I'm faced with a possible ACL reconstruction. Has anyone else had this done, or declined to, and have some input?

SFC Walter Mack — Mon, 29 Jun 2015 10:54:35 -0400

I was told that my ACL is present but not functioning as intended, or at all. I'm just reaching out to see if others have some valuable input as to the value of doing it or not. I'm also interested in retiree responses, as the retirement system is unknown to those of us who haven't done it, and I don't want to face bureaucratic issues later on as a result. Thanks to any and all that might have some advice.

Response by Maj Matt Hylton made Jun 29 at 2015 11:58 AM

Maj Matt Hylton — Mon, 29 Jun 2015 11:58:56 -0400

I'm not sure what is meant by "not functioning as intended," but I did have mine done several years ago and don't regret it.

Mine was due to an injury - I tore it playing soccer. I was also still on active duty, so I can't help you on the retired input.

Before surgery, I found that it really didn't impact my day to day life, but would occasionally bother me. It did hinder me from doing certain things like playing sports or running off-road as it was no longer able to provide the needed support to my knee. I'd either have a sensation that my knee was popping out of joint or my knee would kind of "give" under pressure. I put off surgery for over a year b/c I was getting ready for a PCS from AK to CA and figured I'd get a much better doctor in Los Angeles (which I did BTW). Then I got picked up for a deployment, so that delayed it even more. I could still pass my PT test and operate with all my gear. I was asked if it would affect my ability to react or operate if I needed to do so if I was involved in combat and pretty much said that I'd have to lose the entire leg before it would affect me.

I got the surgery about 2 months after I got back from deployment. Recovery was the worst part. I had actually gotten into the best shape of my military career while deployed, but being on crutches and very limited in PT while recovering from surgery made an impact. Typical recovery with 3 times a week physical therapy sessions normally takes 6-9 months. My run time has never gotten back to what it was before surgery, but I can play sports again and don't have to worry about my knee anymore. I do feel some occasional discomfort from time to time, but it is definitely not as bad as the pain before the surgery. Also I choose the cadaver method, where they take a ligament from a donor and replace the ACL vs. the other method, where they'll take muscle from your own body (normally the quad or calf) and replace the ACL. The second method requires a little more recovery because then you are not only rehabbing the knee, but also the muscle where they got the donor tissue.

Response by CAPT Kevin B. made Jun 29 at 2015 12:00 PM

CAPT Kevin B. — Mon, 29 Jun 2015 12:00:16 -0400

Absolutely do it. I blew mine coming off the back end of a Herc in a LZ. Great start. You can only do so much with PT and will be limited and likely degenerate the joint needlessly over time. It's a good fit and you can spare some hamstring.

I'm adding to my original post. Make sure you do the recovery PT fully to get range of motion and strength back. It will take time. Although the fix and diligence will reduce your VA percentage, I can't tell you how much better it is to feel good vs. not much more money. I was able to start refereeing soccer when I was 49 and that side hobby/job was more therapeutic than getting in touch with my chi. Your health and ability to do things is much more important as you age. That said, I get some pain when sitting on the floor and an itch on the outside has to be scratched on the other side so it conducts through the screw. Not a bad trade for movement.

Response by SGT Private RallyPoint Member made Jun 29 at 2015 12:15 PM

SGT Private RallyPoint Member — Mon, 29 Jun 2015 12:15:26 -0400

I blew my ACL and my Meniscus. Still weak, but glad I got it done. But listen to the Drs. at your physical therapy, take your time healing, don't push it like I did. I think that is where I went wrong. O.o But I hate being a gimp and relying on others to help me. Hated it. But I love softball, so I had to get back on the field. (too early) But, I'd do it. :-)

Response by CW4 Private RallyPoint Member made Jun 29 at 2015 1:25 PM

CW4 Private RallyPoint Member — Mon, 29 Jun 2015 13:25:07 -0400

I tore my right quad in 2012 and in 2013 I tore my right calf and Achilles, two separate sports injuries and both times had to have surgery to repair along with 10 months or rehab and I am back to running everyday I'm glad that I got everything taking care of. If I had knee issues I would most definitely elect to have reconstructive surgery. Advancements in technology with those types of surgeries have come along way.

