Advice from my ACL Surgery

knee-braceWould you like to learn from someone else’s knee surgery experience? This is a summary of what I learned through my ACL surgery (which took place in February of 2009):

  • Yoga is an excellent way to build strength and balance prior to surgery- something that I reaped the benefits of post-surgery, because there’s a lot of hobbling around in crutches and balancing on one leg while reaching down and picking up things
  • Wait a while before the surgery. It took 6 months for my swelling in my knee to go completely down where I regained most of my motion back and was able to do strength exercises. The surgery is said to be more successful after all the swelling subsides. Just be careful in the mean time to not reinjure yourself, and it will be worth the wait.
  • Ice machines are good if you have people around to help maintain it. They run out of ice quite often, every 1-2 hours. So, unless you have people helping you with it, you won’t get much rest constantly getting up to fill the machine with new ice and drain out the old. Crushed ice is worst, regular size ice is mediocre. The longest lasting is homemade ice in 16oz cups- denser- and still fits in container- it may last 3-4 hours each batch. There’s also an electrical shock hazard on the Game Ready ice machine I had. Water from the drainage may leak onto the AC outlet underneath. What were the product designers thinking?
  • Try to avoid hopping on one leg with the other one dangling within a week after surgery. I suspect this and other extra movements led to me having some extra pain and internal bleeding- which they had to manually drain with a needle 1.5 weeks post-surgery.
  • A wheelchair is not a bad idea, as an alternative to get around in your home.
  • For rehab, it’s better to listen to your body (pain level) and let that dictate the speed of recovery rather than follow a physical therapist’s recovery timeframe to a T. It’s ok to take the exercises slow- there’s no rush.
  • It’s nice to have a cart on wheels. One that’s not tippy. You can put dinner plates on it, and roll items from the refrigerator to the table, or for moving your heavy ice machine around, etc. Otherwise, it’s a challenge moving objects around the house with crutches.
  • Don’t try to touch toes to put on/off socks- I may have pulled my hamstring doing that.
  • Don’t pay your bills too soon! Wait until absolutely everything is resolved between your providers and insurance company first. You don’t want to start paying bills you don’t owe. There’s a degree of negotiation between the provider and insurance company and it’s best to postpone paying until everything is settled and knowing that you’re not getting jipped- it puts you in a better position to negotiate in case your insurance didn’t cover something they were supposed to.

Post ACL Surgery Timeframes:

  • Same day: went home and used crutches to get around
  • 1.5 weeks – stopped using the ice machine full time, much of the swelling gone
  • 2.5 weeks – started driving (very carefully) and went completely off pain pills.
  • 3 weeks – less dependent on the knee brace- went without it- and start walking.
  • 3.5 weeks – able to climb/descent stairs
  • 4 weeks – started walking without crutches, able to use stationary bike and do light squats

Insurance companies will harass you and will try to find any loophole possible to not cover your benefits. As tedious as it is, it’s best to speak to the billing department of each of your service providers in advance and get price quotes and take good notes with who you spoke to, dates, billing codes, time spent on each procedure, etc. Then speak to the insurance company and ask them based on this scenario what your coverage will be. They are trained to be extremely vague about everything, so it takes some work. Take detailed notes on everything.

How much does ACL surgery cost?

I got a couple quotes (before insurance coverage) and here’s the range…

Surgeon fee – $1,350 – $2,200
Facility fee – $810 – $9,300 (huge range!)
Anesthesia – $748 – $845
Implant fee – $500

Other fees:
Full knee brace – $490
Ice machine rental (2 weeks) – $300 (not covered by insurance)
Prescription pain medicine – $100
Crutches – $30

Get more info on ACL Surgery Costs

If you are having a hard time with the cost aspect of ACL surgery, there’s nothing wrong with shopping around and choosing a different doctor. You can even travel to a larger metro area if its important enough.

Insurance issues

My insurance is supposed to cover 80%, but with the deductible, 20%, and some things not covered, when it’s all done it’s supposed to be $2,000 – $3,000 to me. That’s a little too vague of a price range for my comfort, but that’s part of the billing game.

It’s 5 weeks out and my insurance company is playing the game, saying initially that my benefits are denied, while requesting an ‘incident report’ form to be filled out. Basically, they’re trying every possible scenario to get out of paying, fishing for someone else to be potentially liable for the incident. I think they’ll have to pay though, according to the conditions of the plan.

