Anyone else had an ACL avulsion fracture?

[aaroncmh]

Yo, just wondering if anyone else has had an ACL avulsion fracture and how the rehab was, how long it took to get back, etc.

Also wondering how it compares to an ACL reconstruction. When my knee hyper-extended instead of the ACL tearing it pulled out a chunk of bone that it was attached to. The doc is going to try to screw the bone back into place tomorrow morning at surgery.

Anyway, would like to hear how people did with the ACL avulsion (or reconstruction really).

Thanks,

Aaron

[dirtsquid]

it took me 12 weeks of rehab every day before i was back to the track, still was sore even with my brace for another 3 months

[DrMark]

I have never seen a repair of a bony ACL avulsion fracture in an adult that led to a stable knee. So whether or not the post of course is easy or hard, the result with not be any good.

An ACL reconstruction is the only answer for this problem.

[dirtsquid]

my knee is very stable after reconstruction but it took alot of dedication and desire to get back to racing

[aaroncmh]

I have never seen a repair of a bony ACL avulsion fracture in an adult that led to a stable knee. So whether or not the post of course is easy or hard, the result with not be any good.

An ACL reconstruction is the only answer for this problem.

Wow that's not good to hear. I'm suprised too because my doctor is an expert and does all the "work" for the Columbus Blue Jackets and he said this is the way to go. He was very confident and said I was actually kind of lucky to have the avulsion.

And it makes sense to me seeing as I'll have my own ACL in tact back in place (not a cadaver, hamstring ligament, etc.).

We'll see...

[DrMark]

You can schedule the reconstruction for six months or a year from now.

[dirtsquid]

you can schedule it for six months to a year but you are going to have to deal with the pain and recovery all over again

[MXATC]

I have never seen a repair of a bony ACL avulsion fracture in an adult that led to a stable knee. So whether or not the post of course is easy or hard, the result with not be any good.

An ACL reconstruction is the only answer for this problem.

Ditto. I've never seen one in my 15 year career either. You need the ACL reconstruction for sure.

[DrMark]

This doc must be brain dead or he must have not cracked a book in 25 years. But he is the doctor for the Columbia Blue Jackets. Naturally when you buy the sponsership, you get to be the team doctor, and what ever you say must have come down from On High. Here is what the American Journal of Sports Medicine's section on Medical Ethics says about the team doctor deal, taken from the May 2007 issue:

Medical advertising, including sports team affiliations, raises particularly difficult ethical questions in sports medicine. Given the tremendous popularity, prestige, and revenue associated with college and professional sports, serving as team physician at this level has marketing advantages.12 Medical advertising was considered unprofessional and illegal in the United States until about 25 years ago when these regulations were lifted. Capozzi and Rhodes5 raise important questions of whether there are ethical reasons for physicians to avoid advertising and whether there are certain moral boundaries that should not be crossed. Of particular concern in sports medicine are ethical concerns surrounding relationships between team physicians and professional sports teams that are contingent upon ongoing corporate sponsorship.2 For instance, the reported annual cost for being Major League Baseball team physicians for New York’s Yankees and Mets was $1.5 million per team.21 As many as 7 teams in the National Football League and 12 teams in the National Basketball Association have a marketing agreement with their current team physician that, on occasion, has supplanted a previous physician who was unwilling to engage in a bidding war.12 Teams in the National Football League have placed the team physician position up for bid4; however, this practice does not appear to be widely accepted.

The Committee on Ethics of the AAOS has recommended that the orthopaedic surgeon not use publicity in an untruthful, misleading, or deceptive manner.9 Medical advertising based on a professional team affiliation is not inappropriate when it does not mislead the public. However, the physician should not buy an unmerited mark of quality by purchasing an association with a team.3 When people are led to believe that the selection and title of team physician is based on merit when in fact it is based on the highest bid, they are being misled.5 The team physician has an obligation to make sure that patients are choosing the doctor based on merit rather than misguided assumptions of quality or skill. Hence, Bernstein et al3 suggest that if medical advertising regarding team affiliation leads to patient self-referral and the patient expresses this to the physician, the physician is duty-bound to confirm that the patient has chosen sensibly, and might address the issue by saying something on the order of "Yes, I am the team doctor, but that’s only glitter. You should choose me as your doctor because I have done hundreds of these surgeries—not because I hang out in the locker room." It is not recommended that physicians pay for the right to be team physicians. However, the current reality is that exclusive marketing contracts are linked directly to the choice of medical providers, especially at the professional level. Perhaps just as orthopaedic surgeons are obligated to disclose to their patients/consumers ownership in MRI or outpatient surgery centers, team physicians should disclose to both athletes and private patients any financial arrangement associated with being the team physician

[evan1]

Wow that's not good to hear. I'm suprised too because my doctor is an expert and does all the "work" for the Columbus Blue Jackets and he said this is the way to go. He was very confident and said I was actually kind of lucky to have the avulsion.

