Grade 2 ACL injury. Wait til after hunting season?

[elkocd]

Don't work in ortho. But, taking a looking at the 1.5k per year subscription I get through work, there is not good evidence to support taking either approach. The risk is that knee instability causes you to injure more parts of the knee.

A discussion with both a surgeon and a physical therapist would be your best bet to understand your particular case. My inclination would be to give it 2 months of PT and see if it recovers to a notable extent or not. This approach could cost you a hunting season, but it could also save the season and avoid surgery. Some of it will depend on how unstable your knee is, this is a question for ortho. A grade 2 looks to fall in the area that might need surgery or might heal on its own.

That is kind of the plan. I've had a partially torn ACL for 36 years now and I knew it would not last forever. I think I'm going to try and get thru hunting season with a lot of PT and then bite the bullet and get a new ACL in the fall. I had this conversation with a surgeon about 10 years ago and we landed on, it was working and stable so it was up to me, but the one I had would probably not be good forever if I wanted to remain very active. I guess it's time to pay the piper for living hard on my body.

This all might change if the US Dr tells me my ACL is totally shot right now and will not be stable enough to hunt. Then I get it done as soon as I get home.

 

[lintond]

I wouldn't burn 14 points on a sketchy knee. I'd look for other options that are less of an investment and plan to use 15 points in 2024 on a healthy knee.

I'd hate to be on the hunt and say "Damn if my knee was good I could get to that 350 bull, but I just can't with it at 50%"

Also I wouldn't want to rush rehab and jeopardize long term health for one season. Find a lower priority hunt is my advise.

 

[DAOutfitters208]

I know a guy that completed two Ironman triathlons with no ACL. Lots of physical therapy to compensate until he was in a position to take the time off work to get surgery and recover.

 

[Hschweers]

Had my ACL redone one year ago yesterday. I was 25 at time of surgery, so factor that in. At 3 months I felt 100% in daily activity, but still felt discomfort when squatting or other similar maneuvers that bent my knee past 90* with body weight on it (such as climbing a mountain). By 6 months i was 99% pain/motion wise, but my leg still tired faster than it did before surgery. If you had an ACL injury in 1986, you’re older than 25. From my personal experience, even if you rushed home and had surgery tomorrow, the fall would still be pushing it to be 100%. Burning 14 points, I’d wait till next year.

 

[Felix40]

Ive had two knee surgeries. One ACL replacement. I think doctors tend to be more optimistic about recovery times and how “normal” the repair is going to be. Normal use for most people is just walking around on flat ground and maybe doing a light jog once in a while.

I bet you will have a hard time carrying a heavy load downhill in September no matter what you do. If it were me, I would explore every other option before surgery. PT and a knee strengthening program all summer. At least you would find out if it will heal itself.

 

[ztc92]

Don't work in ortho. But, taking a looking at the 1.5k per year subscription I get through work, there is not good evidence to support taking either approach. The risk is that knee instability causes you to injure more parts of the knee.

A discussion with both a surgeon and a physical therapist would be your best bet to understand your particular case. My inclination would be to give it 2 months of PT and see if it recovers to a notable extent or not. This approach could cost you a hunting season, but it could also save the season and avoid surgery. Some of it will depend on how unstable your knee is, this is a question for ortho. A grade 2 looks to fall in the area that might need surgery or might heal on its own.

I’m not a surgeon but am currently in a sports medicine fellowship to become a primary care sports medicine physician. I think this is very sound advice and is similar to what I was thinking when I read your story. Compared to when you had your prior surgery, things have changed significantly, both for surgical and non-surgical management.

On the surgical side, the surgery has become less invasive and the techniques for harvesting and securing grafts are more refined. There is also a trend towards waiting longer to do surgery after the injury than in the past, with a strong emphasis on “pre-hab” - main goal is to get the quad firing well and regain full range of motion at the knee joint.

