 Poster: A snowHead
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OK- probably been discussed may times, but have just ruptured my ACL, skiing in Lech yesterday ( fab. powder at the moment BTW).
Any advice on the pros & cons of reconstructive surgery? Local doctor says best within 3 days, or otherwise have it done in 5 or 6 weeks.
Surgery in St Anton is about 5,600eu so I doubt if my insurance will pay, seeing as the stretcher, doc, MRI scan etc has cost 1,500eu so far.
Should I wait for the later surgery with the NHS back home? I guess private in the UK would be even more.
Any advice greatfully received.....
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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did this myself about 4 years ago - bad luck and hope it's not too painful
i got mine reconstructed about 4 months after the injury. i have met a couple of people who have opted not to have it done but both seemed to be thinking that this wasn't sustainable long term (maybe fatbob can update us on his current thoughts on this?)
accepted wisdom then seemed to be that you either got it done straight away or left it for a while so that the swelling could subside and you can take a bit of time to do physio and build up the muscles supporting the knee. the big thing to think about is how long it will take you to get through the NHS IMO. if you need to get an MRI scan, this can take several weeks in itself. you then need to get yourself booked in for the operation - this actually seemed likely to be easier than the scan in my experience, but by then I had got a job with medical insurance and gone private.
so i'd be pretty tempted to get the op done in Austria if you can. i would think that any hospital near St Anton will do this procedure loads but it would be worth doing a bit of research on that. the op is pretty unpleasant and the last thing you want is for it to develop complications
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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geoffers,
My heart goes out to you and hope you are recovering with not to much pain. I would go for the Austrian option. This is bread and butter work for them and you wont get any better care or service than you will there. Not sure how the NHS works but it would have to be spectacular to be better than the Austrians
Hope it heals quickly for you
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geoffers,
Bad news.
FWIW, my thinking would be; how long is this all going to take and will you get back for next season..?
I had an MRI a few years ago and I think the waiting time for that was 12 weeks then..so if it is anything like that...you are eating into your season's downtime. I would think the Op might have the same sort of waiting list...but can be corrected on this, so that could be 6 months before you even start rehab...!!!!!
Lampbus had a similar injury late mar last year, and AFAIK is not skiing this year...
I wouldn't rush into this myself....so I think I would consider ALL options in the 5 weeks period for the swelling to go down and then get as much down privately for the speed element alone...almost...
Fatbob is skiing well on his knee, but I don't know how he does it... I'd want it fixed.
Can you bring the MRI scan with you so you can talk to people and get advance opions done. They might still want their own MRI done as well.....but if they can use your one already..that will save time....wouldn't it.
One for a few Dr's on here about the best way to go...
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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I've ruptured my ACL, completely detached.
Had the arthroscopy to clean it all up, was skiing 4 weeks later  , and have done a further 3 weeks - over 4 years.
Reconstruction not yet done, consultant recommended waiting to see if it was really necessary. So far so good
It's survived the skiing and the Martial Arts that I do reasonably well. A few twinges, but nothing major.
All seems to depend on your work/leisure activities.
Whatever you choose to do, hope it goes well
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You'll need to Register first of course.
You'll need to Register first of course.
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geoffers, bad luck. sounds horrible. Can you not get immediate feedback from your insurers as to what they will pay for? I wouldn't make any expensive decisions without their explicit backing unless you have plenty of money to spend. And with possible complications it could cost you a lot more than the upfront cost of the surgery.
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| and you wont get any better care or service than you will there |
don't rely on that. My son had a smashed ankle (toboganning) treated in an Austrian hospital some years ago. The surgery was done extremely well but he said that the accommodation, food and general ambiance was positively third world. e.g. old man in bed opposite having something unpleasant done to his willy, with no curtains drawn, and all the other old men standing around commentating! Horrible food. And he is a lad who has spent a fair bit of time in the third world and thought nothing of staying in the cheapest dives in Dar es Salaam! And he speaks German. But the important aspect was fine - the local orthopod in Portsmouth said the work was excellent, though he had a subsequent operation to remove the ironmongery.
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I would think its swings & roundabouts - I ski without an ACL at the moment but am thinking of going back to my surgeon to get it sorted this year - like kermit I've had the cartilage tears sorted but not the full monty. Main reasoning is long term health related rather than ski.
I've met people who had it done straight away and others who've let it settle/built up muscle first. The reconstruction straight from the blood wagon seems to be a very US typical approach e.g. Steadman has his clinic in Vail.
As to the cost thing if the doc is recommending it as the best treatement get him to talk to your insurers direct to get them to authorise itif you want it done now.
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geoffers,
When you get home up look up Jonathan Webb at the BUPA hospital in Bristol - he specialises in knee injuries and he reconstructed my wife's ruptured ACL. He's a very nice guy even though he used to play full back for Bristol and England  I think it would cost about £4000 -£4500 to have it done privately (excluding scans and X-rays)
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Six months to get through the MRI and and into hosp. for the reconstruction. 6-9 months recovery means I missed skiing this season.
(Ok, I did slide (shhhhh) 2 days at the MSB but it was gentle stuff bimbling bout with Easiski and her beginners.)
