Anterior Cruciate Who?!

In this post I will be briefly explaining what the ACL is, what options I had for recovery, and what decision I finally made. I have greatly simplified all of this to give more of an overview of the options and procedures… I am not a doctor of any kind! You can always reach out to me if you have any further questions.

I had heard the term ACL before, I knew that is was in the knee, and I knew that a lot of professional athletes had problems with, it and that was pretty much it. So, in simple terms, the ACL is the ligament that essentially holds your leg strong and together when you pivot or transfer weight. It runs through the middle part of your knee on a diagonal from the back of your femur (your thigh), to the front of your tibia (your shin). When the ACL is torn whether it be partially or fully, the leg will lose a lot of its strength and stability (some people can still walk after, and some report constantly falling over).

What causes it?

Most commonly an ACL injury occurs when there is a sudden stop or change of direction - like twisting your knee… or…falling from a lift as a dancer, cough cough.

When I first looked into my options, I was finding a lot of mixed reviews on whether or not I needed surgery at all (I was originally told that it was a high grade partial tear - NOT SO BAD… later to learn that there is nothing left of my ACL… VERY BAD). Naturally I got really excited about the possibility of not needing surgery so I looked into those options first. There had been lots of research done to see if physiotherapy was simply enough for an ACL injury. I liked the sound of this. On the other hand there was a lot of research that pointed to surgery being the superior option. The main problem was that I didn't see myself in the data. However, once I started looking for dancers with this injury it was made very clear that surgery was the ONLY way that I was going to dance on stage again.

My daily reminder

Once surgery is established there are so many different options. I learned A LOT of new big fancy words that made me sound like I knew more about this than I did. There were the options of the allograft of the autograft… Allo-who? Auto-what? The ALLOGRAFT is when you are using a donor tissue to replace the ACL, and the AUTOGRAFT is when you are grafting tissues from your own body. Naturally I wanted to look into the donor first as it sounded like it was going to hurt a lot less. I found that it is not advised for young athletes to use a donor as they have a higher failure rate over a period of time, and can sometimes be rejected from the body… well there goes that one. Next I started researching the autograft option. When it came to the autograph there were a lot of different places that I could graft from. The two most common options that I found were to graft the Patellar tendon performing something called a Bone-Patellar Tendon-Bone procedure, and the hamstring. The BPTB procedure, they take 1/3 of your patellar tendon and a part of the bone - well as a dancer this did not sound like a good idea (why am I going to take away even more stability in my knee?). I learned that this option often leaves the athlete with chronic anterior knee pain, and makes it very hard and very painful to kneel. Well… you can see how this would be problematic for someone like me who spends my days jumping, rolling around on the floor and hanging from the rafters, not to mention the crazy activities I make my boyfriend do with me around the world in our free time(ie. swimming with sharks, hiking to the tops of mountains, helicopters, surfing on Waikiki and much much more). I almost immediately decided that there was no way this was the only option for me, even though the first surgeon I met tried to convince me of this, even agreeing that it would make the return to dance very hard. He then went on to tell me that there was no way he would use my hamstring, as women have weak hamstrings (try and tell a dancer of over 25 years that). Thank goodness I was proactive and did my research, because you better believe I challenged this doctor. I was not convinced he was willing to try anything he could to get me back to the stage.. THANK YOU NEXT!!!

After seeing one more surgeon while I was in the states it was decided that returning home would be the best and most productive decision. Luckily I have the BEST family doctor in the world, and through a series of being in the right place at the right time, she was able to get an appointment with a surgeon at home in Toronto who has worked with dancers from the National Ballet of Canada. This was all I needed to know… I felt like I was finally going to see someone who understood me and was going to be willing to work with me to make sure that I get back where I belong. My first meeting with him was wonderful and a weight was instantly lifted. He actually didn't give me options, rather he told me what was going to be done, and why this was the best option for a dancer specifically (finally some answers that made sense, and a doctor that spoke the language of dance!). The option that we were going to go with was to graft from my quad tendon (I didn't even know this was an option prior, but it made total sense when he explained it). This tendon was almost twice as thick as the other options, was not going to leave me with chronic pain or problems kneeling, and the rest of my quad tendon would be able to heal and grow back. Insert the moment that almost made me cry and brought a tear to my moms eye - he also said that he was going to provide me with my previous hyper extension because of its importance to a dancer (he just gets it!!!!).

For this procedure they will be grafting about 10cm long and 1cm wide of my quad tendon (2cm out of that 10cm being the top of my patella a.k.a, kneecap). They will then drill two holes- one in my femur, and one in my tibia. They will thread the new tendon through these holes in my bones and anchor them in with titanium screws… basically I will be a super hero haha! Now imagine having your quad sliced down the middle… this option is probably one of the hardest recoveries, not in the new ACL, but with the recovery of the sliced quad. However once I get through the initial rough patch, this option just makes the most sense for my lifestyle.

What I learned through all of this was do not settle. Do not settle for a doctor that doesn't listen to you, or understand you, or make you feel comfortable. Do not settle for others telling you what is best for you - DO YOUR RESEARCH - you have to become your personal advocate of your health care, your treatment and your recovery. There will be someone out there that is the right fit for you, this is not a minor surgery so make sure that you are working with a team that you fully trust, and that you believe is on the same page as you!

Coming soon I will be keeping track of this recovery and will let you all know the good, the bad, and I am sure the unfortunately hilarious.