Provider issues

The providers are also a little tricky in the way they bill. For example, they quoted me only the surgeon’s fee each time I asked about billing with no mention of any other weird fees. But now that it’s over, they decided to bill separately for one of the assistant’s time too. I would have wanted him out of the room if it were up to me- it would have saved $490.

The providers also quoted me one rate and billed another- higher $ of course. They also said the prices will be going up after the new year, which may be reflected in my bill. There’s really no guarantees of anything and the patient is in a very poor position for negotiation.

I hope this information helps someone. I wish I had this kind of info beforehand.

Remember to also read everything on this site and read the ACL surgery tips and comments from other people.

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Learn about the decision of which graft to get: Patellar vs Hamstring

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28 thoughts on “Advice from my ACL Surgery”

  1. Excellent information Trent. I am glad you are much better by now.

  2. Thank you so much. My surgery is coming up and I am scared to death. Everyone keeps telling me how terribly painful it’s going to be.

  3. Thanks for your info. My surgery is scheduled for 9/23/09 and like Nansi I’m terrified!! I’ve heard so many horror stories. I’m hoping I’m making a bigger deal of it in my mind…..

  4. Thank you for posting this. it is really helpful you gave the ballpark on the cost of the surgery. my surgery is coming up and i have been trying to pry this info from the provider and the insurance company..nightmare. i do not know when you had your surgery, but i hope you are all better!

  5. Excellent information, thank you.

  6. Hey guys just got my acl surgery,

    do yourselves a favor and chill about the pain- you get meds to take care of it and if you have a little pain along the way it won’t kill you. Just try to take care of yourselves as best as possible to facilitate good recovery.

    And trent-good info, right on the “money” about insurances

  7. I just had surgery on monday, and boy does it hurt. really bad swelling. I have something similar to an ice machine but it is like a cooler, runs water around my knee (not in it) at a 43 degrees. 1st week in and its really bad

  8. Hi,

    I have a question about the recovery. I had it done last Friday (cadaver) and I am still in bed and not being able to do much. I can crutch to the bathroom and all that good stuff without help anymore. I am very careful with the pain meds since they make me very sick. How long was it until you could bend your leg? And how long until you could go out in the world! I am in college right now and counting the days until I feel alright enough to go back to class!

    Thanks so much,
    M

  9. Thanks Trent! This is extremely helpful! Great suggestion on the pre-surgery yoga too! I hope you are feeling much better.

  10. Hi,
    I am a 49 year old Male who is facing ACL surgery in aprox. 2 weeks. I am very active ski 70+ days a year and Fly Fish is some nasty wading. I am looking at a Hamstring Graft my Surgeon uses the APERFIX securing system. Its fairly new in the last 2 years but my research says it looks promising, to prevent stretching out over time.
    My question is did anyone out their have the Hamstring Graft using this APERFIX system and what is your feedback.

  11. Excellent advice and tips! I just found out my ACL is fully torn and I will be getting surgery (after i go to Hawaii in a couple of weeks. I will not be doing any crazy activities there.)

    Good recovery to all!

  12. B.Raghunandan says:

    Thanks for information i got done ACL surgey two months back no need of any fear
    but my recovery is getting delayed i want to know the reason kindly help.

  13. aclsurgery says:

    Hello. 2 months post surgery is not very long. It can take 9 months to a full year to fully recover from ACL surgery. Give it time. Even though doctors and PTs can give estimated recovery timeframes, everyone is a different. Keep being proactive in strengthening, stretching and getting range of motion, but other than that, relax and give it time.

    1. i was wondering if i could talk to you on acl surgery i had in august.

  14. I had a hamstring (cadaver) acl surgery along with a meniscus, PCL, and lateral ligament repair due to knee dislocation. After my survey 4 years ago, I had minimal pain and was able to complete several 5k, 10k, and three half marathons. About 3 months ago I started getting severe knee pain and swelling. I have an appt with surgeon but wanted to see if you had any advise before I go in.

  15. NotGivingUp says:

    I tore my ACL and menisci about a month and half ago. My question is similar to “M’s” above. I have seen My ortho and scheduled surgery two weeks from now. I will be using my hamstring as the replacement. This schedule puts my surgery in line with our family’s thanksgiving. My family gets together once a year and it’s a week before Turkey day. I don’t want to miss them or my turkey. If my surgery is on a Wednesday and the celebration is on Saturday, think I can make it? BTW this website has been a great help!!

