I injured my cruciate ligament in May 2007 playing soccer on an astro-turf pitch while chasing after a ball and stopping suddenly. I’ve not played hurling competitively since October 2006, apart from 1hr and 30 mins at intermediate level in 2008.
The problem with an Anterior Cruciate Ligament (ACL) injury is that the knee becomes unstable. So despite my best efforts to become fit and build the strength of my quad and hamstring muscles around the joint, alas the knee just buckles under a sudden change of direction. The “buckling” of the knee is painful but even worse leaves a deep psychological scar and even watching other people jump and land on one leg now makes me queasy at the thoughts of ever doing it myself.
Fortunately the success rate is now up to 90% for ACL reconstruction, that is 90% of knees repaired are “clinically stable” after the operation. Now we all know there are lots of people with recurrence, however a lot of these cases are due to rushing back into competitive action and not giving the injury a proper chance to heal. I’m going to take a full 9 months away from the hurling/soccer fields.
The big question with an ACL operation is which way to do it, after all there are 3 entirely different methods:
- Patellar Graft: A strip of tendon with 2 chips of bone at either end is taken from the knee-cap/shin and grafted into the knee as a straight replacement for the ACL.
- Hamstring Graft: More complex procedure where a section of the hamstring is removed and joined into the knee by drilling holes through the bone. Modern techniques make a plat of the muscle to increase strength.
- Donor Graft: An intact ACL is taken from a cadaver (corpse) and grafted into place. Apparently the techniques have imrpoved greatly and its a very simple operation technically. Weird too though!
The operations above all work, but there are pros and cons to each. There seemed to be no definitive concensus on which is the method of choice, with the highest success rate and least problems.
I sought professional guidance on the matter and to my delight today I received a crystal clear response from a highly regarded physiotherapist:
Most surgeons seem to be performing the hams graft these days. The failure force of the patellar tendon is technically higher than that of the hamstring graft but the hamstring graft is associated with much less post operative soreness and complications, and quicker recovery of quads strength.
So there you have it, the hamstring is the best bet in 2009 for a successful ACL operation and recovery.
I’m in for my op on June 11th so looking forward to it now.
2010 Update: I have been tracking my post-op recovery here: Me and My Knee
August 15th, 2009 at 2:06 am
Would love to hear the outcome. Have a 16 year old son who is booked in for surgery on the 18/9/09. Would be good to see how you went with re-hab etc.
August 30th, 2009 at 9:31 pm
Hi Kay,
here’s my story so far
March 22nd, 2010 at 9:37 pm
i had the patella graft ACL reconstruction in 2007 – and 3 yrs later i have just had the hamstring graft ACL reconstruction (after only my third game of football fter 3 yrs recovering). The patella one was never right – in hindsight i don’t think the surgeon was an expert but besides that the healing process takes a lot longer and weakening another part of the knee can’t be the best idea. i’m two weeks after the hamstring graft ACL and feel a million times better than the last op, but theres a long long road ahead….
March 22nd, 2010 at 9:41 pm
That’s a tough break to get injured again so quickly… I am still quite nervous about getting into contact sport again.
April 6th, 2010 at 3:22 am
In February 2002, I blew out my ACL and had the hamstring reconstruction. It honestly took me about 3 years before I was mentally healthy enough to do things like go skiing. Knowing it was all in my head, it just took me a long time to be willing to do much. I do have to say that when my ACL went out, I also tore my meniscus and it folded in half, so it was more than just the ACL. However, last November, I was playing with kids on a trampoline and I “tweeked” my knee again. After an MRI and two months or rehab, I just don’t have any stability. The doctor told me that I stretched out my new ACL. Apparently, this is becoming more common with the hamstring graft. So, now, I am 9 days away from the patella graft. The doctor I am going to is one of the best in the USA, but I am growing more nervous as the days get closer. I remember what it was like to rehab, and I know that this is going to be more painful and much worse. I am really hoping that this fixes the issues and I can be better the future. As I approach my mid 30′s I know my time is becoming limited on my ability to do things if this doesn’t work. I really hope this works, but reading your post(s) it doesn’t help with my worries….
April 6th, 2010 at 8:18 am
Hi Kevin, I did some damage also at the time to my meniscus and cartilage and that’s the biggest worry. If you’re going to one of the top surgeons in the US then obviously you’re getting the very best treatment available for this injury.
I just wonder though should you be looking at lifestyle changes to stop it happening again, sudden reflex movements like jumping on a trampoline, or skiing are sure to be high risk compared to just cycling, running, swimming or rowing.
Good luck with the operation, and more importantly the recovery!
