Tore ACL skiing. Don't want surgery. Can I ever ski again?

I know its explicitly not what you are asking for but I cant imagine why anyone would not want the surgery. Its a total slam dunk procedure, quick recovery and you will be back with better, after-market parts.

Everyone: thank you for taking the time to reply! This produced many more replies and much more information than I hoped to get. (Once again I'm reminded how much I love AskMeFi :-).) Here are some replies to specific comments above: @medusa: That link to Doctor Skeptic was a fantastic find. Thank you very much for that. I was able to find a follow-up paper (January 2013—link included below) to the 2010 Frobell et al. NEJM article mentioned in that Doctor Skeptic page, and the conclusions from that study still stand after a 5 year assessment. (That is, the study did not find a difference in outcomes for surgery versus non-surgery for their subjects even after 5 years post-accident.) @notsnot: I think I'm more squeamish than you :-). @H. Roark: Here are some of the reasons to think twice about having joint surgery:It's not just a decision about short term results: there are possible long-term consequences of having joint surgery. In medical studies, ACL injuries are well-documented as increasing the probability of developing osteoarthritis in the affected joint. This is generally attributed to collateral damage at the time of injury (e.g., to the meniscus) as well as to changes in how your joint moves. This leads to a question: does surgery reduce the probability of developing OA many years later, or increase it? And the answer appears to be: it does not reduce the probability. Here are just a few articles I've read that discuss this:http://www.nejm.org/doi/full/10.1056/NEJMoa0907797http://www.ncbi.nlm.nih.gov/pubmed/23349407http://www.ncbi.nlm.nih.gov/pubmed/21127860The surgery itself may be quick, but the process doesn't end there: the recovery will take much longer than the surgery itself. I already suspected that, and a number of people confirmed it in their replies to my question here. In addition, the following past discussions on AskMeFi document the length of recovery and some of the problems that can arise:http://ask.metafilter.com/219266/Is-my-knee-ever-going-to-get-betterhttp://ask.metafilter.com/39387/What-to-expect-with-ACL-reconstruction-surgeryhttp://ask.metafilter.com/20316/Possibly-torn-ligament-or-tendon-in-kneehttp://ask.metafilter.com/131142/What-kind-of-ACL-graft-did-you-get Just because you have the surgery doesn't mean that it will be successful or that the results will be without problems. Complications may arise during the surgery itself. It's a low probability, but it's not zero. @Rodrigo Lamaitre: Those are good points. I've been thinking a lot about them. @Shoggoth: It's incredible what you can do, and does give me some hope, as we're in the same age range. Overall: After researching the medical literature, studying over 40 journal articles, reading about people's experiences, talking to my doc, etc., I've decided to try physical therapy first. I'm also researching braces. My goal is to see how my knee recovers, and reevaluate the decision to have surgery in a year. Decisions to have surgery have to be weighed carefully. It would be different if I weren't able to walk without it, but as it is, right now I'm close to being normal in everyday around-the-house activity. I'm very, very glad to have the opportunity to think through the options and research the pros and cons, rather than make a hasty decision.

Here's some information that might be helpful in deciding: research shows that ACL reconstruction is often unnecessary. In particular, you can wait and see, then have the surgery later if needed. From http://doctorskeptic.blogspot.com/2012/09/cruciate-ligament-reconstruction-wait.html, a summary of the research on surgery for ACL tears: [P]atients will function just as well, and have symptoms to a similar degree if they opt to leave it alone and only have a reconstruction later if necessary, and most will avoid a reconstruction. H. Roark, why would anyone want to have unnecessary surgery?

I have one repaired and one un-repaired ACL, and I have no regrets about electing to not have the second one repaired. Both were skiing accidents--the first was in 1993 and although the repair (a patellar tendon graft) has held up well, I had complications after the surgery (broke my patella at the graft site a year later). When I tore my other ACL in 1998, I decided not to do the surgery, and that knee has held up fine. It very very occasionally ''goes out'' which can't be good for the soft tissue and joint, and may well set me up for some issues later, but it's been 15 years since then and I am not at all limited in my activities by either knee. I sometimes use a compression type brace when doing twisting types of activities. I ski with a custom brace on both knees; I used to ski quite aggressively even in the years after the torn and unrepaired ACL, though now not so much, but not because of any knee issues--just more cautious in my old age.

My son tore his ACL at 15 and had reconstruction surgery on the advice of the orthopedist and the physical therapist. He returned to high school sports, but found it too painful to snowboard. He also had a "dead spot" on his leg that never came back. Two years later later he tore it again while wearing his ridiculously expensive and physically limiting custom brace. Rather than see an orthopedist right away (we had an insurance change), he went to a sports medicine specialist and got what we think was good advice. He told my son to go out and live his life, and if he experienced limitations because of his knee then have the surgery. Otherwise, don't. The doctor cited a small study that showed a group of patients that did at least as well with PT only as a group that had ACL reconstruction and PT. Small so inconclusive, but it was enough to convince my son to wait. Now 20, my son has played intramural sports and returned to both snowboarding and stupid boy tricks. He wears a lightweight brace he got from the doctor. He sometimes experiences soreness and uses ice, but it is no worse than when he had a reconstructed ACL. At this point the surgery isn't even on his radar. Whatever route you choose, I wish you a speedy recovery.

I haven't had a left ACL since I was about 20, about two decades. I can walk and bike easily and spend a lot of time doing both, but the knee is pretty compromised for all other activities. I do go skiing occasionally and that knee is unstable and develops more pain in the course of the day, both in the joint itself and in surrounding muscles, which are straining to compensate for its looseness. I can't run at all without some pain, and I have to be very careful with activities that put a lot of lateral stress on it, like tennis. Can't do common yoga poses. It's gone out a few times on my at inopportune moments, such as at the top of a stairs. If I had it all to do over again, I'd have gotten the surgery when I was young and not as busy as I am now. One of these days I still hope to get my shit together to have it taken care of. Meanwhile, my wife tore her ACL in a fall maybe 6 years ago, got it repaired immediately and it is now the stronger of her two knees -- she runs probably 30 miles a week.

hi, i'm a manual therapist who is totally averse to most surgical procedures, i even avoid taking tylenol for headaches, ffs. but if surgery is at all an option, i would say go for it. my patients who have had their knees repaired seem to have less knee pain, and can be more active - but also less back pain, fewer hip problems, etc, because the body isn't always compensating for some huge laxity in one of the joints. having said that, if you elect not to get the surgery, you'll probably be fine until you're not - if/when you fall or do some twisty maneuver, a knee brace is going to help you but not save the day. good luck!

I would disagree with the "quick recovery" but if skiing is important to you, I would strongly consider surgery. The main thing the ACL does for a non-competitive athlete is slow the progression of arthritis. If you have some already, that may not be as strong a consideration. If not, as a skier you will want to keep it that way.

I am about mid-way through recovery of ACL surgery (allographt). Let me tell, the surgery is quick but the recovery is very long. Now if you do opt for surgery, you might be ready to go by the next ski season, so there's that. When I first met with an orthopedic surgeon for a consult, he told me basically the same thing. If I ever wanted to do active, cutting sports (like skiing or soccer), I would probably have to have surgery. He tore his ACL skiing and just gave up the sport. So yeah, I echo the others that say if you want to ski again and it's super important to you, get the surgery. Some days I'm annoyed at the whole thing, but then I remember I will get to play soccer again, so it's sort of worth it. Also, there's sort of a club of people who do their ACL.