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I tore my ACL and meniscus several years ago — got reconstruction done with David Altchek at Hospital for Special Surgery. Would definitely recommend. Had a great experience with him and his team at HSS through the whole process, and haven't had any issues with my knee to this day. I'm back to skiing, running, etc. no problem. Believe he is also the medical director for Mets and has consulted with the NBA.
Regardless of Dr., would recommend trying to do some physical therapy beforehand to work on strengthening your leg so that your muscle atrophy isn't as terrible after. And be diligent in your PT post-op as well. If you haven't already, definitely invest in an ice machine (I used a Game Ready ice machine, but there are definitely cheaper ones out there such as Breg polar care), as well as one or two knee sleeve ice packs (can find on Amazon) — both are SO helpful to use both pre- and post-op to reduce swelling and pain. Good luck with surgery and praying for a quick recovery for you!
Thank you - I just looked him up and he seems great. I've heard great things about the Hospital for Special Surgery in general.
I had a few additional questions for you:
Are they still doing grafts for ACL repairs? I thought grafts are inferior to newer approaches.
From my understanding (based on just googling around the last few days) there are three techniques:
1. Autograft - taking another ligament from another part of your body, usually hamstring or patellar. The advantage is that your body is unlikely to reject the graft, and the strength of the graft is the highest. Most pro athletes get the patella graft. Downside is they’re cutting out a ligament from another part of your body and recovery time is longer. Patellar is supposedly the gold standard for pro athletes to use due to its durability, but the recovery time is long. From what I understand if you ever end up tearing this one, you’re sort of forced to just get an allograft and now you’re missing two ligaments.
2. Allograft - Ligament graft from a dead person (cadaver). Pro is that it has the fastest recovery time and doesn’t involve cutting anything out of another part of your body. Con is that your body may reject the graft and it’s weak so it may tear again. Apparently a lot of older people get this one.
3. Synthetic graft - don’t know much about this other than I’ve heard it isn’t really reliable but I’m not sure if that is true or not.
I’m honestly pretty scared to get the autograft - I’m in really good shape apart from this injury and I really don’t want to risk harming another part of my body, even if that’s potentially the best result. Would welcome any corrections or thoughts if any of this is misinterpreted or wrong.
How did you tear your ACL?
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Robert Marx at HSS. HSS has some great options and I had a great experience working with them
Thanks, I just looked him up and he seems really qualified. He's also in-network with my insurance.
Similar to the other poster above, I had a few additional questions for you:
Second Dr. Marx. He did my shoulder, was great and have had zero issues since (4 years out).
Non-NYC, but can answer a few questions you’ve been asking in the comments. Tore my ACL and meniscus during basketball, had the surgery 5 months after the accident (during which I was doing physio, it’s a must. Tbh, the earlier you get the surgery the better), got the graft from my patella (my ortho recommended that one - as mentioned above, it’s gold standard for sports people). Went skiing 9 months after surgery, with high caution advised - communicate with ur physio. I recommend a lot of training in physio, preferably 3 times a week, starting 3-4 months in recovery till the end. I fully recovered after 12 months, but could already play chill basketball at 10-11 months after surgery.
Thanks, this is really helpful context. Do you feel any weakness / pain in the leg where the patellar graft was taken from? My biggest fear in this process is messing up another part of my body in the process of trying to fix this one knee.
How did you approach choosing a surgeon? Any specific questions you found helpful to ask them beforehand? I've been told that I should make sure that they're used to working with athletes and perform hundreds of these surgeries each year. I've also been told to expect them to be raging assholes and not to take that personally lol.
I'm trying to push aggressively to get my surgery scheduled in the next two weeks.
How is life for you now? Does your body feel permanently different from what it was beforehand?
Let me say this straight up: your leg will never be the way it was before. First of all, ACL helps with proprioception which is like deep feeling of your knee. You will not get it back, however you will learn to “feel” your knee in different ways. In my case, I also lost skin feeling on my patella (just didn’t regenerate after surgery), so you can pinch my knee and my skin will not feel it (doesn’t disturb me at all).
Pain not at all, but my knee does pop a lot (just sound, no pain at all). Strength-wise I think I have improved: was squatting 140kg x2 as my max at the end of physio recovery. I’d say my knee functions very well and even seems sturdier than my other knee (which is also confirmed by the medical papers on the sturdiness of the natural ACL vs patellar graft - after recovery it is around 1.5x stronger)
I mean, you don’t have much of a choice when it comes to messing another part of your body: it’s a trade off you have to make to be 100% again (it’s possible).
I choose my surgeon based on a recommendation from a friend + a background check: he is a well-renowned ortho for sports and works with a sports clinic, performed surgeries for Olympiad representatives from my country, so if he’s good enough for Olympians he is good enough for me. I guess you will also get a feeling whether they know what they’re talking about when you meet them. They certainly need to perform a lot of those surgeries every year to be good.