Response by LTC Bink Romanick made Jun 29 at 2015 1:45 PM

LTC Bink Romanick — Mon, 29 Jun 2015 13:45:28 -0400

Tor mine in 97 no surgery...gives me a little trouble but not much.

Response by SSG Ed Mikus made Jun 30 at 2015 12:46 PM

SSG Ed Mikus — Tue, 30 Jun 2015 12:46:26 -0400

Get a second and third opinion

Response by PO2 Jeffrey Sheibels made Jun 30 at 2015 2:26 PM

PO2 Jeffrey Sheibels — Tue, 30 Jun 2015 14:26:06 -0400

I'm kidding with the whole cut it off with a saw vote. The ACL is one of those things that can make or break careers, especially when it come to professional atheletes. From the few people I have talked to who have had an ACL injury, it was a matter of being able to walk or not. They opted for the surgery and where able to walk after going through physical therapy. What they have all shared is that it will never be the same as before. They usually have pain from doing various activities and are restricted a little bit. But if the alternative was not being able to walk, they were glade they had it. As for when you retire, as long as it is in your medical record and is service related, then you will be able to receive treatment through the VA and it should be free of any financial cost to you.

Response by LTJG Robert M. made Jun 30 at 2015 2:35 PM

LTJG Robert M. — Tue, 30 Jun 2015 14:35:32 -0400

Had my ACL/PCL Repair in 1983, went on to Shipboard duty, 9 Years, OCS training & retired in 1996. Had total knee replacement due to Degenerative Arthritis issues in 2004.

Response by SFC Jon Vandeyacht made Jun 30 at 2015 2:57 PM

SFC Jon Vandeyacht — Tue, 30 Jun 2015 14:57:58 -0400

I would do it, esp if you can get DOD to cover it. After you get out, if you retire, tricare will do it but copay is still rediculous. Va will do it but then they will try to reduce your rating because it will be 'fixed'. Your going to have it done sooner or later anyway, so do it now. When you exit out, you have better odds at a slightly higher rating after the dod cuts into it versus getting a rating and then fighting to keep it. I would be more than happy to talk with you more but not on this forum. Email me at [login to see] -lake.wi.us and we can chat alot more on post military, the va and ratings as well as best course of action for when you feel the end of your time in uniform is approaching.

Response by SSG Clayton Blackwell made Jun 30 at 2015 3:28 PM

SSG Clayton Blackwell — Tue, 30 Jun 2015 15:28:39 -0400

Tore mine in 97 in OJG. Tore the ACL in half, partial tear of PCL and MCL and the meniscus. My advice is the sooner the better because it will cause less arthritis issues later. I tore it in June and because I was on deployment, they sent me to a vet college in Hungry to get the MRI. Three weeks to get to Landstuhl, Germany, follwed by another 2 weeks to get back state side. Then the doc wanted to do PT and see if I could do without the repair. Had the meniscus done in OCT. It was not cutting it and took till Jan to convince them to fix the ACL. By the time they did in Feb I had torn the meniscus again. The repair of the ACL has left it more stable than it was before it was fixed, however, I do have pretty bad arthritis in the knee and current doctors say that if I would have had it done within weeks of the injury, I would have much less problems. But after getting it fixed, I was able to run half marathons, tough mudder, spartan race, etc., all of which are things I didn't do before the injury. Now I carry about 25 pounds of extra gear on my body at work everyday and the knee is still strong. So for me, I highly recommend getting it done as soon as possible and moving forward.

Response by LCDR Doug Nordman made Jun 30 at 2015 3:43 PM

LCDR Doug Nordman — Tue, 30 Jun 2015 15:43:06 -0400

I'll stake out a contrary opinion: don't have surgery.

I've torn both ACLs and read extensively about the surgery and the PT. If you haven't already, I'd recommend that you look into more PT to strengthen your quads & hamstrings-- especially lunges and squats. If you decide to have the surgery then you're going to have to do PT anyway, so try it now and see how you feel. Give it 2-3 years before you make an irrevocable decision.

I don't know how or when I tore my ACLs, perhaps one as early as 1989. I sprained one knee with bad judo technique in 2001 and the other knee with bad TKD technique in 2006. Maybe the ACLs were already torn before those dates, or maybe they were torn during those incidents. There's other damage to all of my meniscii and some crepitation in one knee. (Sinovial fluid cavitation-- like cracking a knuckle.) In both cases I held off the surgery. After PT I continued with TKD (custom orthopedic knee braces in the dojang) and my own flexibility/strength exercises. After two years I felt totally comfortable doing full squats. After another year I put away the knee braces.