  16. aclsurgery says:

    Hello! I think 3 days after your surgery you’ll be fine for enjoying the celebration as long as you don’t mind feeling needy/vulnerable in front of your family. You’ll be on crutches and it will be harder to mingle. You’ll probably be scaling back pain meds a little at that stage. It’s advised to lay horizontal and keep your leg iced and elevated as much as possible during the day. So, if that’s a comfortable thing for you to do in a family situation for them to take care of you then go for it. Personally, I would not want to be around family in that condition, but everyone’s different. Hope that input helps.

  17. Hi there! Thank you soooooooo much for your information. I have been in tears the last few days because my husbands surgery is set for wednesday before thanksgiving and we thought everything was set with insurance. Until all of a sudden they told us they aren’t covering anything anymore because of how/when the injury happened. Can you tell me who to talk to to negotiate fees?? Would that be the surgeons office or the hospital where it’s done. My husband is going through the surgeon/dr. from the college he coaches at and the surgery will be done at an outpatient center. I am just confused on where to start to get help on lessening the costs as possible. Wouldn’t insurance rather pay it now, rather than make us wait 6 months and have to pay more costs for a worse injury? Would they even listen to that reasoning?? ANY help would be great. I am in grad school and his job is definitely not adequate to pay off a 20,000+ bill!

  18. aclsurgery says:

    Hello, thanks for sharing.

    It sounds like you feel a lot of pressure and maybe your husband does too. Well, I have the solution: postpone surgery. That’s right! Sounds too simple, doesn’t it. There is nobody saying you have to have it by a certain timeframe. There’s no expiration date for surgery, seriously. Just push it off until you’re at a more secure place in your life financially and otherwise, to proceed. There is absolutely no reason to put yourself through a whole stressful situation for no reason. He can always have the surgery later- 1, 2, 3 years or more later, it doesn’t matter. He should just be careful in the meantime to not to a sport that injures himself worse.

    In a few years from now, when you have a better financial stability, then he can do the surgery and it would be much easier for your family. You’ll have lots of time to shop around and compare rates. Since its pre-existing condition, its unlikely insurance will help at all, either now or in future, but worth asking down the road when you’re ready.

    Hope that helps.

  19. I’m 36 years old and have had 2 ACL surgeries. My first ACL surgery was in 1998 when I was 23 using the Patellar graft. It was a long recovery and I still have pain and sensitivity shen kneeling on my right knee. It feels almost as if there is no cushion between my bone and the ground. My second ACL surgery was in 2007 using the Hamstring graft. I have no pain in my left knee whatsoever but I do see a slight striation behind my leg (hamstring) when flexing the muscle. I assume this is where the portion of hamstring that was removed used to be. I do notice a strength difference between my left hamstring and right hamstring which bothers me because I am very athletic. I have gotten used to it though. Every now and then I will cramp when over exerting myself but it is something I’ve gotten used to. When comparing the stability of both knees I feel that there is no difference. Both knees are strong and I have no fear of re-injuring them. I actually feel like they are stronger than before I got injured.
    The recovery time for the patellar graft seemed to take a little longer than my hamstring graft. I was almost 10 years younger when I had my patellar graft acl repair so I often wonder if my recovery time would be longer with the same procedure now that I am older. The hamstring graft was definetly less painful and seemed to require less effort to gain my full range of motion back. Over all, I think the patellar graft is more suitable for a person who is very active and/or into sports because your muscles are not compromised. The trade of is that there will always be pain when you kneel, but it is very minor (2-3 at worst on a scale of 100).
    If you spend a lot of time on your knees working, or if you have a hobby that requires you to be on your knees, go with the hamstring surgery.

    1. Miss Dragonfly says:

      Thanks for the info on comparison. After much thought and research, I decided to go for the patellar graft, even though I am older (40). I am very active, have an active job and don’t plan on stopping (other than for 9months to fully recover), so I felt it was best suited for me.

