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Hyperextended: An ACL Story By: Natalie sell

In mid-October of 2019, I tore my left ACL. The injury occurred during a field hockey game, in which my knee went backward instead of forward while I was sprinting down the sideline. My knee tripled in size overnight and developed a squishy texture that I consider similar to a beluga whale’s head (or a puffball mushroom, if you are so inclined).

The beautiful incision in question
Electrical muscle stimulator therapy

Above are pictures from my MRI. Through the persistent and cacophonous noise, I managed to fall asleep and therefore remember very little of the process itself. The top image shows my ruptured ACL between my femur and tibia. Despite what the picture shows, ACLs are generally not supposed to look like cobwebs between the two bones. The second image shows the bleeding in my bones (the white stuff that’s definitely not supposed to be there). Bone contusions are common with ACL tears, but they aren’t usually as severe as mine, which means that my surgery was more delayed than most.

The bone contusions also resulted in a large effusion (accumulation of fluid) around my knee. This fluid was extracted with a needle and syringe in a rather unpleasant process that I have included a video of (watch at your own risk- the exciting part starts at 2:40). Here is the link to the video: https://drive.google.com/file/d/1pDI8d7QlgNk0It6QJEiV0zmLVdBViHaw/view?usp=sharing

After the swelling went down, my physical therapy started. I went twice a week for several months, and eventually built up strength I had lost and got rid of the crutches. Turns out, if you try to go too fast on crutches, you can get tendinitis in your elbows. Also, you might fall.

I had surgery on February 12, 2020. I got there at 6:30 in the morning and they gave me one of those beeping, flashing discs that go off when they call you to the front, like at Panera (not sponsored). No matter how much I expect it to go off, it scares me every time. I went back with the nurse and changed into my hospital gown, very carefully holding the back closed in order to avoid flashing everyone at the hospital, though I doubt it would be an uncommon occurrence. After I got into the bed, they wrapped my right arm in a warm towel to dilate the blood vessels before they put in an IV.

Me with my burrito arm
Me with the IV, looking lunch lady chic.

They placed the EKG electrodes and marked the correct knee to operate on, and I was ready. I don’t remember being wheeled into the operating room, but I woke up about 3 hours later with snacks. There’s much about that day I don’t remember, but I was apparently very concerned that if I went to sleep, my dad would eat my snacks (he didn’t, by the way).

After surgery, I got into the car with great difficulty and for some reason decided to answer all of my emails. At this point, I was still feeling the effects of the anesthesia and painkillers, so this was a regrettable decision that I will not include the details of.

The next day, I met with the physician’s assistant and my surgeon to unwrap the gauze from around my leg and discuss what they had found during surgery. Fortunately, they hadn’t had to do any work on my menisci, which were slightly damaged but not fully torn. The surgeon did find that my lateral ligaments were naturally loose. This puts me at higher risk for reinjury or injury of the other leg. However, these risks can be reduced by strengthening the muscles to make up for what the ligaments lack.

The menisci of my left knee
The unveiling of the incision below my knee

The ACL reconstruction surgery consisted of going in and taking the middle third of my patellar tendon and using it to replace my torn ACL. The patellar tendon will not regenerate, but it can regain its strength with physical therapy. This surgery resulted in two incisions: one directly below, or inferior to, my kneecap, and the other on the lower, or distal, left side of my thigh. To secure the ends of the graft, the surgeon used the bone plugs and screws to compress the bone to help it heal more quickly.

My left leg with screws in
My ACL before the surgery
My ACL after the surgery- new and improved, made of patellar tendon

When I went back to physical therapy, they told me I had a “beautiful incision,” which I chose to take as a compliment. The exercises they gave me were mainly to improve range of motion, especially getting my left leg to hyperextend as much as the right one does naturally, which is the first objective after surgery in order to keep everything working smoothly and avoid tissue buildup in the joint. They also gave me an electrical muscle stimulator for my quadriceps as an addition to my home program.

The beautiful incision in question
Electrical muscle stimulator therapy.

While this experience hasn’t been easy, I think it’s been a valuable one. Being on crutches in particular gives me a different perspective, and forces me to ask others for help more often, which I tend to avoid. As of today, which is February 19, 2020, I can bend my left leg almost 90 degrees. The rest will come back, in time.

Created By
Natalie Sell
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