So you tore your ACL, is surgery your only option?

Posted on November 29, 2011

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So I tore my ACL. Yayyyy.

For those of you who don’t know, the anterior cruciate ligament is in your knee. When you hear so and so blew to their knee normally this involves tearing the ACL. The most common time you hear of torn ACLs are in NFL football players. It’s an injury that has ended many of careers and crippled many of knees.

I decided to write about my experience dealing with my torn ACL. I also tore my meniscus. Double yayyyy. But I’ll write about that later. The ACL will take priority for now.

This is an insanely deep topic so writing about it will help me organize my thoughts. Hopefully it will help other people who, in some way shape or form, have experience with this as well.

I think it will also be a great way of examining how much thought I think people need to take into consideration before opting for ANY surgery. As opposed to letting their bodies be cut open like they’re freakin’ science experiments. Or thinking they’ll get cut open, you know, no biggie, then walk away completely fine and go on with their life. Surgery is never that simple. Anyways…

This first post is going to be brief. The first thing I want to write about is do you have to have surgery? I want to address this because of my experience with the various surgeons I’ve talked to.

From talking to some surgeons you would think that if you didn’t immediately have surgery your leg might as well be amputated. That’s how crucial some surgeons make this surgery out to be.

This is bullshit. I will delve into specifics in coming posts but just know that if you’re talking to surgeons about this they should be having an open dialogue about your options. One of which should be whether surgery is beneficial for you. The first surgeon I saw said, “Yeah, you tore your ACL, you need surgery. I’ll send you over to so and so and she’ll schedule you.” Uhh, thanks, asshole.

The main thing I want to address in this post is when it comes to torn ACLs some people cope very well without surgery. In fact, some people cope so well that they wouldn’t even know they had an issue unless someone told them they did. These are referred to as copers.

Copers seem as if they almost have no need for an ACL. They might completely rupture the ACL but after the swelling and such goes down, there off as if nothing ever happened. It’s like they just had a sprain and needed to let it rest a little while.

This is compared to some others who, after their rupture, can’t step off a curb without their knee giving out to the point of face planting. These make up the non-copers.

One of the leading researchers in the area of copers versus non-copers is a woman named Lynn Mackler. While this is a fascinating and deep topic, this quote from Lynn says it all: “I have spent the better part of 10 years studying true copers – those who can compensate fully for ACL rupture and even decades after injury have no OA (osetoarthritis). They are remarkably rare. Most people are non-copers.” (Found in this roundtable on ACL injuries: http://www.orthosupersite.com/view.aspx?rid=2568 .)

Again, a fascinating topic but the fact of the matter is copers are outliers. By definition you are probably not one. If you’re reading about ACL injuries you’re almost assuredly not one. You would have no reason to suspect you have a torn ACL if you were a coper. You’d be too busy playing sports while the rest of us give you the finger out of jealousy.

If people are interested enough at some point I’ll write about what seems to differentiate a coper from a non-coper but at the end of the day it’s just not very well understood. Lynn Mackler has research suggesting that if your knee has had a giving way sensation one time since you tore your ACL, you are put into the non-coper group. A group where surgery may be suggested.

Therefore, rather than focus on the outliers, I’m going to focus on the majority. A majority I am a part of. By definition of us being non-copers we are possible candidates for surgery. What makes one person a better candidate for surgery than another? Is ACL surgery even beneficial? I feel a lot of ACL posts are about to come up….

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