I won't ski moguls or skydive or play street basketball again. I'm now a 2nd dan in TKD. I can deliver head shots and 540-degree round kicks with either foot, so I think the ACLs are not necessary. I've backpacked 30-pound loads through lava fields for four-day hiking trips-- twice. I'm low on knee cartilage so I avoid excess running, but I can run a few miles. I can go all day on a bicycle or an elliptical machine. I'm fine on a longboard (turns, cutbacks, kickouts) and I can do single-leg squats. I'd build up to heavier squats using a rack, but at age 54 I think I'm "good enough". If I'm on my feet all day then I take 800 mg of ibuprofen.

On the retiree aspect: I've been told that Tricare Prime will pay for the entire operation (well, after a $12 copay). Recovery can be totally outpatient. I was able to get a referral to a (civilian) sports orthopedic surgeon. They understand "full mobility" for college athletes and won't merely settle for "good enough". The orthopedic surgeon also said that they have a list of two dozen painkillers from placebos to morphine, and they just ratchet up the list until you find the one that works best for you. If I decided to do the surgery then I'd prefer to recover as a retiree rather than on active duty-- just because of your regular workload and the demands of the chain of command.

I don't know how the VA will assess the knee injuries. I've been retired for 13 years and I'm just getting around to filing a claim. But regardless of the VA's conclusions I'm going to defer the surgery until my knees limit my life. After all these years without the surgery I suspect I'm going to defer it for the rest of my life.

In 2002 a small study (~180 patients) was published on arthroscopic surgery: https://en.wikipedia.org/wiki/Arthroscopy . (I wonder whether they could replicate it under today's ethics rules.) The patients were told that they'd have their meniscus repaired. In reality, only half of the patients were rebuilt or debrided. The other half just got the arthroscopic incision and no repair.

After recovery and PT, the patients self-reported on strength, stability, and range of motion. There was no difference between the groups.

The surgeons didn't even know which procedure they'd be doing until the patient was anesthetized and the doc opened the envelope. A different doc supervised the post-surgery recovery, so they didn't know which procedure the patient had. It was as double-blind as this type of study could be, and the repair was apparently no more effective than simple PT. I don't know whether any of this could be extended to ACL surgery, but I see no reason for aggressive surgical treatment.

Arthroscopy - Wikipedia, the free encyclopedia

Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed to evaluate or treat many orthopaedic conditions including torn cartilage (known by doctors as "meniscus"), torn surface (articular)...

Response by SPC George Long made Jun 30 at 2015 4:32 PM

SPC George Long — Tue, 30 Jun 2015 16:32:01 -0400

I tore my ACL in 2 pieces in 1978. I had had remaining sections removed and carried on. If your quads are strong you will never miss it.

Response by LCDR John Comar made Jun 30 at 2015 5:40 PM

LCDR John Comar — Tue, 30 Jun 2015 17:40:44 -0400

Absolutely do it! I blew mine out on a flight deck 24 years ago, surgery was done by Navy Ortho in Portsmouth. While the full recovery is a bitch (12-18 months), I am pain free and have no limitations because of it. Before the tear, I had a partial tear, that while not bad, would give out on me on occasion with moderate swelling. Most likely damaged the meniscus during the 6 yrs waiting for it to go all the way. i had the partial tear for 6+ years. VA rated the knee at 10% during my Comp and Pen exam. No argument from them. I agree with the PT recommendations too. Do as much PT as possible before the surgery, because you are going to need the leg strength afterwards.

Response by LCDR Ray W made Jun 30 at 2015 7:36 PM

LCDR Ray W — Tue, 30 Jun 2015 19:36:06 -0400

You will be better off. PT is hard at first use all your options. I had iit done, but my options were limited. I am better now. & so will you!

Response by CSM Charles Hayden made Jun 30 at 2015 10:02 PM

CSM Charles Hayden — Tue, 30 Jun 2015 22:02:52 -0400

SFC Walter Mack, A son had ACL Cadaver implant surgery last November. He did a LOT of recovery pt (w/ an ice bucket of cold water driven by a pump), and now says he is progressing well. As I understand, the 'rejection' rate for cadaver implants is about 50%. His surgery was done at Stanford, CA Hospital by the MD for the San Francisco 49er's. The surgery report had maybe 6 crucial? items that that surgeon attested he had personally performed.