With this in mind, I think it is very reasonable to take at least 4 weeks to heal and begin the process of “pre-hab” and see how you feel. Then at the end of March you can decide if you want to fly home early to have surgery (and accept that it’s unlikely you’ll be 100% for hunting) or complete your trip with plans to (potentially) hunt this fall despite your non-repaired ACL injury.

As others have said, you can still perform at a high level without your ACL. Currently there is a lot of research being performed to determine which patients may actually be better off not undergoing an ACL repair. These would all be great questions/topics to being up during your virtual consult with the surgery team.

Feel free to PM me if you have more specific questions and I’ll be glad to help if I can. Best of luck!

 

[EdP]

So much depends on your individual case. How bad is the ACL, how strong are your secondary supports, how old are you. I had ACL reconstruction in 1995 via patellar tendon transfer at age 41. It took me a year to be fully recovered and hiking in the mtns again. Regardless of how hard I was willing to work at PT, swelling limited my rate of progress due to my age. The same surgeon did the same surgery on a 17 y/o high school student on the same day. The kid was cleared to return to football after 5 mo.

If you tear your ACL (complete tear), chances are you also damaged cartilage. It sounds like maybe you didn't with your grade 2 tear. Like others said, don't risk further injury.

 

[wannakillabigbull]

Had ACL surgery in 2011, and a subsequent clean-up surgery in 2020. Agree with some of the previous posters who’ve actually had the surgery: recovery times I feel are optimistic. There’s “recovered” and there’s “elk hunting the backcountry recovered.” If I were to do it over again I’d have the surgery immediately following hunting season, then still plan a very easy next hunting season (burn some pronghorn points, hunt late season deer/elk near the roads), then plan any major hunts for the following year. It’s just not worth trying to push it the year you have surgery. Don’t put yourself on some sort of timetable that doesn’t allow for minor setbacks and ensuring you feel truly 100%. If you try to come back too quickly and have a major reinjury, there’s no go backs. I personally wouldn’t plan a 14 point elk hunt until at least a year and a half post-surgery.

 

[BCSojourner]

What a kick in the balls. I'm in central america and just had an MRI in which it showed a grade 2 ACL tear. I actually had an ACL surgery when I was 16 way back in 1986, so I knew this ACL would end up being an issue at some point in my life. I'm supposed to be down here until May. So now my dilemma is:

1. Do I rush back to the states and try and get it fixed soon with hope I can hunt this fall? I think 5-6 months recovery sounds optimistic?
2. Stay down here and rehab and try and hunt in the fall then get fixed in Oct/Nov? WIll a grade 2 heal enough and be stable enough to get thru an elk season. FYI it will be a high country rough elk DYI hunt.

Anyone else have experience with a grade 2 partial tear ACL and hunting?

Going to send the MRI to someone in the states that hopefully can give me some guidance, but not sure how much I can get from afar.

I've had 2 ACL replacements, and finally, after they wore out after about 10 years, 2 total knee replacements. Always had them scheduled and done in April so I could hunt archery elk in September. Also tore both Achilles tendons, latest one was in June of 2018. I have yet to miss a season. Really good surgeons who operate on Olympic-class athletes here in CO. Can't say enough about Dr. Kim at the Steadman Clinic in Vail-he has fixed up many world-class athletes. I am also fortunate to have a great PT who is also an avid archery hunter and knows what it takes to get those repaired parts ready. My first knee replacement was in 2015 when I was 62 years old-was ready to go and used a special ortho sleeve just to make sure. Still going strong on the new knees-probably average 6 miles/day and 120 miles per season on them. You should be fine if you need, and can get, the surgery done by the end of April and are religious about your rehab and don't do anything extremely rash during the hunt. Recommend that you start with the 2nd opinion first though.