(and I sorta regret doing it cos it does feel slightly odd since then)
(but for the last couple of days I have been doing a teeny bit of physio (sorry easiski, I have been slacking) and it feels better today)
My surgeon at Wansbeck hosp. does one a week, and thinks the merkins are so far behind the times in their approach. I was done as a day case.
I dont know how anyone skis without the ACL - several times during my 6 months wait I did normal manouvers involving twisting the knee (toes outwards) that resulted in rather a lot of pain (and nearly dropping my neice on her head).
I suspect that a good normal ski technique dosnt load up the ACL but in a fall......
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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I came back from this year's skiing/falling over jaunt (less than two weeks ago) with torn collateral and cruciate ligaments*, went to the minor injuries clinic of the local hospital two days after I got back, showed them my scan/x-ray, got examined, resulting in confirmation of injury, appointment with knee specialist 2 weeks later (standard for full mobility assessment after swelling has receded I was told) and have first physio appointment in two days.
Swelling has pretty much gone now, pain reduced to not much more than annoyance (aches, twinges, stabbing), can't do much but I'm optimistic 
*I blame the pole planting/not/understanding overconfident instructor/underconfident student combination!
(must add I'm rubbish at skiing and can't wait to go again - having visions of packing knee braces for the future )
Edit: sorry, you asked for pros & cons of surgery. I'd say wait but then I'd do anything to avoid surgery (I'm an nhs nurse, so of course I would!) but I only know two people (personally) that have had reconstructive surgery for completely torn cruciate ligaments (both footballing injuries) both waited, not because of operating waiting times I might add, but because preparation of the limb/joint improves recovery. Anyhow, both have excellent results.
But it's such a personal decision, you probably need to work out if you'd feel as though you were going through the recovery process twice (once with original injury and again following surgery) and if you could cope with that, this can only be done by examining your lifestyle/needs/wants.
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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kittya, I skied for a year (well, a few weeks in the year!) with a knee brace following a knee disaster a couple of years ago (torn acl, medial & lateral ligs, medial & collateral cartiledges) & this year it was fine without a brace - I've done lots of leg exercises in the meantime & to be honest, I'd now have to think about which is the bad knee!
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geoffers, talk to the insurers first. If they'll pay, Austria would be good as anywhere, if not better than many places, on the grounds that bust ACLs there must be one of their most common procedures. I'd have thought a hospital round St Anton would have decent other stuff - food etc - it's a fairly well off area. If not, get the number of the nearest pizza firm before you go in. Do you have friends/family with you?
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You know it makes sense.
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| Hywel wrote: |
geoffers,
When you get home up look up Jonathan Webb at the BUPA hospital in Bristol - he specialises in knee injuries and he reconstructed my wife's ruptured ACL. He's a very nice guy even though he used to play full back for Bristol and England I think it would cost about £4000 -£4500 to have it done privately (excluding scans and X-rays) |
Good advice - Jon Webb is a well known entity in this field. He and a chap named Jon Hull are connosieurs shall we say.
Geoffers - now I know why you were prickly the other day with the Tele stance post - sh*t situation and hope that you find an agreeable resolution and if you choose surgery that it goes well - you don't have to have surgery by the way - there are plenty of people that don't have an ACL and continue to live a very active life including skiing.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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Thanks for all your kind advice folks - luckily zero pain, in fact I tried to ski off after it happened....
Looks like the insurance can't / won't cover the op here, so back to the jolly old NHS, (or bite the bullet & go to Jonathan Webb)
Luckily I've got the MRI scan, so that's a step in the right direction...
TelemarkKing, sorry mate - bit of a downer out here (will remove mý rude post) - BTW it was them bl**dy fixed heel contraptions which blew my knee!!!!
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Poster: A snowHead
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Thought as much about the fixed nonsense - never heard of an ACL blow out myself on teles - you should have known better!
No hard feelings re the post - did wonder though!
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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lampbus,
Thank's for the link - v. interesting & informative - hope your recovery is continuing successfully
I'm feeling a bit of a fraud, as (1 week after the injury) I'm walking pretty freely - a couple of poor folks on the plane on Sunday on crutches were unable to put any weight on their legs. I think I may have been "lucky", as it appears to be only my ACL & some minor tears in the menisci. It wasn't a fall that did it, so maybe that was why nothing much else was damaged - it just seemed to go pop.
My GP has referred me to the serious fracture clinic under the NHS, and I'm also going for a consultation with Jonathan Webb, as he seems to be the local guru in the field.
Interesting the number of folk who manage to ski without reconstruction - I was thinking this could be an option, but I do a fair amount of back-country / ski-mountaineering, and the thought a knee problem happening in the back of beyond doesn't bear thinking about... 
I'll try to keep this post going, as I've found all the other postings a great help, and hope this will be helpful to anyone else unlucky enough to suffer the same misfortune
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Thanks for the update geoffers.
I went to my first physio appointment last Friday, by the time I'd got there I could barely walk, was in agony. The poor man, spent an hour examining, pressing/twisting/turning/bending, did some ultrasound, then declared I do nothing until I've seen the specialist.
