Ruptured ACL and torn meniscus - What do I do with my horse?

Polos

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I posted a couple of weeks ago that I had managed to tear the meniscus in my knee. Unfortunately last week the consultant decided that after reviewing my MRI I needed to be booked in for an emergency arthroscopy and debridement surgery over the weekend.

What was meant to be just a 'day surgery' has meant I was kept in for 2 nights. Thankfully I was discharged this evening so I am now back at home.

This morning when the consultant came to see me he broke the news to me that I would need ACL reconstruction surgery but would need to wait a few months until I've done some physio so the knee is strong enough to go through the surgery. He said I wont be getting back on a horse for between 4-6 months but he wasn't clear whether this would be from the reconstruction surgery or this arthroscopy. I have an appointment in 6 weeks so will ask then.


Right now I don't really know how to feel, what am I going to do with my horse if I can't ride her for 6 months :/ I'm absolutely heartbroken at the prospect of not riding.

Shes currently having a month long holiday in the field but what do I do? She's too sharp to loan out to someone, I'm not sure who else will ride and compete her and it would just be a waste of a talented horse dumping her in a field for 6 months .

sorry this has turned into a rant, I'm just very frustrated right now :(
 

Sukistokes2

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Horse won't care a sausage about being wasted. Just stick her in the field for the summer and worry about yourself. My friend did the same thing playing hockey. It was a long recovery but she has been fully sound since and back playing hockey. It seems ages now but it will pass quickly enough. Good luck.
 

Polos

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Horse won't care a sausage about being wasted. Just stick her in the field for the summer and worry about yourself. My friend did the same thing playing hockey. It was a long recovery but she has been fully sound since and back playing hockey. It seems ages now but it will pass quickly enough. Good luck.


She's already had her shoes off so like you say I could just leave her in the field for the duration and bring her in when I'm ready. Thankyou for your response, I didn't know whether I was being silly for thinking about chucking her in the field
 

criso

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I had a similar injury to you about 18 months ago - torn medial meniscus, torn/partly detached acl and an impaction fracture the tibia. We decided not to do the reconstruction surgery for the ACL as the statistics on improvement with reconstruction v leaving it to heal on its own was 50/50 and he said he wouldn't let me ride for 6 months if I went for this.

Just did the arthroscopy on the meniscus - I had to wait max time for this on the NHS (and I had initially been misdiagnosed at the urgent care centre when I did it so it was 5 weeks before it was MRI'd) and negotiated with the consultant that I could ride while waiting. His wife rides so he had an idea what he was dealing with. No rising trot, two point seat or jumping. I dismounted on a mounting block. My horse was coming back into work after having his back medicated so he was at a crucial point and he would have gone backwards if I'd backed off completely. I quickly discovered that lunging was not an option as if they pull away or have a moment, you put a lot of weight through your legs/knees to counter this so that was out of the question.

By the time they operated, they assessed the ACL and established it was healing well naturally and had reattached.

After the op I followed my rehab plan with the physio, she wasn't sure about riding but I made a judgement that the point that my rehab plan said was safe to starting riding a bicycle would be safe for gentle hacking - about week 3/4

Many of the muscles I was being asked to use in my physio exercises to strengthen my knee both before and after surgery, are the same ones I use for riding so IMO the only issue really was safety.

A meniscus rehab is usually 5 to 6 weeks so I would say your consultant is talking about the ACL reconstruction.

ETA the biggest issue is if your consultant has no idea what riding entails - I was lucky with my consultant but not the physio. They really don't know what muscles you use and sometimes have an overinflated idea of the dangers.
 
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silv

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I can understand your fraustration, but in the grand scheme of things 6 months in the field isn't really that long, I would just keep her turned away. The only other option would be to send her to a professional to ride and look after but that would work out expensive.
 

MDB

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it will be 6 months after surgery. add on several months to strengthen the knee prior to surgery. so you could be looking at 9 to 12 months.

