<p>There was a thread on this a few years ago but seemed to have a lot of info about younger, more athletic people getting the surgery. I’m hoping to get updated opinions, so I thought I’d start a new thread.</p>
<p>Here is the situation - my sis injured her knees in an accident. Her doc said the acl ligament would not heal on its own in someone her age and she should have it replaced with donor ligament. She is very active, her job keeps her moving and is up and down stairs a lot, she has a cottage with a 25 ft. cliff to negotiate to get to the water via ladder - she does not do any sports at all. She would like to be able to resume all of her normal activities eventually and wants help deciding what to do. </p>
<p>Any opinions on doing the surgery or not? Or, for that matter, any advice tips or experiences with this?</p>
<p>I would do the surgery. Her knee will always be unstable without the repair and it will prevent her from doing things or worse, give out on her while she is climbing that cliff. It’s an involved rehab process but most people with donor ligaments actually end up with a stronger joint when all is said and done.</p>
<p>For anything and everything your sister could want to know about the surgery and rehab, reach out to scualum on this message board. Our family would not have been prepared for DS’s ACL surgery two years ago without his sage coaching. It’s not an experience to take lightly.</p>
<p>Thanks all - looks like a consensus for doing it! I will pass this on to her. Also any opinions between using her own ligaments vs donor tissue?</p>
<p>Thanks for the book tip and sorry about your situation ek4 :(</p>
<p>That’s typically a surgeon choice. They do many of these surgeries a year and they are going to be more comfortable with one particular graft whether it be patellar tendon, hamstring tendon or allograft (cadavar).</p>
<p>I had a partial tear of my ACL in my 30s, with lousy insurance I decided not to do the surgery, I did not want to spend the money. The fact that the tear was only partial was critical in allowing me that choice. No more downhill skiing, but cross country is fine; no more soccer scrimmage, but anything that does not involve serious lateral movement is fine. I walk, hike, and run with no issues.</p>
<p>If it is a 100% tear that is different and if she has the insurance coverage, that too changes things. I did not have $10,000-$15,000 available at the time and it has rarely been an issue.</p>
<p>Do the surgery - no doubt about it… As for the graft type - as Hops Scout says that is a surgeon’s choice. My son’s doctor used an Allograft but the quality of the surgeon and the rehab facility is way more important than the type of graft.</p>
<p>Not doing the surgery means risking even greater injury if the knee joint slips under pressure. </p>
<p>Happy to provide more info via PM.</p>
<p>p.s. thanks for the kind words Worry Wart - happy to help.</p>
<p>Medical opinion is mixed. Recommendations depend on current stability of the knee, presence or absence of a meniscal tear, and expected activities.</p>
<p>Thanks for all the responses. Scualum if you don’t mind I’m going to formulate some questions with her and pm you - thanks for the offer and the tip worrywart. </p>
<p>Because her injury was caused by a distracted driver all her expenses will run through no-fault insurance and this is proving difficult to always get to the ‘best’ doctors. She is finding many don’t want to deal with this. Unfortunately her own insurance is not great as she is self-employed. She has been having trouble feeling she is getting good advice. She is understandably exhausted just trying to navigate her daily activities and dealing with a seemingly unsympathetic medical system so I volunteered to information gather - so where else to start but cc? </p>
<p>Thank you so much for the links my$0.02 - even though this is the type of info that makes this all so confusing.</p>
<p>somemom if you had good insurance or a way to cover the cost would you have done the surgery? From everything I read recovery is the same, it is just quality of life in the future that is the issue. It sounds like you do not think this has been a problem.</p>
<p>Actually, your surgeon will have a recommendation but the decision re: type of graft will be your sister’s. DH and I both had the surgery 8-10-ish years ago. Not all doctors were doing allografts back then but because of our age, we both really wanted that. DH is extremely active/athletic; me not so much. The surgeries both had very positive outcomes.</p>
<p>My youngest has had two ACL surgeries within the last three years, both autografts (one hamstring, one patellar tendon). He is young and athletic and the surgeon strongly recommended using his own tissue.</p>
