Wrong diagnosis

by Tammy
(Auckland)

On August 16th 2009 I was playing soccer, with a player beside me I was pushed sideways my leg seemed to hyperextend outwards which was followed by a large pop sound. Immediately I fell to the ground in agony and knew this wasn't good. I didn't want to move and felt like I was going to faint. I was carried off the field and immediate put ice on my knee. After the game I got a ride to my local A and E. The doctor diagnosed a partial dislocation of the patella- and said the pop sound marked its reduction. He seemed to think I'd be back to driving the next day (my clutch leg was my injured leg) and back to sports in a week. Swelling at this time was minimal and I hovelled off expecting the best. No X-rays were taken.

Driving the next day my leg would shake when changing gears. I couldn't walk normally and it was very painful. The swelling had increased greatly and extended down my leg. A week later and driving was still a challenge, I couldnt walk properly and when trying to work I had to leave because I was in so much pain.

Physiotherapy went along with the diagnosis and treated accordingly but progress was slow and then plateaud completely. Full movement wasn't coming back and we suspected there could be a meniscal tear. The physio oreder me to see a knee specialist but my doctor would not give me a referral, saying the injury was still recent and should clear up soon. I went ahead and made an appointment as I knew my knee wasn't getting any better and it had been over two weeks. It would be two months until I could see the specialist. Fortunately, as a physiotherapy student I had a lecturer who pulled a few strings to bring forward my appointment. She also had a look at my knee and suspected a medial meniscal tear but thought all the ligaments were in tact.

3 physiotherapist, 1 doctor and 1 specialist later, via MRI it was clear that I had torn my medial menisus and partially torn my ACL.

I saw a handful of people about my knee and none suspected a ligament tear. Don't stop pushing for answers ACL tears can be hard to diagnose especially after an incorrect diagnosis.


My physiotherapist gave me some sound advice, surgeons like to operate. The appointment I had with the surgeon was all of 5-10minutes. There's not a long time to think. When I was told I had torn my ACL I was in shock. I thought I would only need a meniscetomy and be back to sports in no time but I knew ACL tears were a different story. I filled out all the necessary paper work afterwards to ensure surgery. My main reasons for surgery were; the fact that I was so limited in what I could do, I wanted to return to competitive sports and not be limited in daily activities and I knew the risks of developing knee osteoarthritis increased for those with torn ACL's. However, I know that surgery isn't always ideal it can go wrong and sometimes the benefits are outweighed. If I had only torn my ACL then I may not have opted for the surgery. Are there any of you with torn ACL's who did not opt for surgery? Is there anyone reading who has a menisus tear that is not having surgery? Would be very interested to see your feedback.

I had the surgery on December 18th 2009. Am now four weeks out. I had the hamstring graft and spent one night in hospital. The hardest thing post surgery is going to the toilet! I almost fainted twice that night. If it is an option I would recommend the local anaesthetic, I was able to watch the whole surgery (but you don't have to) and didn't experience any adverse side effects.

So the first week or so after the operation sucks, I won't lie. The first 3 or so nights it was really hard to sleep, you're instructed not to put anything under your knee (as this encourages your leg to stay bent and you want it straight!). Lying on my back I could feel my leg stretching and boy it was painful. I'd wake 3-4hours after taken tramal and I'd be in agony. Walking is really difficult. I spent a total of 13 days on crutches. I spent 10 days on both crutches and then 3 more using only one crutch. The downfall with cruthces is that your hands aren't free so you can't move anything. The cryocuff is great for swelling and pain management but very hard to fill with ice when you have no hands! Oh and always take your medications on time. I was on three kinds of meds; voltaren, paracetamol and tramal. Tramal was taken for severe pain and it does have side effects, try to get off this one as quickly as possible. Make sure you do your exericses every hour or as prescribed. I have to recommend putting a towel or pillow under your foot and relaxing your leg this will help get your leg straight...take your meds before you do this.

My flexion has come back really quickly and is almost the same as my non-operated leg. Increased in range of movement can take time so be patient, keep up wiht your exercises and you will see results don't be disheartened if it's taking a bit long. I can relate to you all as my extension is still lacking. I'm about 5 degrees off straight but my legs hyper-extend so another 10-15degrees of movement is there.


I have to recommend cycling, cycle as much as you can. 10 days after my operation I could only cycle for 5minutes and gosh it hurt. Cycling is great, it losens the joint. I decided that I'd cycle every day. I built up from 5minutes with no resistance to 10 minutes with no resistance and then 20. Now I can cycle for half an hour, building the resistance gradually. Swimming is really good to help re-gain cardiovascular fitness. I swim freestyle and sometimes kick to hard...you have to be mindful of the hammies for about 6weeks if you had the hamstring graft. I can now walk for 30minutes with moderate discomfort...avoid malls!

4 weeks out from surgery and I'm doing well. Sleeping well, keeping up with the exercises the pain is minimal although my longest incision (where the graft was taken) is rather painful and I still have numbness over my lateral shin. Looking at starting jogging at 6 weeks. I'm part of a study on ACL reconstruction and post surgery joint bruising when running. Will have to let you guys know how this one goes. Going to need 3 MRI's and will do 3 runs over a week.

Would love to hear your milestones, especially on gaining extension and returning to sport. I'm wanting to get back to soccer mid June but know this will be hard psychologically.