Parting company with my ACL

Arapahoe Basin

Day 4 of 10 glorious days skiing in Colorado, and my ACL and I parted company in my favourite ski resort A Basin!

I fell, careered down the mountain a bit, came to a stop, and took a minute. I remember feeling a bit shaky, but in no great pain, I went to do my first turn and ‘POP’. Not a little ‘pop’, but a very loud, very disconcerting ‘POP’, followed by a collapsed left leg. I should have probably have left it there, but foolishly tried another couple of turns, before realising my leg didn’t work.

Later that day with the assistance of ski patrol, and Summit County Hospital I was advised I had a subchondral fracture of my tibia, and that I’d probably done some damage to my ligaments, but my leg was too swollen to conduct an MRI scan. A week later an Orthopaedic Consultant back home in Wales, confirmed I had torn my ACL and done a fair bit of damage to my MCL. I was advised to start physio straight away, and talked through the surgical and non-surgical options.

Researching my options

It’s strange how you go from vaguely knowing what an orthopaedic consultant does, to feeling like you’ve done a post doc on ligament reconstruction. I didn’t like the thought of a traditional reconstruction from the get-go - 6 months plus to get to pre injury activity levels was bad enough, but I couldn’t connect with cutting a perfectly healthy ligament to reconstruct another ligament. The research I conducted was a minefield, -could I cope without an ACL or did I need reconstruction? I’d just about convinced myself to become a ‘coper’, when a thread on a ski blog introduced a third option - an internal brace. Square eyed from all the research and online stalking of consultants using the technique, I called Professor Wilson’s office on Monday morning, I met with him the following Tuesday, and the following week I had the surgery.

I didn’t have any expectations. I’m a fairly healthy, active working mother with a busy family. I rarely go to the doctors, and hadn’t been in hospital. I went on a ski holiday with friends and family, and was looking forward to hitting 50 in good health with all of the celebrations that go with that. The injury attempted to put a stop to that. I don’t know what traditional reconstruction or living without an ACL is like. I researched those options, and recognised that whilst they work for thousands of people, I didn’t think they would work for me. The Prof’s repair of my ACL has enabled me to get back to the things I love, safely, with the least impact on work and family life. That’s important to me, life really is too short.

ACL repair X-ray

X-rays from the front and the side, showing the fixation devices for the ACL repair

Rehabilitation

I walked out of hospital the day after surgery with what felt like a Columbian cartels drug stash. After a few days I was only taking ibuprofen and paracetamol, and I drove back to see the Prof for my check-up two weeks later. I was walking without a crutch after about a week, and have seen my local Physio weekly since the op. In the first few weeks post op, I ironically watched the winter Olympics - as I did my physio - hooking myself up to a Game Ready icing machine between rehab sessions. Now at 10 weeks I have started running on an Alter G, I can easily walk the coastal path for a few hours, and some of the less taxing hills in the Brecons. I try to spend about an hour on rehab a day, either in the gym, pilates or just being out with the dog. I’m not running cross country yet, that will be the next hurdle, as I continue to get my fitness back for an ascent of Cotopaxi in Ecuador this July.

The Prof has been open, honest and offered advice both pre and post operatively. I was able to access loads of information from him on the procedure, and the work other surgeons have done, which was invaluable for the work I’ve done with my Physio. I couldn’t ask for any more. 

My own advice

There are so many people who have issues with their ACL, consequently there is a lot of advice and opinion on what should be done. My advice would be:

  • do your research, no one knows you better than yourself. I must have bored family and friends senseless with the latest article I read, but they now seem proud of how well my rehab is going, and keep asking me to speak to others with similar injuries. 
  • There seem to be three routes, cope, reconstruct and for some repair. Being sure about your decision, understanding the procedure, and the work required post op if that is the route you go down is important. 
  • Don’t under estimate the rehab phase. I’ve met quite a few patients now who gained weight through the reduction in activity. Building muscles up and regaining the range of motion takes time, which can be particularly difficult to fit in, when your able to return to work early. 
  • Take advice and help from wherever it’s offered, the ‘game ready’ in the early stages and now the Alter G have really helped in keeping my motivation going.

Post op issue 

I was with Jess my Physio today, who thought it best to let the Prof know I’ve had a small amount of seepage from one of my wounds. I attach a photo.  Currently treating with iodine, it doesn’t look infected, and isn’t giving me any problems, albeit hasn’t healed after 8+ weeks, when the others are hardly noticeable.  Everyone seems to be referring to a stitch possibly not dissolving, but there is nothing visible [this turned out to be a minor stitch abscess which settled with antibiotics].

portal infection
Adrian Wilson

Adrian Wilson

Ceri had an ACL repair with internal brace in early 2018 and her physiotherapist has been blown away by her recovery.

She is a keen skier to say the least. Hers is a great story. She walked into my clinic at 3 weeks, having driven up from Wales!.


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