Knee Injury from Ski Fall

[andywest]

Hello everyone
been reading this forum for a wee while know following my own ski accident

In march I collided with another skier and had a bad fall, ski bindings did not release on hire skis
and I knew straight away I was in trouble as I felt my knee go !!
tried to ski on but it was no use and I felt like I had little control over the affected leg
and had the sensation that the lower half of my leg was "hanging" and moving outwards as I
walked, any knock to my foot ect gave great pain in the knee.

Given it was 2 days till I returned home I waited and went to my GP on my return
who immiedatly suggested a total MCL rupture on a quick examination and said it needed
braced ASAP and referred me to the hospital Ortho Dept
after a TWO WEEK wait and no word about brace I went to Accident and Emergency and
was put in a splint and saw the Ortho Surgeon 2 days later
He diagnosed a full MCL rupture with laxity in the ACL suggesting a partial tear
but I was never given an MRI scan and instead began 4 months of intensive rehab that greatly
improved my mobilty but fast forward to now and I still have a feeling that my leg sort of hangs
from the knee, I still get some pain when my foot gets knocked or I twist on the knee and
sometimes it just aches. It also pops and clicks a lot sometimes when it clicks it feels like its
about to give way and I stumble slightly but it has never locked or I have never actually fallen because of it ?
Went back to my GP and he said the MCL is still very loose and has referred me back to see
another surgeon.
So do you guys think I may have ACL problems ? does it sound like the MCL is not healing as well as hoped and may need looked at and should I demand an MRI scan to make sure once
and for all.
The reason the original surgeon said he was not giving me a scan was because I never heard a
loud pop but as I was tumbling around in the snow and shouting a few obscenaties at the time
would it have been that loud to hear over all that.
Its really making me depressed as I have an active job that requires jumping in and out of an large lorry numerous times a day and I have to make sure I land on the good leg as I just basically do not trust the bad one. Its hard to describe but feels like I have a small weight around my foot all the time on the bad leg that is pulling at the knee joint ??? does that make sense to anyone

sorry to ramble on at length I am just looking forward to talking this over with those who have suffered likewise

Andy West
Scotland

[Heidi]

Hi Andy

Well, I haven't suffered the same injury but I do have experience in treating this kind of injury.

My opinion is that you should try to get an MRI. You are right that you may not have heard a loud popping noise at the time, or there may not have even been one. I don't think this is gospel when it comes to diagnosing ACL injuries although it is a common feature it is not always reported!

If you have fully committed to a rehab programme over a 4 month period and the knee is still this unstable and causing you problems in your job (compensating with the other leg could cause overuse injuries there too) then you should definately push for an MRI and depending on the findings, surgery. I would have personally though that if damage to two of the main ligaments in the knee was suspected, then an MRI would have been pretty routine.

[andywest]

Thanks Heidi
When the Ortho surgeon examined the knee he said the MCL was definatly completly ruptured
given the amount of laxity in the joint he also said there was a good deal of laxity in the ACL
but that it had an "end feel" suggested a grade 1 or 2 tear to that ??
and that he hoped the rehab would do the job as the MCL would heal itself ??
and the strengthening at the rehab would help the ACL ?

I just feel that although the MCL is much better it has obviously not healed properly or
that there were other problems in the first place
at least if I can get an MRI it will help rule out or rule in all the possibilities

Is it possible for the ACL to heal itself from a partial tear ?? I thought I read that it was not
possible for that ligimant to heal on its own !??

Many Thanks
Andrew

[QUOTE=Heidi;3283]Hi Andy

Well, I haven't suffered the same injury but I do have experience in treating this kind of injury.

My opinion is that you should try to get an MRI. You are right that you may not have heard a loud popping noise at the time, or there may not have even been one. I don't think this is gospel when it comes to diagnosing ACL injuries although it is a common feature it is not always reported!

If you have fully committed to a rehab programme over a 4 month period and the knee is still this unstable and causing you problems in your job (compensating with the other leg could cause overuse injuries there too) then you should definately push for an MRI and depending on the findings, surgery. I would have personally though that if damage to two of the main ligaments in the knee was suspected, then an MRI would have been pretty routine.[/QUOTE]

[andywest]

Update

Saw Surgeon today who said in his opinion my knee is about 80% of normal
and there is definatly instability in the joint so its not just in my mind

He has indeed referred me for an MRI scan

but he did say that in his opinion surgery would probably not be the way to go
as even after surgery it may mean only getting up to 85/90% and that it
would not be worth the hassles involved as he couldnt promise it would be
that much better

from what I was able to pick up the problems were during the pivot test
so does that mean ACL as opposed to MCL that is causing this ???

4 to 5 week waiting list for MRI scan :-(

[Heidi]

I think all you can do is wait for the MRI unfortunately. It will either show that the damage was as expected and then its back to following the surgeons advice on no surgery and continued rehab. Or...they will find something different, then it depends on what it is as to how you proceed.
I think the test you refer to is the pivot shift test - which is for ACL injuries.