  20. Bill Wagner says:

    I am now 4 years out from my ACL replacement surgery (cadaver). I’m now 68 and very active. Skiing (at which I was injured), mountain biking, racquetball, hiking are a few of my current activities. I have total recovery with no pain other than that which age brings. In fact, my ACL repair knee has less pain than my original equipment on the other knee.
    I pushed into surgery as quickly as the swelling went down (two weeks or so). Post surgery I pushed (gently) getting mobility back – which means for me, bending that leg until pain was telling me “that’s enough for right now”. I also did a lot of walking, but was especially cautious to elevate my leg when not moving around. Also, a stationary bike at the gym was a good exercise if you pay attention to not push the pain level.
    I went beyond the program of my physical therapist, but sensibly. Therefore, I was told by my doctor that I was Non-compliant – but, he added that it seems that non-compliant people, who are sensible, seem to have a quicker and easier recovery.
    Plan on working at recovery and even at an old age you can expect full activity in six months.
    For me – the process – and recovery is a process – was worth it. And, the cadaver route was the best choice also since there is only one surgery site to recover from.

  21. Polishmommy says:

    thanks for all the info. I am 8 days post op, and I bit surprised because my doctor said no knee brace is necessary…I guess every doctor has different advice, which makes me nervous!

  22. Lydia Lee says:

    1st of all I want to THANK -YOU everyone that contributed content & comments on this website!!

    I’m a 52 year old female, kid at heart, can’t grow-up, active, in excellent health & physical shape, thrive on exercising (biking uphills, hiking summiting mountains, simply love climbing to SUMMIT!!!). I just returned from summiting Mt Kilimanjaro early Jan 2013 and 2 weeks later, I tore my ACL doing capoeira at my gym (Brazilian martial art) which is routine workout for me 🙁

    Yea, pain, sadness, pain, sadness!!! At age 52, not many bother with surgery but simply go on with detach ACL and just modify your lifestyle as needed. I consider this as I regained my flexibility & strength in Pre-Op PT. But following my heart, I knew I want to summit more heavenly mountains on my bike & on foot for many more years this lifetime! So the right personal decision was to go for ACL surgery 😀

    The next decision was do I harvest from cadaver or autograft from hamstring? I knew I did not want autograft patella. This decision also meant different surgeon for the method I choose. I was overwhelmed but I was so appreciative of this website, the content, the real patient’s blogs – I found real comments, reassurance that allowed me to comfortably make my final decision.

    Last week, 3-12-13, I had my ACL surgery with autograft hamstring! Like some of you already said, WOW!!! PAIN like heck few days post-Op. But today’s Day 7 for me and with daily use of Iceman (ice therapy machine) + daily 6 hours of CPM @ home, rehab is going very well. The awful swelling with my ankle & calf has substantially gone down. Every hour, everynday, I know I’m getting better & stronger, hooray!!!

    I will blog again to let you know when post-Op I finally was able to spin on an indoor bike, & better yet, when I get on my real bike & do my 1st outdoor ride c: With great hope, patience, determination, I know I will make a comeback & bike the Pyrennes and the Alps again, just as I conquered it few years ago – Cols de Galibier & Tourmalet, I will be back “soon” with a stronger renewed right ACL 😀

    Thx to all the contributors of this website again!! Cheers & Hugs, Beija-flor c:

  23. I was very nervous about my surgery. I was not sure what kind of pain I would have. I am an active 46 year old female. I had a autograft hamstring done three days ago. I want to do all I was told and am icing every minute I can, doing my PT exercises three times a day and using the CPM machine six plus hours a day. I guess it is different for everyone. I have not needed any pain meds today and managed a walk outside today. I really feel good I am tired of laying on my back but will ice for the ten days plus follow other directions. I think the key exercise is doing the isometrics. I think it is very important to do them as much as possible pre surgery and post. It hurts when you are doing it but it always feels better after.

  24. carpinteyroxhn says:

    ice machine not only won because of the evaporation temperature below the dew point temperature condensation caused by moisture content, but also moderate increase the moisture content of the outlet air; thus improved both the cooling effect of household air conditioners, humidifiers

  25. pletchermig says:

    ice machine outlet to an additional enthalpy humidification device, you can resolve these contradictions.

  26. Hi I would like some advice onacl surgery.I am 52 and overweight I torn my acl in a auto accident.I.I also mess up my disks inmyback my husband salsa broke aboneinhis wrist so any helpful lnformation would be abighelp ialsohave other damage to myknee

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