<p>I agree that too much reading can be scary but I would ABSOLUTELY recommend having the surgery and having an allograft at her age. It’ll be just fine for what she needs. The rehab is not fun, but the post-op pain is NOTHING compared to harvesting your own tissue.</p>
<p>I have a different take on this. I tore my ACL 4 years ago skiing, and decided not to do the surgery. At least so far–you can choose to do it any time. It’s not that I’m against it, it’s just not necessary for me right now.</p>
<p>I do just fine running, biking, etc, (straight ahead stuff) and I wear a brace for skiing (the only side to side stuff I do). But I had a friend who had hers redone because her knee wasn’t stable in daily activities. And another friend who waited a couple of years until he had other knee problems, then did it all at once.</p>
<p>So this can be a wait and see thing…you can’t do it immediately anyway, you have to wait until the knee isn’t traumatized anymore.</p>
<p>If she is not sporty, she may not have strong enough surrounding muscles to stabilize the knee.</p>
<p>^^I agree that it depends on how stable the knee is, how much can be mitigated with PT, and what kind of activity the individual does. I also think it’s important to get an orthopedic surgeon to work with who works on alot of knees (as opposed to one that does alot of hips, or shoulders, or hands, etc.).</p>
<p>My husband and many of my friends have torn their ACLs. The consensus is, Definitely Have the Surgery. And work very, very hard before and after to strengthen the quadriceps muscles (ride a stationary bike, etc.).</p>
<p>It would have been a tougher choice if the money were not involved; however, I think I would not have done it right away. I would have waited to see how I did with it. I was still able to play volleyball by wearing a knee brace (the kind with metal hinges so the knee cannot move laterally.) </p>
<p>In the first few years I noticed the knee injury now and again in terms of choosing what I could and could not do. But really I have not thought about it for years unless I am doing something like jumping across a ditch and I need to think, which knee should I not land on.</p>
<p>For me, the cost of surgery plus PT, the time to be spent in PT when I had young kids, and even more the general risks of surgery mean I would probably not have done it. I do extremely poorly with anesthesia and that means I would always choose to avoid it.</p>
<p>I am not sure, if I did not have to worry about the anesthesia nor the money, then maybe I would have done it right away because that seems logical. But really, I have played volleyball, I run, I power walk, I have done races, I have cross country skied, snowshoed, etc. For me it has not really affected my lifestyle dramatically. No more gymnastics, but that was likely not a wise choice at thirtysomething anyway, since that is how I tore it ;)</p>
<p>Again, I have to reiterate, mine was a partial tear, I think a complete tear would automatically indicate surgery.</p>
<p>Thanks all - the differing points of view are helpful. Sis has read the links and is in the process of sorting out the information. </p>
<p>One of the issues she is facing is both knees were damaged. One knee is not able to straighten or bear any weight so she has been on crutches just to get around. That knee, it seems to me, might have to have the surgery just so she can begin to walk normally. The other knee perhaps should go the somemom route - I guess there comes an age where we have to just ‘think’ our cartwheels :)</p>
<p>As she said she would love to avoid the surgery altogether but more important is to be able to do her favorite moves - like climbing down ladders, up stairs, and walking without crutches!</p>
<p>If she is having one knee done, is it possible to do both at once? Like when they do double knee replacements? Or is the PT different enough that you need one good knee. If I knew one of my knees had to be done, I would do both, since you have all the time & energy commitment anyway.</p>
<p>that’s a good question somemom - I was wondering that myself. I think she is still figuring out the basics and hasn’t gotten to that point. It seems more convenient but at the same time I wonder how she would get around at all with both knees completely out of commission. </p>
<p>I know she has tears in the meniscus which have to be repaired in any case. </p>
<p>I tore ligaments in both knees 30 years ago and surgery wasn’t really an option so I just did the slow heal thing - of course I was younger but it was a long, slow, painful process, I don’t know if that the slow heal process would be easier than surgery for her.</p>