April 12th, 2010 at 9:00 pm
my 13 yr. old son is due to have sugery in the 3 weeks , had such a hard time getting anyone to see him let alone operate because he is so young, bad soccer tackel, he is devastated but it doesn’t help reading paul MC GRATHS auto. he’s not eating or sleeping because football is his life , any thoughts when he’ll play again. thanks
April 13th, 2010 at 8:07 am
Hi Michelle, you could have a look at my other post about post-op too if that’s any help.
Me and My Knee
It is unusual for such a young boy to have that injury, but my advice would be for him to take up a different sport for the next year or so that has no contact or sudden directional movements. If he takes enough time he should be ok but if he rushes back into soccer he could be finished playing by 16 because recurrence is very likely in the first 12 months. My main objective is to avoid recurrence, but I was 26 when I got hurt so I at least had some kind of sports career before hand unlike your son.
December 24th, 2010 at 1:19 am
i had the patella graft ACL reconstruction in 2007 – and 3
yrs later i have just had the hamstring graft ACL reconstruction
(after only my third game of football fter 3 yrs recovering). The
patella one was never right – in hindsight i don’t think the
surgeon was an expert but besides that the healing process takes a
lot longer and weakening another part of the knee can’t be the best
idea. i’m two weeks after the hamstring graft ACL and feel a
million times better than the last op, but theres a long long road
ahead….
February 22nd, 2011 at 9:49 am
Hi all,
I had a patella graft surgery on 10/31/2000 on my right knee. I tore the ACL and meniscus stopping quickly, playing hockey, and hyper-extending it. The surgery was a complete success and I was able to get back to playing full contact hockey at 5 months. Unfortunately, 10 years later, I blew out my other knee playing softball. Since I didn’t have insurance, I had to wait to get it fixed until 2/7/2011. My biggest decision was which graft to get. I was leaning towards patella again, but my buddy is a physical therapist and kept telling me to go with the hamstring. I took his advice and went with the hamstring. 2 weeks since surgery and I’m happy with my choice. Swelling is almost gone, I’m not taking any pain pills and I have 135 degrees bend in my knee. I was given the green light for walking on the treadmill and light non-impact lifting. So, I’ve had both surgery grafts and can honestly say that I’m extremely happy with both. I hope this helps someone out there.
Mike Zapatka in CT
email me at zapatka@hotmail if you have any questions or need a doctor referral
February 22nd, 2011 at 10:44 am
Thanks for your story Mike, I should really update my post now. I’m almost 2 years post-op now and knee is fine. This year I hope to make it back playing at a high level in contact sport and I’m quite confident in the knee at this stage.
May 2nd, 2011 at 9:28 am
Macdara,
I am now 3 months post op from ACL reconstruction using my hamstring as my new ACL. I am happy to report that swelling is non-existent, I have no pain and have full flexibility. I was cleared for leg presses and body weight squats after 1 month and have now been cleared for straight running, which I am on treadmill for 20 – 30 minutes at a max speed of 10 mph (only for 2 min). I feel great and hope someone can benefit from my experiences of having 2 blown out ACL’s. My e-mail address is above, so if anyone is feeling down about hurting themselves or just need some advice, I’m always here to help cause I know what it’s like……twice !!!
Mike Zapatka
October 13th, 2011 at 7:34 pm
My son (class of 2012) tore his right ACL during a varsity soccer game 3 weeks ago. His season was forced to end early (sad)! We have scheduled his surgery in two weeks (after his MCL sprain healed). After reading many posts from different websites, we decided to switch his ACL reconstruction from patella to hamstring. My son is doing fine but sometimes he is a bit down watching his team play. He has committed to a college soccer team earlier in spring which means he is going to play soccer for another 4 years if everything turns out fine after the surgery/rehab. Thank you all for providing your honest feedback to benefit others who also need ACL surgery. My son is now in good hands of an experienced doctor and a very professional PT who inspired and motivated him working hard on the rehab. I am confident that he will be back on the field next year! Wish all of you the best.
December 31st, 2011 at 5:09 pm
Had my first ACL reconstruction on the left knee (Hamstring graft). I was on crutches for 2 weeks and i took a few painkillers the first few days. No swelling at all. Did intense physiotherapy for 2 months and then just stayed away from sports for 9 months. I was pretty happy with my recovery and for 3 years i did practically everything. 3 months ago i played basketball and i shot in the air and when i landed i felt my knee collapsed inwards and it sounded horrible as well. I had tore my ACL on the left knee for the second time. I did the operation again (Knee cap graft) and it is very different for the first time. Lots of swelling and my quad is looking terrible. I have the feeling that its going to take much more work to build it up. My hamstring seems ok. My calf seems quite week as well. I definitely recommend the Hamstring graft reconstruction for anyone who is doing the operation the 1st time.
January 1st, 2012 at 11:34 pm
Thanks for sharing your story, sorry to hear about your relapse.
Maybe post back in a few months with more info on the patella op if you have time.