[tireddogs]

Some of you may recall my post from earlier this winter asking if I could learn to ski on AT equipment. Well...I did it. I got some AT boots and Fritschi bindings and took a ton of lessons at Stevens and through WAC at Snoqualmie. I've made some new friends and even met a guy I've been seeing for a few months. I probably went up 25-30 times this season and as a result I think I got pretty good. I'm not skiing black diamonds regularly but I'll occasionally step up to the challenge and have been told I ski really well...except if there are a lot of moguls. I went up to Whistler for 4 days last weekend with some new friends and was looking forward to using my new longer/wider skis with the highly praised Kingpin bindings. Unfortunately on day 2, I ended up having an epic fall down Sun Bowl that resulted in a torn ACL. I think it was a combo of more powder than I know how to ski in, longer skis, new bindings, and doing a run that was a little too steep. I skiied out carefully and hobbled around with a brace for the next two days while everyone else went up skiing. Now I have surgery scheduled for Tuesday and have a couple of questions for any of you who have had your ACL reconstructed or know someone who has. 1) Patella or hamstring tendon? I'm leaning patella right now after a lot of research. My main concern is the risk of ongoing pain when kneeling. 2) How long before you or the person you know returned to backpacking and skiing? I've been told backpacking is out for this summer and I should be able to get back to skiing by next January...all dependent on PT progress. Thanks!

[Bedivere]

How old are you? I've had my ACL reconstructed in my right knee twice and my left knee once. The first injury to my right knee was in my 20s, back in 1996. Surgery was in February and I followed my doc's recommendations for PT and was back hiking in the summer. We did a traverse of the ALHR in August of that year. Repair was hamstring graft because that's what the doc recommended. Worked out fine. Left ACL torn in Feb. '13. Surgery to repair in March. I didn't go on any long hikes that year because I also had shoulder surgery in April. That was a rough year. Didn't ski that winter, either. Another hamstring graft because that worked out well before and I do a lot of kneeling in my line of work and having to deal with a lot of pain from that if I chose Patellar tendon wouldn't work out that well for me. This repair didn't work out as well as the first. The knee is fairly loose now and my hamstring has never fully recovered. I need to get into some targeted PT for that. Got back to skiing in winter '14/15 and managed to tear my right ACL again halfway through the season. Also significant damage to the meniscus this time around. Chose cadaver graft this time as again, I needed to get back to work ASAP and the patellar recovery is longer and more painful though possibly a more successful choice long-term. We'll see. I work in construction so when I don't work I have no income and each time I've done this it's cost me 4 months of work with 6 months to being allowed back to full duty. With the cadaver graft there was very little post op pain and I regained strength and range of motion quickly. That knee is giving me some issues now which are most likely related to the meniscus damage. It's "tighter" than the left knee (less "slop") so that part of the surgery was a success. We'll just have to see if the cadaver tissue holds up long-term. I'm still not back to 100% though, but I'm approaching 50 and recovery times are getting quite a bit longer than when I was in my 20s and 30s. In any case, after surgery at the end of January '16 I was able to do several hikes this last summer including a week long trip in the Alpine Lakes in August. I think if I didn't work in construction and was younger I'd have chosen the Patellar repair as the docs say it's the strongest repair. The first time I had this done back in '96 there wasn't as much info out there and I was less informed. I just went with what the doc recommended and he was one of the pioneers of arthroscopic repair. Back then some docs were still opening up the knee with a big incision. The doc that did my shoulder and this last knee is a team doc for the Sounders and Reign and says they choose the Patellar repair for the athletes because they are more committed to PT, already in better shape than most (def. better than me) and are usually younger. Keep in mind that a hamstring graft will permanently alter your hamstring and slightly weaken it. That might not be an issue for you as it wasn't for me when I had it done the first time in my 20s. It's been more of a problem with my left leg which was done when I was 47 and has not yet fully recovered. Cadaver grafts have a higher long-term failure rate but a much quicker and less painful recovery. I'm rolling the dice here, hoping I'm on the successful side of the statistics. Patellar grafts are longer recovery and more painful but possibly the best idea depending on your particular circumstances. NOTE - this is my opinion based on my experiences and the research I've done into my own situation. Your experiences/needs may differ. Consult with a good doc and make the decision that is best for you. Good luck!

[Celticclimber]

I completely tore my R ACL back in 2001 in a very non-spectacular bc ski fall. Getting off the mountain and back to the car was not the lest bit fun. The PT I talked to said if I didn't want surgery, then to build up my leg muscles. Which I did.And continue to do. I've not really had any issues since. And I can tele turn all day inbound. And have no problem in the bc either. People I've known who did get their ACL fixed always seem to blow them out again and again. I'm 65 and still going strong. Live every day like you will die to-marrow.For someday that will be true.

[drewcoll]

I blew out my ACL last January my second day skiing. I know it can be pretty depressing seeing the rest of your season disappear! I think the graft choice comes down to your age and activity level. Sports / performance types typically get the patella, since they will risk the pain for performance. Hamstring is for younger people who can rebuild, and allograft is for older folks or for people who want the quickest recovery. There are great outcomes from people who just do PT and skip surgery as Celticclimber mentions. It sounds like you're pretty confident about surgery, and that's probably what you want. For me, when they got the camera in there, they found some bad meniscus damage that they hadn't seen on the MRI. They tried a suture repair of the meniscus, but now 1 year after surgery they have decided that the repair didn't work. Because of this, I can't really speak to the typical rehab, since mine was slower and now I'm not really back to 90% because of my meniscus damage. That said, even though my surgery results weren't great, I was able to go on a few backpacking trips last summer that were of moderate difficulty, skiing however has been out of the question. At any point in your recovery, generally, if you feel ready to do it, you're probably ready to go do the activity. I did have a few setbacks when I broke that rule into the "maybe I can do it" territory, but none of them were more than a few weeks of babying my leg. Good luck, and feel free to send me a message if you have any more questions.

[RichardJ]

Hey tireddogs. Welcome to the club. My first torn ACL happened while skiing at Whistler about 30 years ago. A couple of years later I blew out the other ACL playing basketball and went through the reconstruction. I had the patellar tendon procedure. They took about 1/3 of it for the repair and rehab took about 5 months. I had a job requiring heavy lifting that required a more complete recovery. Kneeling down was painful for about a year. After all these years I am extremely happy with the surgery. Knee is still tight and with full motion even after a real stupid fall at Crystal Mountain. I tweeked it hard and thought I blew it out again. I would advise to take the rehab seriously. It will help you get your full motion back. There might be times you will think your knee joint will never be the same again. Be patient and train hard to make it better than ever.

[tireddogs]

Thanks for all your stories It makes me feel better to hear what others went though. I went under the knife yesterday and got the patella ACL graft. My gut just said that was the right decision over weakening my hamstring. Long road of recovery ahead! It is so odd to not be able to bend my leg all the way or get my quads to fire properly when I try with all my might.

[chiwakum]

Patellar graft was likely a great choice. I skied 3 months after my reconstruction. Was on crutches for first 24 hours after surgery but didn't use a brace. Very easy and fast initial recovery but had tendinitis in graft area for about 2 years. No regrets.

[everyfrog]

Ah yes, been there, done that, both ACLs. Patella on one (soccer), Quad on the other (hiking). Regardless, from here on out - be DILIGENT about your physical therapy!!!! That's what will get you back in the field just as strong as before. It may take time, since you're recovering from two surgeries essentially, but doing your exercises every day will get you closer to the outdoors sooner! Good luck! TR