Knee ligament advice needed!

[Crisis management]

Knowing some of you on here have had ligament repairs done (Vazza?) I need some advice about recovery time and how successfull it has been plus any other comments.
I have managed to tear my posterior cruciate ligament, the one at the back of the knee opposing the ACL, in half and I suspect the doctor is going to want to sew it back together. Given it is only a problem (now the swelling has gone down) when I'm running (tends to swell and is a bit sore) one option may be to leave it alone and just strengthen the muscles around the knee to compensate, has anyone had experience with leaving the ligament broken long term?

What I want to achieve is a workable knee for the next 40 or so years but if not repairing it is a viable alternative I want to know about any experience you may have had. Alternatively, how long is the recovery after surgery and how much effort is required to get your knee back in action.

Remember I'm not young & fit like you guys, being 54 and having a preference for beer rather than the gym will affect my outcome.

Finally the safety warnings....don't backflip your bike on whoops and wear knee braces (I do now) :facepalm:

[SpikedPunch]

has anyone had experience with leaving the ligament broken long term?

Yes, I did this injury a few years ago. The surgeon I spoke to won't do PCL reconstructions, I don't think they are very common in NZ as they aren't super successful or something. You will have to keep the muscles around it strong and you should be sweet. So lots of physio and then when he/she gets it feeling good, lots of weights. I can run on mine now and it's fine 98% of he time. It's just when I re-injure it or twist it laterally that it swells up and hurts like a bastard.

[FlangMasterJ]

My brother had one of his ligaments repaired. I'm not sure if the ligament was just a bit damaged or torn but he was back into his bodybuilding six weeks later. After a couple of years he was back to squatting and leg pressing the same amount before the surgery.

[Crisis management]

It's just when I re-injure it or twist it laterally that it swells up and hurts like a bastard.

Thanks for all that, good to know it may be manageable rather than requiring surgery, when you mention re-injury, does that occur in "normal" life, ie: a running, walking, lifting type of injury rather than a sports (riding) injury?
Do you wear a knee brace other than for riding, such as a support for running?

Ta
Iain

[D3ALN]

I tore them all cleanly when I brokme my leg above knee and below knee and shattered my knee cap. Don't let Dr Elliot in Hawkes Bay go anywhere near it. Mine still causes me grief and i did it when I was 13 Im 19 now

[Motu]

Just get it locked up - knees are overated.

[Gibbo89]

I think I may be missing something.

why would you not want the surgery? Surely you would like to go under the knife and see if they can make a good job of it?

post surgery will consist of bed rest type stuff and physio.

[Crisis management]

Just get it locked up - knees are overated.

Bastard, you're a short arse anyway so you don't need knees to touch the ground......


I think I may be missing something.

why would you not want the surgery?

I want to know what choices there are before I make them, either surgery or not are both viable choices but the outcomes may be different. Having got the joint working satisfactorily so far I'm not looking forward to having to spend another 3 months getting going again post surgery.

[SpikedPunch]

Thanks for all that, good to know it may be manageable rather than requiring surgery, when you mention re-injury, does that occur in "normal" life, ie: a running, walking, lifting type of injury rather than a sports (riding) injury?
Do you wear a knee brace other than for riding, such as a support for running?

Ta
Iain

Sports injury, like an accidental front flip :) I did a little tear on my LCL and ACL earlier this year and I was definitely out longer than I would have been had I not already lost the PCL previously. I don't wear a knee brace at the moment, just regular guards. I should really buy one. I tried to wangle a free one off of ACC but it wasn't approved. Boo.
Edit: Oh yeah, I don't wear a brace for running etc. But I work pretty hard on my weights and stuff keeping the muscles around the knee strong, so that seems to work well for preventing injury.

[honda_power]

i tore up ligaments in my foot around 6 months ago and its still swolen, supposed to have moon boot on for 2-3months, i was riding 2 weeks later. wish i did it properly, hurts like shit and swells up more if its knocked. so take the docs advice haha

[Mom]

I have no ACL snapped it cleanly several years ago chasing sheep. I went to see a top orthopod in Auckland and he advised against surgery for it. This knee has also had a medial ligament release (I damamged the cartlidge under the knee cap) and this loosened the knee cap so it did not rub against the joint so hard.