To add.... There is a massive difference between meniscal surgery and ACL reconstruction. The thing to remember is that whilst you may physically have the strength, movement and stability to ride at 6 months post op, the actual new ACL graft is at it's weakest point around this time. This is because they basically chop part of your hamstring ir patella tendon out of you and attach it to a new area. At this point it has no blood supply and in effect starts to die off and weaken. It takes months for the revascularisation to take place and the new ACL to strengthen again. So whilst you may be able to physically ride at 6 months, if you do have an accident and come off, the risks of really doing damage to your new ACL are really quite high.
 
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sport horse

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I had 15 months out with a badly fractured femur. 5 yo horse did very little - husband occasionally hacked her out but he had his own horse, a full time job and a useless wife so not much time! Made no difference, once I was back in action getting the horse re started got me fit and she was subsequently a huge winner show jumping.
 

Polos

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I had a similar injury to you about 18 months ago - torn medial meniscus, torn/partly detached acl and an impaction fracture the tibia. We decided not to do the reconstruction surgery for the ACL as the statistics on improvement with reconstruction v leaving it to heal on its own was 50/50 and he said he wouldn't let me ride for 6 months if I went for this.

Just did the arthroscopy on the meniscus - I had to wait max time for this on the NHS (and I had initially been misdiagnosed at the urgent care centre when I did it so it was 5 weeks before it was MRI'd) and negotiated with the consultant that I could ride while waiting. His wife rides so he had an idea what he was dealing with. No rising trot, two point seat or jumping. I dismounted on a mounting block. My horse was coming back into work after having his back medicated so he was at a crucial point and he would have gone backwards if I'd backed off completely. I quickly discovered that lunging was not an option as if they pull away or have a moment, you put a lot of weight through your legs/knees to counter this so that was out of the question.

By the time they operated, they assessed the ACL and established it was healing well naturally and had reattached.

After the op I followed my rehab plan with the physio, she wasn't sure about riding but I made a judgement that the point that my rehab plan said was safe to starting riding a bicycle would be safe for gentle hacking - about week 3/4

Many of the muscles I was being asked to use in my physio exercises to strengthen my knee both before and after surgery, are the same ones I use for riding so IMO the only issue really was safety.

A meniscus rehab is usually 5 to 6 weeks so I would say your consultant is talking about the ACL reconstruction.

ETA the biggest issue is if your consultant has no idea what riding entails - I was lucky with my consultant but not the physio. They really don't know what muscles you use and sometimes have an overinflated idea of the dangers.

I'm not sure whether I'd get away with not having the ACL reconstruction as the dr this morning made it very clear I'd need it after I'd got my knee strong enough. Apparently I've done a lot of damage :(
Is it worth asking to not have it do you think it am I really going to need it? I'm really not feeling like going through another operation right now. This one has been my seccond one this year and the fourth in 18 months ��
 

Polos

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Horse is 8 and has competed to 1.35 and this summer was going to be our chance to finally start getting some 1.30 double clears which is why I'm even more frustrated :(

The plus side I'm seeing to this is that she will get the oppourtunity to just be a horse for months (something she's never really had) as a 4 year old (before I had her) she competed to 1.20 and as far as I'm aware she was never turned away after backing so maybe this is her time for that
 

criso

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I'm not sure whether I'd get away with not having the ACL reconstruction as the dr this morning made it very clear I'd need it after I'd got my knee strong enough. Apparently I've done a lot of damage :(
Is it worth asking to not have it do you think it am I really going to need it? I'm really not feeling like going through another operation right now. This one has been my seccond one this year and the fourth in 18 months ��

Only you and your consultant can decide that but there's no harm in going through all the options and asking for success rates and outcomes. In my case, it was very much a joint decision after much discussion. The meniscus was a no brainer as it had a very good prognosis with and without I couldn't bend my knee but the ACL wasn't as clear cut in terms of outcome and would have meant no riding for 6 months. We actually left it open that if it didn't heal well enough we could come back to the ACL if needed but I'm now a year on from surgery and can do everything I need to.
 