Response by SSG Johnny Hall made Jul 1 at 2015 2:31 PM

SSG Johnny Hall — Wed, 01 Jul 2015 14:31:46 -0400

I had a acl reconstruction while I was active come to find out from the VA they need to go back in and do it. My knee gives out on me at times. Hard times Walking sometimes. You could be better with it depends if they do it right.

Response by PO2 John Briggs made Jul 1 at 2015 4:32 PM

PO2 John Briggs — Wed, 01 Jul 2015 16:32:28 -0400

Being 1 that has had 4 knee surgeries. ... I don't know what your job is....if you can do with out your acl....try it...the more you let someone in your knee the weaker it gets....work out you hamstring ....make it stronger...your going to need it stronger either wayside

Response by COL Larie Wilson made Jul 1 at 2015 4:51 PM

COL Larie Wilson — Wed, 01 Jul 2015 16:51:40 -0400

Get it done on active duty. It will cost nothing and you will be able to document it and it will up your disability rating when you retire. I had mine done about 5 years ago and have had no issues since.

Response by SSG John Erny made Jul 1 at 2015 5:12 PM

SSG John Erny — Wed, 01 Jul 2015 17:12:45 -0400

I tore mine in airborne school, as rigger they could not send me any where so I had to stay in the holdover room. 6 weeks of BS details. I feel you pain

Response by GySgt David Andrews made Jul 1 at 2015 5:30 PM

GySgt David Andrews — Wed, 01 Jul 2015 17:30:56 -0400

I had mine done back in 2005 after ever failing a PT test I went to the doc and they said I needed it done. I retired in 2011 after last deployment and went thru VA disability meeting and they filed for knee that I didn't think about since it was old. Receiving a percentage for my knee. I can feel it when weather is coming in and have a limp when I strain it.

Response by SGT Dale Briggs made Jul 1 at 2015 7:42 PM

SGT Dale Briggs — Wed, 01 Jul 2015 19:42:31 -0400

I tore my ACL while on duty completely in two. Having it repaired is well worth it. And is going to help protect your other knee in the long run because weather you realize it or not it's trying to compensate for your injured one. It's going to enable to cut when you begin to run again. It is totally worth having it repaired.

Response by Sgt Kris Newcomb made Jul 1 at 2015 8:25 PM

Sgt Kris Newcomb — Wed, 01 Jul 2015 20:25:08 -0400

I tore my right ACL completely twice while I was on active duty. The cadaver tendon was the first one and exactly 4 years later, I tore it. Use your own tendons. Last surgery in 1996 and is still working. Do your research.

Response by CPL Mike Vinson made Jul 2 at 2015 1:00 AM

CPL Mike Vinson — Thu, 02 Jul 2015 01:00:58 -0400

I had a complete reconstruction in 98. Just make sure your records are correct when you discharge. I've had to fight for the benefits owed.

Response by Sgt Joe Brown made Jul 2 at 2015 1:21 AM

Sgt Joe Brown — Thu, 02 Jul 2015 01:21:12 -0400

I had ACL surgery, make sure you get the cadaver part, it's called a alagram- if you opt to have part of your patilla tendon used, it's like having 2 surgeries in one, plus recovery time is longer. Lot of PT, it's gonna hurt, if you need it get it done!!!!!

Response by PFC John Sankitts made Jul 3 at 2015 12:12 AM

PFC John Sankitts — Fri, 03 Jul 2015 00:12:08 -0400

I had it done make sure it's not with VA benefits. Make sure it's with private doctors and insurance. I did mine with Jewitt.

Response by SPC Private RallyPoint Member made Jan 31 at 2023 10:48 AM

SPC Private RallyPoint Member — Tue, 31 Jan 2023 10:48:28 -0500

Had my ACL and meniscus repaired about 9 months ago and I’m still on crutches. My range of motion is so limited. I guess we don’t all recover the same way. My Knee feels stable now but I can only bend it to 90 degrees angle. I’ll also mention that I had a Deep vein Thrombosis following surgery with impacted my recovery as I couldn’t do much with physical therapy fearing of internal hemorrhage due to Blood thinners.