Why not to have ACL surgery, anterior cruciate ligament.

Updated 03/27/2004

You might prefer to read the short version first, here.

Are you considering having ACL surgery? You may want to reconsider after reading my story. I am living proof of why not to have this surgery.

I have always been very active and in the course of 15 years of racing motocross, street bikes, jet skis and bicycles I tore the anterior cruciate ligaments in both knees. I was eighteen, it was 1980, when I tore the left one and I was 20 when I tore the right knee's ACL. When I tore the left one I waited about three days before going to my family doctor. Most of the major pain was over by then, but I still could not walk on it at all for about a week. My doctor diagnosed it as probably being a torn ACL and said that I could go to an orthopedic surgeon and that they would probably want to operate. He also told me that the surgery was about 50% effective at making an improvement or I could just wait it out and rehab it and see how it went. Back in 1980 they still cut the knee wide open to perform surgery, no arthroscopy type surgery was in general use yet. I opted not to have any surgery and in about four months I was back pretty close to normal. It would lock every once and a while but really wasn't that big of a problem. I still ran five miles a day, worked on my feet nine hours a day and played football or whatever I wanted to do. When I was twenty it happened again to my right knee and I knew to just work through it again.

When I was thirty five, fifteen years after tearing the ACL's, I started having back pain that the doctors could find no reason for. I had orthopedic surgeons and chiropractors take x-rays and even had an MRI on my back, with no results. I finally thought that maybe my knees were the cause of the back pain and after talking to many people that were having ACL surgery I opted to see another orthopedic surgeon for my knees. By this time the surgery seemed routine and was much less invasive, with the operation being done through the scope device and the new ligament, in my case coming, from the front of the knee, the patella. The orthopedic surgeon here in Abilene, Dr. Robert Dickey of Orthopedic Associates of Abilene, indeed verified that the ACL was detached on both of my knees and wanted to do the better of the two, both with detached ACL's, knee, the right one, first and then the left shortly afterward, so I could go through rehab for both at the same time. I was actually a little surprised that the right ACL was torn since I had not noticed anything wrong with it since I had injured it fifteen years earlier. At the time I had pretty good insurance that would pay 80% if I went to one of the doctors on their list, Dr. Robert Dickey of Orthopedic Associates of Abilene being one of them. He gave me the impression my knee be only better after the surgery. I was also concerned that I might have trouble with my knees later in life, when the recovery from any surgery would be much harder. I can't count the times in my youth that doctors said "If you don't have surgery now you will have arthritis at 40" well I'm 42 now and the only problem I have is the right knee that has been operated on three times, the first one really being the only elective surgery. I was also afraid that having a torn ACL would cause my knees to wear out prematurely. Prior to the first surgery I was running 3 miles a day about 4 to 5 days a week or at least riding a bicycle 75 to 100 miles per week. I could ride motocross at a semi-pro level and competitively ride a jet-ski for hours.

I decided the surgery was necessary and went in for the right knee. After post-op as I got to my hospital room, for my overnight stay, the pain was excruciating. All the concussions, sprains, scrapes and bruises and terrible crashes I had suffered before seemed to pale by comparison. Even when I tore the ACL’s, without any pain killers, it was never this bad. Of course the hospital personnel were late with the morphine, but even after I got on the drip it hurt far more than I would have dreamed. The Dr. Dickeys attitude had changed when he did his post-op visit, after he had got his money. When I complained of the intense pain Dr. Dickey simply said “I never said it was going to be a cake walk.” Oh the things he didn't say, they were many. After about three days the constant pain subsided somewhat. After this experience I decided that no one would ever touch the left knee as long as I was still breathing or not in a wheelchair. I started all the usual rehab and was released from rehab after about six weeks. Three months out I still did not have full extension or flexion. The screw that was used to secure the bottom of the new ACL started to poke up under the skin. It was working its way out. I went back to Dr. Robert Dickey and he wanted to put me back in the hospital for another surgery, cha·ching$. I told the Dr. Dickey I wanted a local anesthetic and for him to simply take out the protruding screw in the office. He reluctantly agreed, less money, and it came right out with a small incision, a screwdriver and about ten foot pounds of twisting.

A year after the first surgery I was still not able to bend or extend my knee as well as before the surgery. Running was out of the question and if attempted it would usually result in a fall. If my heel struck the ground hard, as it does running sometimes, I would usually go down. The harder I worked it the worse it got, swelling and an unstable, with a weak feeling. A year and a half after the first surgery I opted to have Scott and White hospital, in Temple, TX. look at it. The hospital had a good reputation and I felt confident in the new surgeon. They decided to operate again and cut more of the meniscus, torn again, out and remove all of the junk in it, debridement. I went through the usual rehab again and had even less ROM, range of motion, after six months. The swelling, or at least what I thought was swelling turned out to be mostly scar tissue, never went away and limited my flexion, especially when it would get excessive fluid on it too. The knee was very sensitive now and it took almost nothing to hurt it and cause fluid to build up. Of course I could no longer ride dirt bikes, bicycles, run or even walk enough to play nine hole of golf. At least it did not seem to be the surgeon's fault this time.