The reason he was anti surgery is that it would have taken just as long to recover from the surgery as it would to rehabilitate the knee without surgery for the same result. It took ages to come right, at times I thought it never would, but finally I began to trust it again.

It rarely gives any problems now, having said that I dont play squash or ride off road, where huge load is put on knees. Good luck with it, hurts like a bastard eh :yes:

[Crisis management]

Thanks Mom, sounds like the sort of outcome I can live with.....was a bit sore when I did it, the funniest part was trying to stand on my one good leg and kick start the bike so I could ride back to the car, took several attempts!

[Pierce]

why would you not want the surgery? Surely you would like to go under the knife and see if they can make a good job of it?

post surgery will consist of bed rest type stuff and physio.


Surgery is pretty hard on the body and isn't always the best option. I've had my ACL done twice. The first time they had to flush out all the cartilage and repair the MCL.
I had to have the surgery because the ACL had stretched so much that it flipped inside the knee joint (meaning I couldn't full straighten or full flex the knee). Also had a chunk of cartilage in the knee joint. The 2nd time my ACL had fully ruptured so I had over a year without an ACL at all (was getting worse everyday).

The recovery time really depends on the work needed and the personal beliefs of your surgeon. First one told me 9 months before being able to ride again and the 2nd told me 6 months and needing 90% muscle mass in the quads compared to your good leg.

I got the ok from my surgeon today however only had shoulder surgery 2months ago and won't be riding again till the end of the year.

[Keithf]

I hyper extended/twisted my knee badly just under a month ago and it is just coming right now.

My doctor and the specialist I saw yesterday suggested that my knee is a bit loose which might indicate that one of the cruciate ligaments might be stuffed -but that it has probably been this way for a while and strongly recommend not operating and rehab instead. I will need a reconstruction at some stage though.

When I did it I didn't dare stop as I knew I would struggle to start my bike-and it wasn't funny!


Thanks Mom, sounds like the sort of outcome I can live with.....was a bit sore when I did it, the funniest part was trying to stand on my one good leg and kick start the bike so I could ride back to the car, took several attempts!

[Woodman]

I tore my cruciant ligament, (can't remember if it was anterior? or posterior?) in a car vs bike crash when I was 17 or so, then majorly aggravated it playing rugby a few of years later. Had a season off footy with my knee clunking in and out often, then got back on the field for another 20 full seasons.

What I did was a fair bit of quadricep strengthening work to compensate. Not many full heavy squats as this tended to push the top of my leg over my knee so was a bit hard on it. Strangely the only thing that really bugs it is golf. I think it is the sideways force or something.

The bottom half of my right leg sits back about an inch compared to the left but otherwise it hasn't given much trouble

[CHOPPA]

Did my PCL along with the rest. PCL was repaired with a donor abbos ligament. It was ok for a few years but its completely gone again. Im gonna get it fixed again, think theres only 2 surgeons that do it. Build up your quads is what the docs will tell you. Its completely livable. I run everyday and my knee has a good 2cm movement back and forward.

My advice if you have it repaired is to take it easy for 6 months like the surgeon says. It will feel mint in 3 weeks but dont go riding just cause you wanna ride your new bike

[CHOPPA]

A neoprene brace works well as it doesnt take much to hold the knee joint in the right position on that particular ligament. The worst thing for me being an electrician is crawling through roofs etc as when you put weight on your shin there is no ligament to hold it so it drops back. Also in the car it can be uncomfortable without the neoprene as it sits out of place for a period of time without your realising until it starts getting sore


Oh but its a cool party trick!

Call John from Advance Physiotherapy say Sloan sent you. He will get your surgery done soooooooooooo much quicker!!

[Crisis management]

Thanks everyone for the advice, I feel as if I've got a better picture of the different experiences and options now, I will see what the surgeon says next week and let you know how I get on.

Ta
Iain

[Keithf]

any more knee brace advice?


A neoprene brace works well as it doesnt take much to hold the knee joint in the right position on that particular ligament. The worst thing for me being an electrician is crawling through roofs etc as when you put weight on your shin there is no ligament to hold it so it drops back. Also in the car it can be uncomfortable without the neoprene as it sits out of place for a period of time without your realising until it starts getting sore


Oh but its a cool party trick!