Saw specialist today who reckons the acl probably isn't damaged (contrary to first thoughts/tellings) but the cartilage is torn. Referred for MRI scan. ?surgery, who knows?
Fantastic physio in knee clinic who advises to do as much as I can bear 'be guided by pain' and she'll organise programme with my named physio, she also told me to not even consider giving up skiing!
I feel a bit of a fraud, last week I was sat around saying things were improving greatly and it hardly twinged. Since then I've been waking in the night seriously uncomfortable and can barely walk at all.
Such is life
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You need to Login to know who's really who.
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Knees, ankles, shoulders they will all get us in the end. Remember when we were kids and played 3 sports in the week and 2 at the weekend and never felt a twinge - this is the body telling us to take it easy
I've been in the miltary for 12 years and done some pretty serious stuff with weight added over some pretty ridiculous terrain - I am surprised at the amount I have put my body through. I've had several problems but only after I reached 30 - however they have not been significant enought o stop me from doing the things I love:
2000 - Dislocated Ankle and walked into Tommy's A&E asking for a tubigrip (the emergency staff almost fell over)
2001 - Snapped all ligaments that hold my AC joint in place and collar bone sprung like a good 'un. Operation to reconstruct and replace ligaments to collar bone/AC Joint and playing rugby 6 months later
2002 - Dislocated patella whilst on an appraoch walk to do some ice climbing. Pulled lower leg back into place which repatriated the patella and walked out with some ice on it. Some swelling and 5 days later I was teleing in Austria
2005 - Was rugby tackled wearing ski boots and dislocated same knee again - some quick physio and lots of RICE (Rest, Ice, Compression, Elevation) and I was back teleing 10 days later
2006 - Racing blew my lateral meniscus, hobbled off the piste and RICE with 2 physio sessions. Racing 3 weeks later
Not advocating getting out there before you are ready but don't let the fear of recurrence after a full recovery stop you from doing the things that you love. I have abused my joints, ligaments and bones most of my life and that may come back to haunt me in a few years but I can honestly say I'd rather have fun now than harking back and wishing that I'd had fun in 20 years time.
Good luck with your rehab - a good fit and healthy body can heal in an amazing amount of time - so long as you are sensible.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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geoffers, sorry, only spotted this thread today.
The question about whether to have an ACL reconstruction or not is a bit moot. There are advocates and antis.
The older you are and the less active you are the less likely it is that you will need one. Some people can certainly ski just fine with a deficient ACL. A Personal Fitness Instructor at my gym (aged late 20s) has just run the London Marathon with an absent one.
However the advocates will say that non-repair, especially in the physically active increases the incidence and severity of arthritis in later years (and therefore the need for a later knee replacement - which virtually rules out skiing).
Personally speaking, I am 50, and if I ruptured mine at my age I would try the rehab route first, but if it wasn't working I would twist the surgeon's arm very hard to repair it. He would probably be reluctant but persuadable, especially if he were a skier.
All the best.
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You'll need to Register first of course.
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Thought it was about time for an update, so.... I eventually went for the op last Friday, at the Jonathan Webb clinic in Bristol.
In the preceding 7 weeks I'd gained pretty normal use of the knee with no pain, near full range of motion(ROM) and was walking easily & cycling reasonable distances. I was wondering why I was going in to have my knee trashed again, but it's apparently important for the rehab to be back to good strength & ROM.
Came out on Sat. morning. Cocktail of painkillers keeping the hurt under control and spent the next few days mainly lying down with leg raised & cryocuff (cold compress) to control pain & swelling, with physio exercises every few hours. Walking with crutches at first, but quickly able to discard these.
First post-op physio was on Thursday and seem to be progressing well - more exercises to do every few hours, but still icing the leg to control swelling, so a lot of dossing around at the moment. Got to be careful not to forget that it's early days and try to do too much. JW said should be OK to drive after a couple of weeks (it's my clutch leg) and probably back to work around the same time  (though I'll probably be so bored by then that I'll be glad to)
For those of you into gory movies, some edited video of the op is here (its a .wmv file so should open in Windows Media Player) about 52 secs - and no gore at all, actually. It shows JW probing the stump of the old ACL, which is completely detached at the other end, then snipping it off and hoovering up the debris. Then you see the new ACL being drawn through the tunnels drilled through the bone. Shame there was none of the actual drilling 
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geoffers, cheers for that - hamstring graft?
Very happy about these immediate motion reports. Did you do a preop weights regime to strengthen the hammie?
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fatbob,
Yep - JW favours this method. I didn't do any specific weights pre-op, but was pretty mobile and managed a reasonable amount of cycling to get strength up.
Just been reading your Knee Gimps thread - have you decided to go for it/got a date yet? Seems like there's loads of peeps with different experience and rehab routes out there. (Maybe there should be a separate ACL forum). I decided that since it was bust I'd go for treatment asap to (hopefully) get back to normal as soon as poss. - wouldn't fancy being out in the backcountry with the worry of a potentially unstable knee
Good luck if you do go for the op, and hope everyone else who's currently in rehab are coping fine
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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