Micropony

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Horse is 8 and has competed to 1.35 and this summer was going to be our chance to finally start getting some 1.30 double clears which is why I'm even more frustrated :(

The plus side I'm seeing to this is that she will get the oppourtunity to just be a horse for months (something she's never really had) as a 4 year old (before I had her) she competed to 1.20 and as far as I'm aware she was never turned away after backing so maybe this is her time for that

Rotten luck for you being forced to take time out at such an exciting time, but she's young and you've got years together yet. She'll thoroughly enjoy a break just being a horse while you concentrate on yourself, and then you can embark on a fittening programme together. Good on you for seeing the plus side.
 

Polos

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Just realised I was not quite clear in my original post.

Dr at urgent care thought I had torn my meniscus. The consultant initially believed this as mechanically it was not possible to straighten my leg so I was sent for an urgent MRI. Consultant reviewed my MRI and decided I had torn my ACL and brought a chunk of bone off with it (there was no more mention of the meniscus). The DR I saw and the consultant where both equally puzzled as to how I'd done so much damage by just sitting down on the sofa. Consultant decided I needed urgent arthscopy and debridement to tidy everything up and remove the bone fragments and to investigate just how much damage is done.

This morning before I was discharged the Dr said I did in fact had a torn meniscus and a ruptured ACL which is when he went on to say I would need reconstruction surgery of the ACL.

So I guess it's a bit of a waiting game now to see exactly what the consultant feels is the best option :/

I think for now I should just be happy about being home rather than worrying about another surgery on the horizon.
 

Cowpony

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You are right, a discussion with your consultant is best before making a decision as nobody else knows exactly how bad the damage is. But just to say that there is a huge difference between a partial tear in the ACL and a complete break. A completely broken one cannot repair itself, and IMO would need the op if the sufferer wanted to ride. I broke mine a few years ago and did try riding while waiting for the op. I could not put any lateral pressure on with the injured leg, and it convinced me I really needed the reconstruction. I also felt very vulnerable - if I had fallen off it would have been disastrous. Waiting for the op is the hardest time and very frustrating. But in my case it was well worth it and the knee is almost as good as new. Its worth investing in some shock absorbing stirrups when you do get back in the saddle. Good luck with whichever route you decide to take!
 

Akkalia1

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I completely ruptured my ACL and partially tore the medial collateral ligament skiing just over a couple of years ago. My knee partially dislocated but popped back in. I was offered the reconstruction if I wanted it, but it was made quite clear to me that I didn't need it. My knee could function without the ACL. Top sportsmen like footballers have the reconstruction due to the continuing strain their knee will be under, but it's generally not necessary. I ride no problem without my ACL although it's possible that knee is slightly weaker. I should be able to ski again too although I haven't yet as it did take a long time for my knee to settle down. Twisting motions took the longest to feel normal. I chose not to go for the surgery as it's a hard rehabilitation and I was also told it sometimes fails and also sometimes doesn't actually improve any pain in the knee. But of course everyone's situation is individual and it sounds as if you're being encouraged to go for the surgery. And of course in many cases it's very successful. Maybe since you took a chunk of bone off too that changes things meaning surgery is essential.

Just wanted to let you know that I can do pretty much everything I think that I could before, although I must admit I'm careful of it. And it did take a very long time for my knee to feel normal. I was riding again I think about 9 months after my injury but I maybe could have been riding before then, I didn't have a horse to ride up until that point. As cowpony above says lateral pressure is the problem, but with time (years!) that's come back to me fine.
 

pansymouse

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I badly damage my right ACL in a fall nearly nine years ago, it was eight years before I was told that was what was causing the pain and instability in my knee. I never stopped riding but my right toe does stick out and if I try to drag it in it make the knee hurt. I have chosen not to have surgery after all this time but have had a lot of physio recently to build the muscle groups around the knee to increase it's strength and stability - it's worked well and I feel a lot more confident in its ability to keep me upright!
 
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