From: yamauchi@zulu.mti.sgi.com (Alan Yamauchi)
Newsgroups: rec.skiing
Subject: Re: ACL Tear, need advice.
Date: 27 Jan 1993 17:59:16 GMT
Organization: Mips Technologies Inc.
Distribution: world
Reply-To: yamauchi@mips.com
NNTP-Posting-Host: zulu.mti.sgi.com
Keywords: Update on procedures

In article <C1IusA.7v2@rahul.net>, kpapai@rahul.net (Ken Papai) writes:

=> I also tore my ACL and MCL 7 yrs ago, on the first time I ever went skiing.
=> What a friggin' lousy way to begin.  Anyway, 3 days later had my knee scoped
=> and put in a cast from hip to toe, and bent 10% at the knee for 9 weeks.

I had to follow up to Ken's post, just so people don't get the wrong idea
that they're going to be stuck in a full hip to toe cast for nine weeks.
If your orthopedist recommends this to you for an ACL repair, quickly find 
another orthopedist.  Immobilizing the knee like this allows the scar 
tissue from the procedure to build up and it severely limits the range of
motion (flexion and extension) and increases the rehabilitation time.
I know someone who had this same thing done 10 years ago and it took him
over a year to get his full range of motion back.

I completely tore my ACL two years ago and had reconstructive surgery in
Oct of 90'.  The ACL was replaced with a "cultivated"  section of the 
Patellar tendon, and I also had a meniscus repair done at the same time.

Immediately after surgery my leg was put into a CPM (Constant Passive Motion) 
machine which, at a fairly  low frequency, allowed my leg to flex from 
~5 to 90 degrees of range.  This did several things, it kept the the knee 
from becoming stiff due to swelling and kept fluid build up to a minimum.  
The machine also helps in preventing scar tissue build up which could limit 
range of motion.  

I was non weight bearing on the repaired leg for 4 weeks, but only becuase
I had the meniscus repair done.  Others who hadn't had the meniscus repair
were non weight bearing for a week at most and progressive partial weight 
bearing there after.  Therapy started the day after surgery, which 
basically consisted of passive range of motion for the first few weeks until 
strength started coming back.  By the end of the third day my range of motion
was 2-120 degrees primarily due to the CPM, which I was in about 8 hrs a
day on and off.

Now the reason I say that the hip to toe cast for 9 weeks is an out of date
procedure is that most sports orthopedists, at least in the bay area, believe
that regaining range of motion as soon as possible is not destructive to the 
surgical procedure and in fact, enhances vascularization of the replaced 
ligament.  This is according to my doctor who, by coincidence, is the same 
doctor (SF 49er Orthopedist) as the other poster from this company has 
seen.  My therapist also mentioned that she or the clinic that she works at 
had not seen full leg casts for at least 5 years (That was two years ago). 

Anyway after fairly aggressive therapy for 4 months, I was back on skis that
same ski season(March '91).  I now ski with a Townsend ACL brace, under my 
ski pants, and it doesn't impede my skiing at all.  I'm back to bumps and 
whatever I skiied before the ACL incident.  A regular weight training program
is now routine to maintain and increase leg stregth and thus stability 
around the joint. Much like Ken mentioned, my knee is doing just fine, but I  
haven't had to give up any activities, that I previously participated in, 
ie: Volleyball, Tennis, running, biking and others.  

Good luck to the original poster of this thread!!

-- 
      Alan Yamauchi
UUCP: 	{ames,prls,pyramid,decwrl}!sgi!mti!yamauchi  or  yamauchi@mti.sgi.com
DDD:  	415/390-4488
USPS: 	MIPS Technologies Inc. a subsidiary of Silicon Graphics Inc.
        2011 N. Shoreline Blv, m/s 10L-175, Mtn. View, CA.  94043

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