And it makes sense to me seeing as I'll have my own ACL in tact back in place (not a cadaver, hamstring ligament, etc.).

We'll see...

thats the same thing my doctor said and he said it the only way to go and that i was lucky with the bone breaking of instead of shredding the ligament

im 4 weeks after the operation now and in 2 weeks my brace will come of so i can start physio and walk!

Dr mark, do you have any ideas on what i should do from here, if that was the wrong operation to be done, and a time frame untill i can be riding again?

this doctor was saying 6 months but it will kill me waiting for that long so any tips much appreciated

PS my one was not the ACL it was the PCL but same thing with the bone instead of ligament being shredded

[DrMark]

The PCL is an is an entirely different animal from the ACL. The only things they have in common is the C and the L.

[evan1]

The PCL is an is an entirely different animal from the ACL. The only things they have in common is the C and the L.

oh ok so what should i do from the position im in now? just alot of physio or bike riding?

[DrMark]

you should do what your doctor tells you to. I would let your rehab to tolerance at this point.

[CaptainKnobby]

Iam soooooooooo glad I went to Dr.Mark!!!!!!?

[Rev Al]

I can't believe I found this forum, and this thread.

I ride street bikes, and I had a similar injury to the OP. Tibial ACL avulsion fracture. The ACL was perfectly in-tact, and was still getting plenty of blood flow from the femural side, so I had the surgery to reattach about 2 weeks ago.

In another 2 weeks, the doctor says I'll be able to start bearing weight on it. He gave me a timeframe of a good 3 months before I'll be able to ride again.

I'm just glad to hear that I'm not the only freak out there who this has happened to.

[Engine_24]

My knee works great. I have no feeling in the front of it but I have gotten used to that. My other knee still has problems occasionally, but I had a tibial plateau fracture in that one. That was some of the worst pain I have ever felt

[aaroncmh]

I can't believe I found this forum, and this thread.

I ride street bikes, and I had a similar injury to the OP. Tibial ACL avulsion fracture. The ACL was perfectly in-tact, and was still getting plenty of blood flow from the femural side, so I had the surgery to reattach about 2 weeks ago.

In another 2 weeks, the doctor says I'll be able to start bearing weight on it. He gave me a timeframe of a good 3 months before I'll be able to ride again.

I'm just glad to hear that I'm not the only freak out there who this has happened to.

You're not alone buddy. (ha, ha)

That's why I posted this thread...just to hear from other guys who may have had this injury and what was done to fix it.

I certainly didn't want my doctor or his diagnoses discredited by another doctor that knows nothing about him or my particular case.

I'm sure you'll be fine in no time (after some rehab of course).

[Rev Al]

You're not alone buddy. (ha, ha)

That's why I posted this thread...just to hear from other guys who may have had this injury and what was done to fix it.

I certainly didn't want my doctor or his diagnoses discredited by another doctor that knows nothing about him or my particular case.

I'm sure you'll be fine in no time (after some rehab of course).

Man I hope so. This has been the most depressing couple of months I've ever had. Its spring/summer, and my motorcycles are laughing at me every time I crutch my crippled ass through the garage.

[aaroncmh]

Man I hope so. This has been the most depressing couple of months I've ever had. Its spring/summer, and my motorcycles are laughing at me every time I crutch my crippled ass through the garage.

Rev Al, this might make you feel better, it's a medical article and it says that re-attaching the bone fragment worked for a lot of people from all age groups. If the link doesn't work I'll send you a PM with it.

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WB8-4BKP4DK-G&_user=10&_handle=W-WA-A-A-BV-MsSAYZA-UUW-AUDZUUBWDU-WWBYEVVWZ-BV-U&_fmt=summary&_coverDate=02%2F29%2F2004&_rdoc=1&_orig=browse&_srch=%23toc%236704%232004%23999799997%23477803!&_cdi=6704&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=bc9db175aef97f0b96bbc0f1e5552a62

[DrMark]

I have done 30 of these. On 14, they were still loose, and they required an standard ACL repair. The reason for this is that the collegen tissue in the ACL stretches in a plastic fashion before the bone breaks, so the ACL is loose even when its replaced anatomically.

My take is that if you have to go through the rehab and all that, a 30 percent failure rate is too high, when a formal reconstruction is absolutely the same degree of pain and trouble and the failure rate is less than 5%

This positon is taken by almost all of the white haired household names in the business, although doing an arthroscopic repair is a cool thing to do and its attractive on that basis.

Lets hope we hear from this rider in two years and we lean how he is doing