Recently, my husband had to have his anterior cruciate ligament, or ACL, repaired in his knee. He’d injured it several years ago playing football in high school. Over the years the pain was either not enough to worry about it or life changes happened to occur that simply put off having this issue addressed.
Finally, after more than 15 years, he took the plunge. As we all know, everyone’s personal experiences will vary so I’ll describe his situation as it happened.
The first step was to see an orthopedic doctor. This “bone doc”, as my husband likes to put it, did his consult and performed several x-rays to determine what the root cause of the pain was. Given the results of these tests and my husband’s history of sports and injuries, the diagnosis was made fairly quickly. His ACL was torn years ago, and was not to the point of basically being completely gone, and it needed repaired.
He was given two options. The first was to undergo surgery, have the joint cleaned out and the ligament repaired. The second was to do nothing. Apparently it is not uncommon for people to choose this option if they don’t care to compensate for the bum knee or to be able to participate in sports. My husband enjoys playing sports and wanted to be able to enjoy years of pain-free joints, so he decided to go with the first option.
Once surgery was decided upon, there were two other options to choose from to decide how the ligament would be replaced. The first option was a patellar tendon graft. With this technique, a portion of the patellar tendon would be removed from the good knee, along with small pieces of bone to which it attaches, and used to replace the ACL in the bad knee. Concerns with this technique include the obvious; having some form of surgery on both legs, and also later on down the road, patients often complain of some pain in the donor knee.
The second option was an allograft. This is the technique that completely replaces the torn ligament, or in my husband’s case, the missing ligament, with that of a donor’s. The concern with this type of procedure was personal feelings about using a donor’s tissue. We were told that the chances of disease transmission, body rejection or other problems associated with this type of procedure are very rare. My husband decided to go with this second option.
After some more diagnostic testing and pre-anesthetic blood work, the surgery was planned. On the day of surgery, he was instructed to not eat or drink anything for twelve hours prior to the scheduled time and to bring along a friend or family member to wait and provide transportation home.
We were scheduled to be there at around 11 A.M. and the surgery was to begin at Noon. We arrived a little ahead of scheduled and were check in right away. My husband’s vitals were taken and his knee was prepped for surgery. As his wife, I was allowed to stay with him during this period. His leg was shaved and marked for surgery, an intravenous catheter was placed and fluids were started. They were able to start surgery a few minutes early. At this time, I was no longer allowed to stay with him. He was taken back to surgery for the procedure to begin while I was escorted back up to the reception area to wait. And wait I did; six hours of it.
During these six hours, I was given updates on my husband’s progress. One of the nurses would come up to let me know that he was doing well under the anesthetic and would tell me at what point they were at in the surgery. When finished, the surgeon himself came up to speak with me. He told me about how the surgery went, some things to watch for afterwards and certain things that I shouldn’t allow my husband to do.
When my husband was awake, I was taken back to be with him and to be taught what to do for his aftercare. A pain pump was installed that had the potential for requiring at home care, but in his case, it ran fine the whole time it was in place so we didn’t have to do anything with it. It was a small whoopee cushion looking pouch that continuously administered a set dose of local anesthetic into the joint for the first two days. This little handy dandy device kept the initial post op pain down to almost nothing. The pain pump is only in place for two days so I was given the option of being taught how to remove it at home, or to simply bring my husband back for removal. I went with the latter.
He was also given a CryoCuff. This nifty tool provided a constant flow of ice water in a wrap-form to keep the pain and swelling in his leg down. The cuff wrapped around his joint and had a nozzle that hooks up to a hose attached to a cooler. It can be drained and refilled as needed with new ice water and it stays in place in the even that he needed to get up and move around.
Sheets explaining exercises were given. Rules telling him “no driving for six weeks” and “keep the foot elevated” were printed out. The prescription for pain medication was given and discussed at this time as well. They even gave us a little card that we could fill out and send in thanking the family of the person from whom he received his new ligament.
As I stated before, and as we see on all the medical commercials on television, these results may not be typical, but after my husband was awake, I pulled the car around to the nearest exit, got his crutches ready and helped him out of the hospital. He barely needed the crutches and was putting weight on the leg before we even got into the car.
The following few days of after care were the hardest. The first day, the day of surgery, wasn’t so bad. I took him home and made him rest while I ran out and got his pain medication from the pharmacy. The second day, was the worse. The pain wasn’t being controlled by the pain pump and the oral pain medication did nothing. It was difficult for him to sleep and he couldn’t get comfortable even when he was awake.
That third day was the day to have the pain pump removed. At the time of that appointment, we wanted to address the issue of the uncontrolled pain, but we weren’t given any other options. The reason was most likely that this is just one of those things that can’t be completely controlled with pain medication. He’d only had surgery a couple of days before.
That second day was the worse and during the following days, he improved. I continued to refill his CryoCuff, made him keep his foot elevated, and kept on him to keep up with his exercises. There were a few days when he just felt sick. His knee wasn’t painful but he felt nauseous and dizzy all the time. As his had no joint pain, he decided he would try discontinuing his pain medication (the doctor told him he could take it as needed for pain). Once it was out of his system, he began to feel much better and no longer had these nauseous or dizzy spells.
On the tenth day, he was due to have the sutures removed, and the bandage taken off. It was amazing to see the improvement from the time of surgery to just a week and a half later. He’d stopped using his crutches after the third day and had been using the leg as much as possible. He was able to walk with just a slight limp by this time.
At this appointment, his physical therapy was started. Physical therapy is required three times per week, with descriptions of daily exercises given to do at home. Since we happen to have a stationary bike at home, he was told to start using this at just a few days after surgery. He’s gone from being able to pedal only a couple of times before the knee became too painful, to being able to ride for six minutes or more at a normal steady pace without any pain.
The physical therapy was prescribed for a total of four weeks, with a note that sometimes it requires six weeks.
Overall, the experience is worth it to know that when he’s completely healed, he’ll be able to live a normal life without being sedentary. The surgery went well and is fairly routine. The aftercare was the worse part, but mostly that reflects on the second day. Once the initial stage of it was over, the healing process has been relatively quick.
Currently, we are in his fourth week since he had his surgery and I’m thrilled at the outcome. He is now able to walk better than he did even before the procedure was done. Prior to the surgery, he’d simply learned to live with the bum knee and to compensate for it as needed. Now, he’ll be able to be pain free and live an active lifestyle as he pleases and that, to me, is priceless.