Around a year and a half after the second surgery it got so swollen and painful I was on crutches, I also had a fever. My family doctor rushed me into my third orthopedic surgeon, again here in Abilene. He stuck some very big needles in my knee to drain the fluid and said I needed surgery again to remove all the possibly infected tissue or I could die! The surgery was performed and I proceeded through rehab a third time. I liked this gentleman very much, Dr. Shannon Cooke of Abilene Bone and Joint Clinic. He is a skilled surgeon and a kind and compassionate man. I still trust him with my life and to recommend what is best for me rather than how much money he will make from the suggested procedure.

ACL Surgery

Two years after the third surgery, the knee now only has 90 degrees flexion and is about 10 degrees short of full extension. It is my understanding that scar tissue is why it is so swollen now and inflexible. It is painful anytime I walk or stand and sometimes just sitting or trying to sleep is painful. Recent x-rays revealed that the cartilage is worn down about twice as much as my left knee; remember that the left knee's ACL is gone still. The expense fell to me personally also, since where I worked had changed insurance companies and the new companies would not cover the second and third surgeries due to it being a preexisting condition. I am not the type to ever want to sue anyone, but I needed money for the subsequent surgeries, unfortunately the statute of limitations is two years from the time of discovery, I believe due to a powerful medical lobby aimed at fighting the frivolous lawsuits that everyone seems to be filing, and that time had come and gone since the first surgery. It is also very difficult to get one doctor to blame a condition on another.

Maybe I just made a bad choice in my selection of an orthopedic surgeon, like Dr. Robert Dickey, to perform my first surgery. Maybe my body is particularly prone to scarring or having drills stuck in it. I was never warned that things could possibly turn out this badly by the first orthopedic surgeon, Dr. Robert Dickey, sure I signed all the papers but who can understand them besides your doctor or maybe the lawyer who wrote them and to this day I am very bitter towards him and skeptical of others I don’t know. In early 2004, while collecting records for my search of another specialist or Social Security Income, Dr. Dickeys office was the only one the charged me for my medical records. When I asked for reimbursement of the $25 they refused and said go ahead and "take it up with the Texas Medical Association", as if this was a routine complaint. This combined with the bedside manner of Dr. Dickey just after the first surgery. What's worse he is still practicing and I wonder how many others he has and will subject to my fate. I see this same surgery being recommended and performed by doctors everywhere. None of the ACL patients I have spoken to ever mention that they were warned it might go so badly. They seem to be told that they simply have no options other than surgery. Furthermore, I have yet to speak with someone that has had ACL surgery after recovering from the initial injury that says they are better now than before the surgery. They are usually blamed and convinced that they did not perform their rehab correctly or that they have done something to re-injure the knee. I believe this is one of the delay tactics some of the doctors use to get past the two year time statute for malpractice. Every time I am asked why I am limping and explain my history the next question is "Who was the first surgeon" when I mention Dr. Robert Dickey they more often than not roll their eyes and tell me of a friend or family member that experienced a similar feeling towards him. This goes against the odds of coincidence that it was simply my body that was at fault.

ACL Orthopaedic surgery abilene

I feel I must also express my great appreciation as well though for the other doctors I have met and treated me. They were kind and truly seemed to have my best interest in mind. Even the rest have all studied long and hard for many years. Most seem to have very good intentions. I simply feel that some have somehow been corrupted, brainwashed or are misguided and the patients are the ones paying the price. It is well know that the doctors and drug companies have strong lobbies in the government and this influence is not for the patients benefit. Don’t EVEN get me started talking about antidepressants they want to try on you for pain, well ok maybe another web page for that.

Needless to say I wish I could turn back the clock and just stay as far away from hospitals and Dr. Robert Dickey as possible. The dirt bikes were far safer. Almost every surgeon I hear about still recommends ACL surgery every time a patient is diagnosed with a torn ACL and the cute little information pamphlets "About Your ACL Surgery" that show happy, active people in surgery, rehab and running afterward is to me complete propaganda to benefit powerful drug companies, hospitals and doctors, not you. It is to late for me, but if you are reading this and are considering ACL surgery please benefit from my misfortune and consider your decision very carefully. I could have gone on with my normal active life had it not been for the initial ACL surgery. Try letting nature take its course, my left knee is the control in my case study and it never gives me any trouble now. Why not give it a chance? It's your body and you owe it to yourself to read all you can and make an informed decision. If you do decide ACL replacement is for you, choose your surgeon carefully, get at least a second opinion and at the slightest hint that it did not go well sue immediately and aggressively with compasion and consideration, not greed.

More of my knee history and information about my surgeries here.

My ACL Surgery

The short version and current my condition

Best wishes and good luck,
Michael Davis

Orthopaedic Surgeons in Abilene

Off Site Links:

Doctors:

Dr. Shannon Cooke, MD , Abilene Bone and Joint Clinic or possibly use this direct link to their site.
Abilene Bone and Joint Clinic

Dr. Derek K. Lichota, MD at Scott & White Memorial Hospital