 

[snowduckin247]

What a kick in the balls. I'm in central america and just had an MRI in which it showed a grade 2 ACL tear. I actually had an ACL surgery when I was 16 way back in 1986, so I knew this ACL would end up being an issue at some point in my life. I'm supposed to be down here until May. So now my dilemma is:

1. Do I rush back to the states and try and get it fixed soon with hope I can hunt this fall? I think 5-6 months recovery sounds optimistic?
2. Stay down here and rehab and try and hunt in the fall then get fixed in Oct/Nov? WIll a grade 2 heal enough and be stable enough to get thru an elk season. FYI it will be a high country rough elk DYI hunt.

Anyone else have experience with a grade 2 partial tear ACL and hunting?

Going to send the MRI to someone in the states that hopefully can give me some guidance, but not sure how much I can get from

This is a question for a Pt or a specialist, main factors are your age present physical fitness. If your 40+ heal time is gonna be much longer. Had one in my 20's and one in my 40's and after 7months was not fully recovered for hunting season and I'm in decent shape

 

[trophyhill]

Quick question, do these same opinions hold true for a torn meniscus?

 

[Magua]

i'm about 3 weeks away from surgery for a new ACL and meniscus repair.
Mine was a grade 3 tear (total rupture). If it wasn't for my meniscus being so badly torn I might have held off on the ACL surgery. In my case its my meniscus that worries me and i'm afraid of developing arthritis and needing a total knee replacement earlier in life. I figure while im being operated on they might as well reconstruct my ACL because the rehab sucks either way. after this surgery, I might be able to do a wilderness hunt this November. Definitely no backpacking fly fishing trips this summer.

you would have to check with your sports doc to see if a grade 2 tear is even something they would want to operate on or do physical therapy for.

you can also look into PRP injections although there isnt a lot of data on it yet.

that sucks you hurt your ACL. On the bright side, a grade 2 tear is super rare and you have better odds of recovery, either from surgical or PT. Im glad no other structures were damaged. Speedy recovery.

 

[Magua]

Also if you have good health insurance and want the best of the best, Steadman clinic in Vail, Colorado is THE place that specializes in knees for olympic and professional athletes.

 

[ztc92]

Quick question, do these same opinions hold true for a torn meniscus?

Assuming you are asking about an isolated meniscus tear, meaning the ACL and other ligaments are intact then no, the management is different. Historically almost all meniscus tears were treated surgically because if something is torn, it should be repaired, it just made sense.

Then about 10 years ago in the Europe, some surgeons performed a now famous study where half the patients got the real meniscus repair surgery and half got only the initial part of surgery that uses the camera to look at the inside of the knee but no actual surgical repair was performed. The patients had no clue which group they were in since they had identical experiences prior to going under anesthesia and woke up with the same scars. Interestingly, both groups had similar rates of improvement after “surgery”. This led to rethinking whether all meniscus tears actually need, or even benefit from surgical repair.

The current thinking is that anyone with mechanical symptoms (knee gets locked or stuck in certain positions, or motion is limited by pain thought to be a result of the meniscus injury) would likely benefit from surgery since these symptoms will impair their rehab. If there are no mechanical symptoms, then we usually start with a solid trial of skilled PT (8+ weeks) and then re-evaluate the need for surgery if they haven’t made significant improvement.

For anyone curious about the study:

https://www.nejm.org/doi/full/10.1056/nejmoa1305189

 

[grossklw]

I'm a PT- a lot of good advice here. At your age class I generally recommend let's give rehab a shot first and see how that goes. Even if you fly home right this second and have surgery it's not a guarantee you're going to be full go in the woods by September. Some surgeries and rehab's go well, and some don't even with great surgeons and rehab pro's. The re-tear rates inside of one year are higher, it's rare I clear an athlete prior to 9 months, if it were my kid they likely wouldn't see a field until we get closer to a full year. You see pro and college athletes jump that timeline, but you need to keep in mind they have access to resources most do not and genetically they are superior to you or I (it's not debatable, if just hard work was required there would be more professional athletes, god given talent comes into play with rehab too).

