Discussion
If anyone has gone through this, and in particular if there are any docs here, I’d appreciate an opinion on the chances of full recovery. This relates to my wife, who is 52.
She is terrified of not waking up from a general, but I assume one would be required for this kind of repair.
Thanks
She is terrified of not waking up from a general, but I assume one would be required for this kind of repair.
Thanks
I will not comment on the aspects of repairing an ACL as I’m an anaesthetist.
I have a regular orthopaedic list. We frequently have patients requiring ACL repair. Your wife is at a very low risk assuming she is otherwise well. She may prefer an epidural (spinal) anaesthetic instead of a GA.
The hardest part of any operation is the recovery, recuperation and rehabilitation afterwards
I have a regular orthopaedic list. We frequently have patients requiring ACL repair. Your wife is at a very low risk assuming she is otherwise well. She may prefer an epidural (spinal) anaesthetic instead of a GA.
The hardest part of any operation is the recovery, recuperation and rehabilitation afterwards
100% agree with that last sentence.
I had my right ACL repaired in 2000. Young athlete and bounced back to competing within 5 months.
Did my left ACL 2010, much heavier and much less an athlete than before and full recovery was 18 months or so.
Both ACL's doing absolutely fine, even heavier than I ever was but still compete and never had any issues with them. It is all about the rehab. If your wife ends on a long waiting list then encourage her to be more active prior to surgery instead of doing nothing and then trying to rehab from there. This will help significantly.
I had my right ACL repaired in 2000. Young athlete and bounced back to competing within 5 months.
Did my left ACL 2010, much heavier and much less an athlete than before and full recovery was 18 months or so.
Both ACL's doing absolutely fine, even heavier than I ever was but still compete and never had any issues with them. It is all about the rehab. If your wife ends on a long waiting list then encourage her to be more active prior to surgery instead of doing nothing and then trying to rehab from there. This will help significantly.
The_Doc said:
The average age for an ACL reconstruction is 29.
I don't do many ACLs in the over 50s.
It is vital that surgical decisions are justified
Chevron, I think you're local to me, please feel free to PM me if you require advice in the NHS.
I *think* I’ve sent you a pm I don't do many ACLs in the over 50s.
It is vital that surgical decisions are justified
Chevron, I think you're local to me, please feel free to PM me if you require advice in the NHS.
Edited by The_Doc on Sunday 19th September 07:52
ChevronB19 said:
She is terrified of not waking up from a general....
She has my sympathy.The process of being anaesthetised is not unpleasant at all, so nothing to fear there.
As regards fear of not waking one way to deal with it is to look at the statistics, especially if she's otherwise healthy. An unexplained death from general anaesthesia is extremely rare and almost unheard of among healthy people. In cases where a patient does die during surgery, it’s almost always caused by something else that's wrong with them.
Waking from anaesthetic should be a gradual drift back to consciousness as if very slowly waking from relaxed sleep and without any worries/concerns. Hospitals make great efforts to ensure it is also completely pain free.
voram said:
ChevronB19 said:
She is terrified of not waking up from a general....
She has my sympathy.The process of being anaesthetised is not unpleasant at all, so nothing to fear there.
As regards fear of not waking one way to deal with it is to look at the statistics, especially if she's otherwise healthy. An unexplained death from general anaesthesia is extremely rare and almost unheard of among healthy people. In cases where a patient does die during surgery, it’s almost always caused by something else that's wrong with them.
Waking from anaesthetic should be a gradual drift back to consciousness as if very slowly waking from relaxed sleep and without any worries/concerns. Hospitals make great efforts to ensure it is also completely pain free.
Unfortunately, in my wife’s case, she has/had a close friend who didn’t wake up (as you suggest, from a different problem), hence her understandable concern.
The_Doc said:
The average age for an ACL reconstruction is 29.
I don't do many ACLs in the over 50s.
It is vital that surgical decisions are justified
Chevron, I think you're local to me, please feel free to PM me if you require advice in the NHS.
Interesting about average ages! As a side note, I've always considered myself fortunate to have had my ACL in 2000 repaired by one Nicola Maffulli. Funny, at the time he gave me a small piece of career advice and it was only 16-17 years later I actually listened to it!I don't do many ACLs in the over 50s.
It is vital that surgical decisions are justified
Chevron, I think you're local to me, please feel free to PM me if you require advice in the NHS.
Edited by The_Doc on Sunday 19th September 07:52
ChevronB19 said:
Unfortunately, in my wife’s case, she has/had a close friend who didn’t wake up (as you suggest, from a different problem), hence her understandable concern.
Understood. Hope she manages to get on top of it in view of the generally positive statistics. You don't want to spend the next 30 years on crutches.. Having required GA for metal to go in my hand, I would say it was a blissful experience to be honest.
Having damaged my acl, pcl and mcl in a MTB accident (foot was planted and everything rotated around my knee). It was the most painful, and arduous injury I have had to date, despite it not being full tears and not requiring surgery.
As others have mentioned, she needs to focus on rehabilitation over the actual procedure. I still get pains/movement 12 years on if I catch it in the wrong way.
Having damaged my acl, pcl and mcl in a MTB accident (foot was planted and everything rotated around my knee). It was the most painful, and arduous injury I have had to date, despite it not being full tears and not requiring surgery.
