain, doc told me nothing he could do unless it was more surgery. Doc #3 just shot me up with cortisone and that was it, unless more surgery. doc #4,took his time and had a new MRI done(no other dr did that) and did an arthroscopic surgery to look into my knee to fix it and then told me what i needed done. to finally fix it! Hopefully!

Hope things get better for you and the doctor listens to you!

 
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Old 10-20-2012, 10:57 PM   #3
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Join Date: Oct 2012
Location: Philadelphia,Pa
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msemily86 HB User
Re: ACL protruding screw pain.

I am going through something like this now. I just had my fourth knee surgery and I have had metal screws in since my first one and with my last one my doctor used plastic screws. But I feel like the metal ones are starting to cause pain. My doctor said that they shouldn't give you any pain but he is taking it into consideration that I have metal ones and plastic ones. My last surgery in March of this year and the dr added a ligament and i had an aci. I hope things get better for you and my 2 cnd surgery was to have bigger screws put in because the original ones were bending and too small.

Back story:
dislocated my knee cap about 12 yrs ago went to doctor #1- nothing wrong and just took x rays. Played sports until senior yr of high school, about 4 yrs after initial injury. Went to doctor #2 took an mri, told I need surgery to fix it and he moved the bone over and put two screws in. I think it is called a release. 3 years later, still in pain, doc told me nothing he could do unless it was more surgery. Doc #3 just shot me up with cortisone and that was it, unless more surgery. doc #4,took his time and had a new MRI done(no other dr did that) and did an arthroscopic surgery to look into my knee to fix it and then told me what i needed done. to finally fix it! Hopefully!

Hope things get better for you and the doctor listens to you!

 
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Old 09-30-2013, 01:20 PM   #4
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Join Date: Sep 2013
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cbonk34 HB User
Smile Re: ACL protruding screw pain.

Hi! I sure hope that you've gotten some answers and relief since your initial posting, but I thought I would let you know my experience, since it seems to really relate.

Tore my ACL and MCL with significant bone bruising at 24 years old, seven years ago while playing Thanksgiving football with my brothers and husband. (And they thought I was just being a weenie, might I add). After MCL healed down (6-8 weeks) had allograft (doner) ACL replacement surgery by arthroscopy.

About a year or so after the surgery, I was having significant pain from my lower graft site and noticed a small, pencil-eraser sized lump that, it became clear, was actually the lower of the two screws beginning to be pushed out. After xrays and MRI, my surgeon opted to remove. Easy surgery (just opened up old incision), one to two weeks recovery with using crutches to provides support and help with "bone pain" pain management. He was also wanting me to use crutches to help avoid a fall or other serious strain to the graft as it healed from the screw being removed. The removal didn't seem to be surprising or a real matter of concern to him.

I DO have quite a bit of pain from my upper screw. The last time I had xrays, it hadn't moved, and the doctor said that some people just have more pain from metal implants than others (my husband didn't have the same kind with the pins from his shattered knee cap). He said that the positioning of the upper screw would make it very difficult and painful to remove and might disturb the tendon graft since it would have to be removed from inside my knee (the "head" of the screw is pointed toward the interior my knee, instead of the outside of my femur...does that make sense?). It aches me pretty good in the fall/spring here in the Midwest, especially when the temps swing hard, and sometimes after strenuous activity.

So... to sum up: I HAVE heard the 2 year rule - bone grafts don't heal completely until 2 years. In general, I have never heard of removal of hardware to be unusual or especially dangerous to a graft. My husband had a VERY dramatic knee cap fracture - 5 pieces - and had his hardware out after a year and a half to facilitate range of motion therapy. The position of your screw(s) might have an impact on the surgeon's decision.

Good luck! After 7 years, I have mild-to-moderate pain with athletic activities, which, at 31 isn't too shabby for someone with a major knee injury!

 
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