The biggest thing is if it is stable or not, if it's constantly giving out on you and you're unable to really trust it that's going to be a tough elk hunt. Could also consider a custom ACL brace, but that would be a bit of a pain on an elk hunt and the research a little iffy on if they actually do much.

If you can get it to a point where it feels pretty stable, I would go on your elk hunt. It's really tough to say from 3000 miles away, a virtual visit may help but it's tough to get a feel for some things through Skype. There are a lot of people that can be pretty high level with an ACL tear. Hines Ward played his entire NFL career without an ACL in his L knee, it can be done.

 

[trophyhill]

Assuming you are asking about an isolated meniscus tear, meaning the ACL and other ligaments are intact then no, the management is different. Historically almost all meniscus tears were treated surgically because if something is torn, it should be repaired, it just made sense.

Then about 10 years ago in the Europe, some surgeons performed a now famous study where half the patients got the real meniscus repair surgery and half got only the initial part of surgery that uses the camera to look at the inside of the knee but no actual surgical repair was performed. The patients had no clue which group they were in since they had identical experiences prior to going under anesthesia and woke up with the same scars. Interestingly, both groups had similar rates of improvement after “surgery”. This led to rethinking whether all meniscus tears actually need, or even benefit from surgical repair.

The current thinking is that anyone with mechanical symptoms (knee gets locked or stuck in certain positions, or motion is limited by pain thought to be a result of the meniscus injury) would likely benefit from surgery since these symptoms will impair their rehab. If there are no mechanical symptoms, then we usually start with a solid trial of skilled PT (8+ weeks) and then re-evaluate thef'nh need for surgery if they haven’t made significant improvement.

For anyone curious about the study:

https://www.nejm.org/doi/full/10.1056/nejmoa1305189

Good stuff! Thanks for posting!

 

[sodaksooner]

Partial tear here and completely tore the PCL at the same time in a MTB crash. Lots of pain and instability after the accident. Rehabbed it, no surgery, no issues 12+ years later. Pain went away and more stable. My brother(not a Dr) is a hospital administrator and completely tore both in HS. Just had them cleaned up at the time and rehab. Minor issues, mostly cartilage related, and he is in his mid 50's like me. His Ortho surgeon buddy at the time of my injury and my ortho doc were not recommending surgery for me and said it wasn't as prevalent as it used to be. I do wear a brace from time to time when doing things that require a bunch of lateral movement like basketball or wakeboarding, but I haven't noticed any issues personally. It is less stable than the other knee but doesn't bother me. Only you can make that call but just wanted to throw out my experience. Ive run and biked and hiked many thousands of miles since with no ill effect.

 

[Gobbler36]

Tore mine packing out a deer on my dirt bike October of 21 had surgery February of ‘22 packed out 3 bull elk fall of ‘22 didn’t feel good at all but i made it, hell i was hunting bears spring of ‘22 don’t think it was smart but i did it anyways. Wished I would’ve rested a little more but I’m still struggling today with explosiveness and pain
not a fun recovery at all.

 

[Gobbler36]

Ive had two knee surgeries. One ACL replacement. I think doctors tend to be more optimistic about recovery times and how “normal” the repair is going to be. Normal use for most people is just walking around on flat ground and maybe doing a light jog once in a while.

I bet you will have a hard time carrying a heavy load downhill in September no matter what you do. If it were me, I would explore every other option before surgery. PT and a knee strengthening program all summer. At least you would find out if it will heal itself.

Thats me…
over a year out from surgery and carrying loads down hill is sketchy still

 

[Whip]

You've gotten good responses on the medical part and I know nothing about that so can't help.
I'm just wondering about the 14 points. That seems like no man's land in CO. Not enough for top tier units and more than you need in others. Given the uncertainties medically I'd sure not want to spend more points than needed to draw a unit that should still be waiting for you when you are physically 100%.

Either way, good luck!