As others have mentioned, she needs to focus on rehabilitation over the actual procedure. I still get pains/movement 12 years on if I catch it in the wrong way.
Just a quick note - appointment with consultant today, who turned out to be at a conference, so she saw a registrar. He confirmed what is stated above that she’s out of the ‘normal’ age range for an op in usual circumstances (I did point the age comment to her after this, and got royally slapped as a result, well deserved), however he was of the opinion (subject to consultant’s comment) that it’s sufficiently serious to merit an op.
On the other hand, with the leg brace she does look a bit like 7 of 9 from the Borg (I got slapped for mentioning that as well)
On the other hand, with the leg brace she does look a bit like 7 of 9 from the Borg (I got slapped for mentioning that as well
)Edited by ChevronB19 on Thursday 23 September 22:23
Hi, The_Doc,
Sent you a pm with a few more details, but I’m having problems with pm’s, so thought I’d post a slightly redacted update here.
Consultant has changed his mind, and gone from op to physio, no op until find out how it is after 6 months. He said the physio would ‘train’ the hamstring to somehow replace what the ACL did.
This doesn’t ring right to me, but I am by no means an expert.
Having said that, on the basis of the report I posted at the top of the thread, the physio was amazed my wife walked in, and said he’d expected her to come in in a wheelchair.
For various reasons I’m not hugely keen on private medicine (no insult intended), but in a classic bit of middle class hypocrisy I’d like to understand options - any thoughts?
Sent you a pm with a few more details, but I’m having problems with pm’s, so thought I’d post a slightly redacted update here.
Consultant has changed his mind, and gone from op to physio, no op until find out how it is after 6 months. He said the physio would ‘train’ the hamstring to somehow replace what the ACL did.
This doesn’t ring right to me, but I am by no means an expert.
Having said that, on the basis of the report I posted at the top of the thread, the physio was amazed my wife walked in, and said he’d expected her to come in in a wheelchair.
For various reasons I’m not hugely keen on private medicine (no insult intended), but in a classic bit of middle class hypocrisy I’d like to understand options - any thoughts?
ChevronB19 said:
Hi, The_Doc,
Sent you a pm with a few more details, but I’m having problems with pm’s, so thought I’d post a slightly redacted update here.
Consultant has changed his mind, and gone from op to physio, no op until find out how it is after 6 months. He said the physio would ‘train’ the hamstring to somehow replace what the ACL did.
This doesn’t ring right to me, but I am by no means an expert.
Having said that, on the basis of the report I posted at the top of the thread, the physio was amazed my wife walked in, and said he’d expected her to come in in a wheelchair.
For various reasons I’m not hugely keen on private medicine (no insult intended), but in a classic bit of middle class hypocrisy I’d like to understand options - any thoughts?
Well, I’m married to a physio, and that’s exactly what I did! I was a lot younger though, and she was my girlfriend them…..Sent you a pm with a few more details, but I’m having problems with pm’s, so thought I’d post a slightly redacted update here.
Consultant has changed his mind, and gone from op to physio, no op until find out how it is after 6 months. He said the physio would ‘train’ the hamstring to somehow replace what the ACL did.
This doesn’t ring right to me, but I am by no means an expert.
Having said that, on the basis of the report I posted at the top of the thread, the physio was amazed my wife walked in, and said he’d expected her to come in in a wheelchair.
For various reasons I’m not hugely keen on private medicine (no insult intended), but in a classic bit of middle class hypocrisy I’d like to understand options - any thoughts?
I hit a rock skiing when I was 21 and snapped my ACL plus damaged something else really badly (collateral?). I happened to be skiing with a orthopaedic surgeon as well as an anaesthetist, the diagnosis of “you’ve properly f
ked that’ was delivered on the mountainside, Flew home in plaster, saw the knee bloke. The decision was not to reconstruct - his view was that unless I was a competitive althete, it would be more trouble than benefit. He had a rummage around inside the knee, tidied up the bits floating around in there, and sent me on my way. Mrs rxe, being an enthusiastic physio student gave me the exercise programme from hell. I took up cycling, got, to point where I was doing 300 miles a week, then did the Etape du Tour. These days I run to keep fit as it needs less kit.
I can honestly say I have forgotten which leg it was 30 years later. I think it was the left one, but the scars from the op have faded. Neither leg hurts, or has ever hurt outside the few months after the operation.
The thing about physio is you need to do the work. It’s your knee, not the physio’s. They’ll tell you what to do, you need to do it 10x over. Poling up to an appointment for an hour a week and only working at it then will fail.
I tore mine when I was 19, the surgeon advised wait until you snap it we will then do surgery. I didn't play rugby for around 2 seasons. Started playing again after lots of gym work, finally snapped it age 44 and then had surgery to replace. I could have been better at my rehab, don't have full range of bending but it means i can run around, knee feels good 8 years on.
Snapped an ACL in a skiing accident at age 45. knee could be pulled forward about an inch. MRI confirmed this. Knee doc cleared out the mess left by cartilage and suggested that if I wanted to ski again, reconstruction was probably not a good idea. Just spent time exercising, lots of biking and was skiing again in a few months. Felt a bit unstable at first but didn't effect me at all really. That was 5 years ago and never had a problem since can't even recall which one is missing.
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