ACL Timeline: The Diagnostic Visit
The first step on the timeline for your ACL reconstruction is the diagnosis. You had an injury, you’re fearing the worst and now it’s time to get a professional opinion.
If it’s the first time you’ve damaged the anterior cruciate ligament you’ll probably end up either at the emergency room or your primary physician’s office. Once they suspect a ligament injury in your in your knee the doctors will probably suggest that you schedule an appointment with an orthopedic surgeon to get an official diagnosis.
Those of us who who’ve done this before (acl revision patients) will probably call our orthopedic surgeon directly to get the knee looked at.
I fell squarely in to this second category. After a restless night worrying about my knee I woke up feeling quite confident that I’d torn my ACL again, as such i wanted to get right in to see my surgeon.
When you get to your surgeon’s office you’ll have to fill out the requisite paper work and wait until someone leads you to an exam room. Here they’ll ask you to put on a pair of those horrible paper shorts, unless you thought ahead to bring some athletic shorts. The doctor needs good access to your knee for the exam.
After asking you some questions about your history and the circumstances of your accident the doctor will likely have you lie back on the exam table while they move your leg in all directions and observe the joint. They may do the same to your ‘good’ knee to compare the two.
In my case this part the exam was very quick. Within moments the doctor was able to confim my suspicions, but he then spent a few minutes thoroughly examining my knee.
After this exam the doctor may ask to have some pictures taken of the joint. In my exams that’s usually meant they took 3-4 x-rays to cover all angles of the knee. It is my understanding that these pictures don’t really show the ligament but serve more to give the doctor an idea of the condition of the bone.
The width of the tunnels through which the ACL passes are of particular importance to a revision patient. Apparently the tunnels grow in width with each surgery and at some point it is necessary to graft some additional bone into those tunnels to make the knee stable.
My doctor says that my tunnels have increased in size but that i can get away with another allograft (cadaver tendon) if we go up a size from my previous one.
After examining the x-rays with you the doctor will more than likely suggest an MRI to confirm the diagnosis. And that will be the topic of my next post!
Yeah, my doc said that diagnosing an ACL tear is actually done by the doc right in the office based off of clinical findings, and that the MRI is just to show all that other stuff that could have been injured during the trauma. My doc knew right when he moved my knee around and I asked him that if he was so sure could we skip the MRI but alas, being the good doc that he is, he said he needed to assess the rest of the structures in the knee to be able to proceed with the surgery.
Oh and by the way, I hope that your MRi dosen’t show any other damage!!!
Thanks Jennifer. I’ll write about my MRI tomorrow, but luckily there was nothing too alarming that came of it.