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So I’ve been pretty aggressive about getting functional again. I was out on the tennis court a couple weeks after the tear before I knew
that it was a torn ACL, admittedly sort of hobbling around at first, but now, 5 weeks after the tear everything feels pretty goodÖ I’m playing not quite full speed several times a week, getting stronger each time. I’ve also been stationary biking about a half an hour a day and that seems to help a lot. And this week I started formal physical therapy, now that I know it is a full ACL tear. By the way, I’m a young 44 year old male, very active and in good shape.

The really fascinating thing is the range of opinions I’ve gotten from three orthopedists I’ve been to see about this:

Doc 1 is one of the orthopedists for the Oakland A’s. His opinion is, get reconstructive surgery as soon as possible and it would be a very bad idea to play tennis or ski on it until then.

Doc 2 is a highly regarded local orthopedist who has done thousands of reconstructions. He says that surgery is required eventually, but isn’t urgent it can easily wait a year which would be much better timing for
me because of my personal plans. In the meantime, he is confident that prior to surgery I can play tennis and ski with a brace at or close to my normal levels and this won’t have any adverse affect and minimal risk to the knee. He says surgery is ultimately required not so much for performance but because of the high likelihood of arthritis if the ACL isn’t replaced.

Doc 3 is an aggressive non-op who says surgery isn’t necessary. He says he has dozens of patients who have been playing aggressive tennis and skiing double black diamonds for decades without an ACL. He also says there is no statistical evidence or experiential evidence in his own practice that op or non-op makes any difference in the future occurrence of arthritis. He thinks surgery is very over-prescribed by surgeons to a man with a hammer, everything looks like a nail.

Yikes. What is a poor patient to think? It is clear to me that there are no absolutes in this science it all seems to be very subject to
fads and fashions, which isn’t terribly comforting when your body is at stake. Anyway, as many others have suggested on this board, there is no substitute for doing your own research and making your own decision.

Thank God for the Internet I can’t imagine how I would have learned all that I have about ACLs without it. This bulletin board is especially wonderful. Thanks, everyone, for your stories and info.

So for now I’m probably going to go the route suggested by Doc 2Ö I’m going to do aggressive physical therapy and see if I can get back to full functionality without surgery, and see how it goes. I'm hoping to play a lot of tennis this summer and then ski next eason back to the Alps, hopefully!. Then I’m expecting I’ll have reconstruction in about
a year, but who knows? I’ll see how it feels by then and see what the current thinking/fad is in a year. What do you think? Am I crazy?">

COLUMBUS, Ohio -- It may be unnecessary for athletes to fasten themselves into cumbersome braces after a specific reconstructive knee surgery, new research suggests.

Injuries to the anterior cruciate ligament (ACL), which stretches across the knee joint, are especially common among athletes whose sports involve jumping, turning and abrupt starts and stops. Part of the rehabilitation process includes wearing a knee brace for up to a year.

"We didn’t notice any difference after surgery between patients who wore braces and patients not wearing braces," said Christopher Kaeding, associate professor of surgery at Ohio State University. "Our study implies a brace may be unnecessary after ACL reconstruction."

"ACL braces were designed to stabilize the knee, to make it feel more trustworthy," said Kaeding, who sees more than 200 ACL injuries each year. "The braces do seem to help some patients who haven’t had the surgery but have damaged their ACL.
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"I'm recovering from surgery of both knees. I've found a great product that has eliminated my pain. They do have University Research reports on-line, but being an engineer I figured I'd do my own research. I used the wrap on my right knee and left my left knee as the control group. I've been doing this for a little over a week and my right knee feels dramatically better (no more stiffness in the morning, or pain when I sit for long periods). The result of my extensive research: I'm going to get another wrap for my other knee."