Surprise ACL rupture - what's the future looking like?

A snowHead

Hi all, I have just had MRI results from a minor ski accident in March and it turns out that I have ruptured my ACL and also got some additional cartilage damage for added good measure! All very odd really as although immediately after the accident (somebody skied into the back of me whilst I was stationary, causing me to slowly topple over to the side whilst my knee went the other way) there was some instability, within 12 hours that had gone, there was a tiny bit of swelling but no pain, just a bit of stiffness. Saw an A&E nurse 48 hours later (at home) and he was pretty sure I hadn't done my ACL as he moved my knee and leg in various positions with no pain and i could bend it pretty much as much as my other leg. Went to see the sports physio 3 days later and he was also of the same opinion, in that I hadn't done my ACL. Fast forward 2 months and I now have the results of the scan which sadly proves them both wrong! It's very weird as I've had no pain, can run up and down the stairs as usual, walk long distances with no issue at all (in fact would not know there was any issue whatsoever with my bad knee) and do other forms of exercise with no issue at all. The only time I'm reminded of the problem is if I do something stupid like i did last week when I climbed up on a stool to get something out of a high cupboard, and stepped down bad leg first and that did hurt! My consultant does not recommend ACL reconstruction (had the other leg done 10 years ago following a ski accident and it's been great) as I'm 56 and he thinks that it could make the knee stiffer and more prone to arthritis. He seems to think I can ski perfectly well without an ACL especially due to the decent range of movement and no instability that i currently have. The thought of it terrifies me though but most of that is probably all in my head. I've read a good few threads on here but many are very old and I wondered if anyone had recently had the same issue as me and had skied with no ACL? Also need recommendations for a brace, assuming I ski next year! Would love to hear other's experiences. Thanks all.

A snowHead

if i was in your place, i would check for a second opinion...you are 56 not 76
however is this a complete rupture? or partial?

Well, the person's real but it's just a made up name, see?

You need to Login to know who's really who.

I've skied for twelve years with a snapped ACL in one leg. Had the bucket handle meniscus tear fixed but consultant advised against ACL reconstruction. I used a Donjoy brace for the first few years but I'm sure, deep down, it was just for reassurance. I spent some time building up my quads and hamstrings as per the consultant and then physio's advice. Been fine whatever I've been doing.

Anyway, snowHeads is much more fun if you do.

@bumble66, i have ruptured both ACL’s and had them reconstructed. I could still ski fine after the 2nd one so continued to ski for the remaining month of the season with a brace before getting the op. If your technique is decent and you’re not doing crazy things you can probably manage without - maybe use a brace for some extra security? I was 10 years younger than you and sometimes ski in challenging conditions so my surgeon recommended get the op. A good friend is a few ears younger than me, has blown both ACL’s and still skis hard 20 years later with a bionic style brace and no apparent problems.

You'll need to Register first of course.

@bumble66, I ruptured my acl fully in Jan 2019 (at age of 45). Sports physio (who had worked with British Alpine team members) and consultant both reckoned no need for reconstruction as no instability. I’ve had no issues skiing since, and have continued to do a lot of offpiste and touring in all qualities of snow. Also no issues mountaineering/ running which I also do a lot of. However I do take care to keep up with strength/ conditioning exercises most weeks to ensure strong muscles around the knee/ posterior chain. On the odd occasion I’ve slipped out of that routine (eg after 7 weeks laid up with covid) I noticed mild swelling around my knee after several intense days skiing. On the whole, I’m happy.

Then you can post your own questions or snow reports...

I skiied for 13 years with an undiagnosed snapped ACL. I was aware that there was some increasing cartilage damage, i.e. it was getting worse each year, and decided it was time for an intervention. I'd previously had at least one arthroscopy to clean up small areas of damage on that knee, so wasn't overly worried about it.

Anyway, they sent me off for an MRI, so a couple of days later I was back with the surgeon and he showed me the broken end of ligament. I could only recall one possible accident that could have caused it, when I fell in some powder as a skier jumped off a drag lift half way up, just in front of me. I definitely felt that something had gone 'ping' so skied cautiously back to where we were staying in Verbier, where the local doc thought it was probably just some small cartilage micro-fissures and not worth following up, so I was skiing again the next day.

So back to 13 years later, the instability had worsened a tendency for the inside nodules of the tibia and femur to compress/damage the meniscus and bash together, so there was some osteoarthritis building up there as well.

So a big surgery to replace the ACL, clean up the joint and straighten the leg by cutting a wedge in the top of the femur and splaying it out, and ten years on it's still holding together.

Unfortunately the attempted experimental treatment to help repair the end-of-bone cartilage didn't really work, so I do get some pain, and one of these days will get it looked at again. For reference, I ski 50-60 days per season, with some days teaching in the snowplough and others tearing through the crud at high speed, and only very rarely do I feel that the knee needs to be protected.

The single key advice I'd give to anyone in a similar position is fitness, fitness, fitness. The stronger your leg (and rest of body) the less likely any instability will occur, and the less likelihood of any damage if you do fall. If you can maintain that you should still be looking forward to many years of skiing.

Edit: Oh, and I guess for me it's such a normal thing I forgot it - Ski Mojo. For longer, harder days skiing and an extended life of skiing still ahead.

After all it is free

I had a torn acl, not skiing but dog walking!! I was deemed too old by the NHS for a repair at 61, and was told to modify my lifestyle. However, my knee was unstable, and gave way resulting in a fracture. I had a repair privately, and was more than satisfied, and have gone back to skiing. I did ski before diagnosis, and now feel horrified at what could have happened. My belief is that although your leg muscles can hold your knee if strong enough, as you age the strength diminishes.

I’ve torn my Acl in March while skiing in söll. Same thing I got up and skied down the mountain and went home to ice my knee. Took the next day off and went back skiing after. Only had an mri a few weeks ago didn’t think my acl was gone but unfortunately it is. I’m not having the surgery though as I’m self employed and can’t take that long off work. Going to join the gym and build up muscle in my legs I’m 30 and play a lot of sports so hopefully that stands to me. Also I was thinking of going on the snowboard next time would that be any easier on my knee? I’m going back to söll in January

Help!!

Surprise ACL rupture - what's the future looking like?

snowHeads Forum Index >>> Ski Fitness, Exercise, Injury and Rehab