Probable re-torn ACL, TKR in my near future

[The_Blood_Bay_Mare]

As I’ve detailed here before, I tore my ACL in 2013 and had surgery. Never totally bounced back, always had some level of pain. It got dramatically worse over the past 6-8 months, and then ramped up again about a month ago.

Pain hovers around a 2-3 at all times, but spikes to an 8 whenever I take a weird step or land heavily on it (i.e. dismounting). Riding puts my leg at an angle that it does not like, and I’m around a 5-6 the whole time I’m on. I tried to ride bareback on Saturday, hoping that just letting my leg dangle would suck less. NOPE. So I’m grounded.

Went to my ortho yesterday. He’s about 95% sure I’ve torn the ACL again, and there might be other damage. MRI sometime in the next week, followup with him on 10/14. If I have in fact torn the ACL again, reconstruction is not in the cards. We took every option to increase the strength of the replacement ligament, and if that didn’t work, nothing is going to.

So I’m looking at a TKR at 22. And honestly I’m scared that nothing is going to make me “riding sound” again.

Experiences? Reassurance? Help I’m upset ;_;

[Doctracy]

Jingles to you. No experience exactly like yours but I have osteonecrosis in both knees. Had limb saving surgery with stem cells (from bone marrow in my hips) two years ago. I’m just starting to ride again and went from a daily pain of about 8 to now a 1-2,except when the disease flares.
I may need TKR in the future but really hoping that the stem cells continue to replicate and improve the joints.
You might check into some of the newer procedures such as the autologous chondrocyte transplant that Dara Torres,the Olympic swimmer had.
Anyway,I can really sympathize with you. I had pretty bad knee pain for years before it became so bad that I was in a wheelchair and it finally got diagnosed.

[The_Blood_Bay_Mare]

Thanks Doctracy. That sounds horrible, I’m glad you seem to be doing better.

I’ve heard that TKRs are often more effective than reconstruction in terms of both pain and function, especially in the case of reinjury. I’m just pretty nervous because there’s no turning back after that if it doesn’t work well.

[vali]

Might want to get a second and third opinion, especially considering your age. Also might want to see if you have also damaged the lateral collateral ligament, which is one of the leading causes of ACL graft failure. It’s hard to catch the LCL (also called FCL) on MRI, but the good news is that if that is the cause of your ACL graft failure, fixing that might mean you are still a candidate for an ACL graft replacement. I saw 5 top knee surgeons when I tore my ACL, and only two of them caught that I had also torn my LCL. I got both replaced with cadaver grafts at the age of 43 and am back eventing and running. I went to the Steadman clinic in Vail Colorado and had my surgery with Robert LaPrade. I knew someone else who was a varsity UC Berkeley soccer player who had her ACL grafts fail twice until she went to the Steadman clinic, and the third time they fixed the ACL and the LCL and the reconstruction was successful. TKRs only last 10-15 years, I would explore everything else if I were your age.