Over the course of the last month, i have done a lot of research on the net, and have found that it is more than possible to live without an ACL. I also have been researching partial knee replacement technology, as this seems a better option to a full knee replacement.
These were the questions i wanted to put to the doctor on my visit.
The usual preliminaries out of the way with the queuing, and 4h later i was sitting in front of my doctor.
I asked him first about the ACL and whether or not he felt that it was necessary at this point in my recovery.
He told me that i was correct in that a person could lead a normal enough life without an ACL at all. It would mean that the knee would be less stable and prone to collapsing if too much sideways stresses were put on it, but in normal walking and such, it would hold up ok as long as the quad muscle was strong enough to support it.
He said that the stronger the quad muscle, the more support the knee would get, as the quad runs over the front of the knee.
I asked him about wear and tear, and he said that the meniscii would slowly get worn out if there was no ACL. Unless the quad muscle was super strong, in which case it could fully replace the function of the ACL. But we're talking body builder strength here!
My next question was about the knee resurfacing technique i had researched on the net. I only found instances of the op being performed in the USA and not in South Africa, and he told me that this is because SA did not think that it was a good idea to perform this op.
He told me that it was the same as the hip resurfacing op, and that issues had come to light that the grating of the metal used in the resurfacing, against the bone, was letting trace amounts of the metal into the blood stream, and this was causing cancer, anaemia, and other problems. He said he would not recommend it.
He agreed with my thinking that it would be best to keep strengthening my leg to the point of being able to walk on it, and then to take things from there. If there was pain we would deal with it then, and decide what to do.
I would think that the ACL would still need to be done at some point, but certainly this would be a better idea once i was already walking, as it is a best case scenario of 3 months to start walking again after the op if you were walking beforehand. And i am not even walking yet, so who knows how far this would set me back again!
He told me that up until now, all the tests that have been done on me; the sonar, MRI, x-rays, nerve tests, physical exams, etc, have all been static tests, and that it would not make sense to go from these tests straight to operating.
He recommended that i start walking first, and also to try and see a biokineticist, as he said that there was a very good chance that my alignment and also muscle imbalance was a major factor in the pain i was experiencing in the outside of my knee.
I was pretty happy with the chat that we had, and left feeling a lot more focused on what needed to be done now.
So now i'm back on a physio routine to keep strengthening the leg, and to try and get walking as soon as possible.
I have tried walking with just one crutch on my left arm, and i can manage it, which is encouraging. It is a lot of a limp and not much of a walk, but it forces me to put a lot more weight through my left leg, so this is a good thing.
I am trying to do this once every other day, as even with a short half the length of the car park outside (30m) walk, my quad and knee are screaming at me.
But it will get better and stronger in time. I am dead set on walking before the end of the year.
In October it will be 2 years since the accident and that is WAY too long to be off my legs!
So, here's to physio physio and more physio.....sound like a stuck record!! ;)