It’s been 4 years since the surgery and I have come back to basketball which I played for another year and switched back to competitive level judo 2 years ago (just got bored of dribbling all the time lol). Also was skiing all winters (big mountain, so no mercy for the knees).
Last tip: Good surgeon is a must, but it is EXTREMELY important to have a physio that will lead you through recovery and trainings. Without one, you’ll never get back to full strength. They are as important as the surgeon.
Good luck with everything.
NVM
Sorry to hijack the post but I am in the same situation. Partially torn ACL and LCL and looking for a specialist in LA to get me up and going as soon as possible.
Wish I had a cool story but it turns out pickleball is a dangerous sport.
bro pickleball... stepping on a step... are you guys like 85 years old... is this something I have to fear now???
LOL trust me I know. I didn't do anything particular to trigger it other than an a small jump to swing at the ball, when I landed I felt the slightest pop and discomfort.
Best way to avoid injuries like this is to weight train and strengthen the body of course which I had recently started doing a few months prior to. I may have weakened it by doing something wrong on leg days but I have no idea tbh.
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A friend of mine in LA recommended Justin Saliman, but apparently he's pretty tough to get an appointment with.
I have fortunately not had to have ortho surgery but there's no other place to go in NYC but HSS - its been the top ortho hospital in the US for like the last 20 years running - best of luck to you
Robert Marx at HSS is the goat
I’ve had 2 acl repairs - once when I was 15 and another at 22. I’m in my 40s now so no Dr reccomendations but if you can strengthen your quads from biking or spin class it will help immensely in the recovery. I still ski and torn acl didn’t stop me from playing sports.
I blew out each of my knees in college playing my sport (both on turf fields). One was ACL / partial MCL and the other one was ACL / meniscus. Got patellar tendon autograft surgery on both knees shortly after each injury (1-3 weeks). My guy was a pretty well regarded orthopedic surgeon in the northeast that specialized in knees and was a big proponent of patellar tendon autograft. He basically thought that it was by far the strongest and most reliable solution for athletes. He’s retired now but otherwise would recommend him.
I got the surgery twice and I’d say recovery in total was right around the year mark for me each time. Aggressive physical therapy right after is extremely important. You will be fighting a constant battle with your knee mobility and you need a physical therapist that will push you and make you uncomfortable. I remember going to PT and the trainer would stack weights on my leg to straighten it out and then go right into jamming it into flexion. It would hurt like hell but if you don’t do it you will lose range of motion. Even now I don’t have full range of motion in either of my knees - for example I can’t kneel and sit on my heels, my knees just won’t bend that far. Otherwise they are fine for everything else. Don’t know if this is a common thing, but seems like it based on every other person I know with the surgery.
I can do pretty much everything I want now as far as athletic pursuits (it’s been almost ~10 years from each surgery). I can run, ski, and lift weights just fine. I basically decided I’m wasnt going to play competitive contact sports anymore after my second ACL tear but I know other people who have been fine. Just a personal choice. Although my knees feel basically 95% of what they were before and my legs are probably 2x stronger now than what they were pre-injury, you will never be the same athlete. Part of it is mental and part of it is physical. It took my a while to gain my confidence back especially after two knee blowouts and i am still cautious with certain things now (mogul skiing, quick cutting, etc). I don’t really ever get knee pain other than where they took the patellar tendon graft out and this only ever happens on long hikes after going downhill for a while. I definitely feel way less explosive now than I did before too. I used to be one of the fastest people I know and post surgeries I think I lost a step. I came to terms with all this a long time ago and life has been great from a knee perspective so far.
Let me know if you have any questions. This has been a big part of my life lol.
Just make sure to get it done at Hospital for Special Surgery if money truly isn't a concern. Best orthopedic hospital in the world.
Just curious, are you planning to take off from work during the recovery given the time dedication to PT? In a similar situation, and was planning to return to college this year so it's a huge bummer.
Probably not... sitting at home alone with my injury is going to make me absolutely miserable. I'll take off post surgery until I'm no longer impaired by pain meds, but after that I want to get back to life. Yeah now things are now 100x more inconvenient, more expensive, and will take way longer, but I don't want to write off months of my life entirely. Definitely far easier said than done, so we'll see how successful I end up being with this.
On the PT front, my plan is to block off time in the early morning and try and go before work / first thing in the morning. Fortunately I found a PT place nearby that works for my schedule. From what I understand, after the first 2 months post surgery, life gets a lot easier and it's mostly about continuing to PT aggressively and be careful with not getting reinjured.
Feel free to shoot me a DM if you want to trade notes / do a venting session about this dumb injury.
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