Call John from Advance Physiotherapy say Sloan sent you. He will get your surgery done soooooooooooo much quicker!!

[Shadykiwi]

reconstruction surgery on both ACL,s. Rehab was a long hard road. Took almost a good year untill you started feeling back to normal. However you wont ever get back to normal. I was young and it enabled my to play sports alot longer. At my age now 38, I wouldn't get it. I would try alot harder to simply strengthen it.

[CHOPPA]

any more knee brace advice?

For everyday or racing?

[gsxr&crf450]

when I was 45 I snapped clean off my posterior cruciate, and tore most of the anterior cruciate and pulled the medial ligament of the bone. I had a full knee reconstruction, they made new ligaments out of my hamstrings from the other leg, and drilled new holes and screwed them in to the bone. Surgeon was Mr Dwaddle from Addidas centre Auckland. Was in steel frame for 12 weeks. I was back racing motocross most weekends after 7 months. I can run on it. I get absolutely no pain at all, and I am an old basdard. That was 4 years ago. And no problems. I wear 2 cti knee braces now. It is worth a proper repair now, rather than trying to work around it. Dwaddle is the best. John

[Keithf]

everyday riding


For everyday or racing?

[CHOPPA]

everyday riding

CTI2 are prob still the best but pretty much anything you can afford will be better then nothing. Asterisk, Alpinestar, EVS etc

[vazza]

Snapped my ACL & MCL at the 2009 Kwaka 2man final round.. September last year.

Took me about 10 months to get back into racing. Only advice I can say is train your assoff before surgury.. cycle like a maniac, do whatever you can to strengthen it before surgury. The stronger it is the better.

And also, invest in some CTi Customs. ACC payed for one of my and I saved up big time for the other. If you can get ACC to pay for the first one the 2nd one will cost $1250. Not bad for a lifelong brace huh?

I will never ride without braces, you're crazy if you don't! I know they ain't cheap but yeah. What's 10 months of being a cripple worth?

[Crisis management]

CTI2 are prob still the best but pretty much anything you can afford will be better then nothing. Asterisk, Alpinestar, EVS etc

I use the EVS braces now, they seemed to be a reasonable balance between quality & affordability taking into account the type of riding I do (non-competitive).


The decision.
Been to the surgeon today and I have a completely severed posterior cruciate ligament, sprained medial ligament and a small tear on the miniscus, those MRIs are great machines eh? Seeing as the joint is stable and the torn cartiledge is not giving me any problems (no joint locking) the plan is to carry on exercising & strengthening it and only operate if the cartiledge plays up.
He was even impressed at how well my home grown physio programme was going, I'm quite chuffed, doctors usually give me a bollocking for not going to see them early enough!

So, I'm happy, I just need to get my muscles back to good shape so it's carry on with the cross training and dig out the bike.

Thanks for all the advice it's been great to get all these opinions and to have the time to weigh up the two options I had, very much appreciated!

[warewolf]

Don't know how the PCL differs from the ACL, but I lived without an ACL for 11 years. Basically was told to avoid surgery as long as possible, but to get it fixed pronto if it started to give trouble lest it damage the knee further. One reason to postpone surgery is that medical science improves with time, every few years there are major breakthroughs.

I finally had to get it fixed as the whoops at Woodhill were giving it death and it kept subluxating - not while on the bike either. Otherwise specific exercises helped keep it under control, but there were things I simply couldn't do because it'd instantly subluxate, or swell up and ache for a week. Tough subluxations would require 4-8 weeks of physio to bring it right again.

There was a 3 month wait for surgery (private) which was required to build muscle for recovery. After surgery I was off the road bike for 3 months and not allowed to ride off-road or go caving for 6 months. Surgery and recovery went very well.

[riffer]

Snapped ACL and medial completely, PCL and collateral partly, aged 22. 21 years later I'm glad I had the full rebuild even though the bolts hurt in cold weather and I have bone spurs in my kneecap now which stop me kneeling on it (and the knee's still too tight to sit on my legs properly or cross my legs reconstructed leg over normal leg).

Rebuilt knee is better than the other one. Russell Tregonning did my knee. And I agree with those who say exercise like a bastard before and after the operation. At 22 and very fit it was around 4-5 months recovery for me. Probably at least twice that now at 43...