Doctor Discouraging Surgery - Advice Please!

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Posted by Karen 2 months ago. There are 9 posts. The latest reply is from snowman24.

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Karen
Member
Posted 2 months ago #

Hello everyone -- I'm new here and have really been helped by the information and encouragement in your posts. On 5/28, my Dr. delivered the MRI results: severed ACL and torn meniscus. My brain stopped working then, so I didn't coherently discuss his statement that due to my age (52) and activity level, I should have PT and surgery for the meniscus, but not ACL reconstruction surgery.

Afterward I realized that he made this recommendation without any knowledge of my activities, just his assumptions based on my age. On vacation, I enjoy long hikes involving steep, very uneven terrain such as Angels Landing at Zion National Park. We hope to move to the southwest in a few years to be closer to the national parks and do more hiking. I also kayak and bicycle. For bicycling I use Shimano "clipless" mountain bike pedals, where my biking shoe sole clips into the pedal and I twist my foot to detach it.

Do I need an ACL for any of that? The more I've read, the more I've come to think reconstruction surgery makes sense. When I'm old, I don't want to worry about slipping or falling because my knee is giving out. When I see my Dr. again in a few days, how do I convince him that I don't want my future activities to be limited by lack of an ACL? Or am I completely off base? Thanks in advance for your thoughts.
Elaine
Member
Posted 2 months ago #

I would get another opinion. I am 58; I ruptured my ACL and tore the medial meniscus in my left knee on May 3. The first Doctor I saw told me he didn't think I'd damaged the ligament; an MRI showed otherwise. I saw a different Doctor a week later, and he encouraged me to do the ACL reconstruction. Insisted, in fact!

The first Doctor was on vacation after the MRI, so it was just by chance that I saw the second Doctor. Doc #1 was older, Doc #2 was younger. I had a choice of whick Doc to see, and I chose the younger, yet experienced Doc. I wonder if the older Doctor would have encouraged the reconstruction? Anyway, I am glad I decided to go ahead with the surgery.

I had ACL reconstruction on May 28, using the hamstring. Although it is a long road back, I am thankful the Doctor was aggressive and fixed the knee. He said that at 58, with my activity level, I would be unhappy with the instability of the knee, and would risk further damage. I already have a total knee replacement on my right knee, which I injured in High School; I certainly want to avoid another total knee!
ssowada@cox.net
Member
Posted 2 months ago #

This is easy...get a different doctor. ACL reconstruction rehabilitation is not that difficult. It does takes time and some hard work, but you will be back to yourself before you know it!

52 years is not too old to have ACL reconstruction and fully recover.
Karen
Member
Posted 2 months ago #

Thanks, Elaine and ssowada, for your encouragement. The first time I saw my young Dr., he told me that he'd had ACL surgery. It's only about 33 hours until my appoinment with the Dr., so wish me luck!
Elaine
Member
Posted 2 months ago #

I know what you mean about your brain shutting down when you got the news. Now is the time to get all the information you can. I spent hours doing searches and reading about ACL injuries and surgery. When you see the Doc, be assertive! It may help to have someone with you for support and to also ask questions. Take notes with you.

You want a Doctor that is experienced and does many of these procedures. My Doctor spent quite a bit of time with me, answering all my questions. I did not feel rushed or pressured into making a decision. He told me I could wait until Fall for surgery if I wanted, so I could perhaps enjoy some of the summer, but the meniscus damage was causing too much pain.

If you do not like what the Doc says or do not have confidence in him, please, do get another opinion. It is YOUR knee, and YOUR future. You have time to make the right decision.

I am looking at this surgery and rehab as an investment in my future. Although I am still totally bummed out about the inury and the timing; at least, now, after the surgery, I am back in contol, and I am focused on new goals; I joke that rehab is my new "job".

It sounds like you are pretty active and your plans for the future include staying active. Don't compromise that future.

Good luck; keep us posted.

Elaine
Deborahlr
Member
Posted 2 months ago #

I'm a very active 43 year old and the doc was hesitant to recommend the complete reconstruction at first, maybe because I came to the appointment with my kids and seemed more soccer mom than soccer player? Actually, there is some talk that the acl becomes less necessary as we age, since it stretches out and we in turn become more reliant on other aspects of our knee's makeup. But when the doc (a well respected, slightly "old school" ortho) told me it was my choice, I went with the acl reconstruction from a cadaver allograft, and he told my husband when I was in post-op that it was a good thing we did it all, since there was other wear and tear that he was able to fix and overall give me a great new knee. I think for me the decision to go with the whole thing made me really nervous (I think my brain stopped quite a few times!) but I don't want to need knee replacement in 20 years, and I want to hike Angel's Landing again and again and again! Good luck!
Karen
Member
Posted 2 months ago #

Thanks, everyone, for your replies and encouragement. I have good news. When I saw the Dr. on Friday, he revised his earlier recommendation, based on his examination of my knee and my responses to his questions. He now thinks I should have the full ACL reconstruction (allograft) in addition to the meniscus surgery. The best part is that it was his idea and I didn't have to try to convince him.

I asked him questions about how many ACL surgeries he has done, possible bad outcomes, how many bad outcomes among his patients, etc. He said he has done 400-500 ACL surgeries and the only bad outcomes were one patient who first got an infection and then had to have a redo when he resumed sports before Dr. gave OK. No nerve damage.

We talked about what would be involved in the surgery and recovery. Since people have compared varying philosophies of surgery and recovery, I'll share the outline. He does not use a nerve block in surgery. He said I would be on crutches for 2 weeks after surgery, and that it would probably be two weeks until I could drive safely (right knee is injured, so my reaction time will be slowed). He does not use a brace post-surgery; does use an ice machine. He feels that range of motion is actually more important pre-surgery than muscle strangth as it plays a bigger role in recovery success. PT begins soon after surgery (I forgot to ask how soon) and continues for months.

My plans at this point are to:
1) get a second opinion to confirm everything, and
2) read back through the older posts in this forum a second time, now that I know the surgery will actually be happening!
Elaine
Member
Posted 2 months ago #

Smart woman!

It will be interesting to hear what the second Doctor says. As discussed here, every Doc has their own protocol and preferred surgical procedure. Please update!

Elaine
snowman24
Member
Posted 2 months ago #

honestly if youre just biking and hiking, you DO NOT need ACL surgery. In my opinion the only reason you would need it is if youre doing actual sports such as basketball, soccer, raquetball etc. you can definetly get by with no ACL as I would know, i did without one for about 6 months and played intense level varsity basketballl without it. ended up deciding with the surgery because i couldnt do as much wihtout the ACL, but this is a different story for you.