6 tips: the best time for anterior cruciate ligament surgery

The anterior cruciate ligament injury

In consultation with your doctor, you have come to the conclusion that you need anterior cruciate ligament surgery. In this blog you will get tips on what is the best time for anterior cruciate ligament surgery to schedule? Obviously, you depend on the orthopedic surgeon and his schedule, but your own situation is also important to consider.

Top and professional athletes are regularly in the news when one of them tears his or her cruciate ligament. For this group of athletes, getting surgery is almost a matter of course. They are intensively supervised by a medical team and are used to training every day. Simply put, their lives are set up to deliver peak performance every day making knee rehabilitation fairly easy to fit in. However, the amount of cruciate ligament injuries in elite and professional athletes is only small compared to amateur sports and it is the tip of the iceberg. Every day in multiples amateur athletes tear their anterior cruciate ligament with sports.

The group of amateur athletes is a diverse group of people. One person plays sports once a week and the other (almost) every day, but around this they have their school, work and other private activities to take into account. For this group, it is therefore more difficult to plan the surgery and there are more peripheral conditions at play that can affect the rehabilitation. This blog is intended to inform the amateur athlete in considering the optimal time for cruciate ligament surgery.

Content:

1. Timing
2. Personal Status
3. Finance
4. Mental status
5. Illness
6. Childeren
7. Can it hurt to postpone the surgery?

1. Het beste moment voor een voorste kruisband operatie (timing)?

An anterior cruciate ligament reconstruction is best performed on a knee that bends and stretches well and with minimal fluid. In addition, it is important to train the muscles well beforehand. Here, a difference less than 20 percent between the affected side and the healthy side is considered optimal. A preoperative course also has other advantages. You have time to get acquainted with your physical therapist, learn new exercises and movements and talk to fellow sufferers. It is important to realize that for the first six weeks you will be dependent on others. You will be walking on crutches and you won't be able to ride a bike, drive a car or run errands. Discuss in advance with your partner, parents and/or friends if they can help you in the early days. Unfortunately, the best time for anterior cruciate ligament surgery does not exist, but try to fit it into your life as best you can.

2. Does cruciate ligament surgery fit your personal situation at this time?

Surgery never comes out. Better said, rehab never comes out. You can do surgery in between. An hour of lying still and the new cruciate ligament is in. For rehabilitation, you have to make time. As a result, good timing of your surgery is essential. It is important to make enough time and energy to rehab. These factors, among others, determine the optimal outcome. Good reasons to postpone or plan around surgery are:

3. What does anterior cruciate ligament reconstruction cost?

In the Netherlands, healthcare is well regulated, but ultimately not free. There are a number of costs to consider. Make sure you have sufficient funds to pay for rehabilitation and expenses to ensure the best possible rehabilitation.

You are unable to work (temporarily). For someone in salaried employment, the sickness law is an option, but for a self-employed person that option is not always there. In the case of a physical profession, you usually cannot work for a long time (several months). Make proper arrangements in advance with your employer and, if necessary, discuss your situation with the company doctor.

Surgery costs money, of course. You are insured for this in the Netherlands, but it will always cost you your deductible. In addition, always check whether your health care provider has a contract with your health insurance company. If this is not the case, you will have to pay a large part of the healthcare costs yourself. For physical therapy after your surgery, you pay the first 20 treatments yourself. click here for further explanation.

It is also wise to consider cab costs and costs for assistive devices such as crutches and an exercise bike (optional) . On top of these, there are always costs that you cannot foresee in advance. If you do not have the financial resources to get the most out of your rehabilitation, think twice about whether surgery is wise at this time. Discuss your personal situation with your insurer.

4. Are you mentally ready for surgery and rehabilitation?

Besides physical, the mental aspect plays an important role during rehabilitation. The knee injury and possibly an upcoming surgery and rehabilitation have a great impact on your knee, but especially on yourself. In the beginning you cannot function normally, you are limited in your hobbies, work and sports. This does something to people. In general, we do not like to be dependent on others and run into your own limitations. 

Each phase of rehabilitation consists of challenges. Recovery has not only improvement but goes in ups and downs. Two steps forward and another step back is an apt description for most rehabs. Confidence in the process and mental resilience is important. Support from those around you is essential to guide you through the process; it is nice if you can turn to family or friends. 

The negative emotions and thoughts such as fear, doubt and uncertainty can interfere with a prosperous rehabilitation. Usually you learn to deal with these during your rehabilitation by building up the complexity of the exercise material step by step. Confidence in yourself and knee grows. However, it takes time to recover and you need to be able to recharge yourself for this. Set short-term goals and avoid stress and (unrealistic) deadlines. If you notice for yourself that you are having trouble with this and/or negative thoughts are holding you back, it may be wise to work on this first. Discuss it and see what you need to prepare yourself. Plan your surgery carefully.

5. Do you suffer from other conditions?

Rehabilitation to get back to your old level is intensive. An illness or condition may make intensive or regular training impossible. This obviously affects the outcome of anterior cruciate ligament rehabilitation. Therefore, consult with your doctor about the wisdom of undergoing the surgery.

6. Can it hurt to postpone the surgery?

The simple answer to this question is to consult with your doctor. Every knee and situation is different and requires individual treatment. Doing our best a little bit we can give quite a reasonable answer to this question. Knee instability in daily life is the main reason not to postpone surgery for too long. Frequent limping increases the risk of additional damage. If this is not an issue, but you are leaning toward anterior cruciate ligament surgery, the advice is to do it within 3 to 6 months or at the latest within the year. Discuss your personal situation and determine with your doctor the most appropriate time for anterior cruciate ligament surgery.

In conclusion:

For most people, the impact on your life after cruciate ligament surgery is difficult to comprehend. The dependence on others, limitations in daily life, the setbacks and still going on make it a challenge on the one hand, but also an opportunity to come back stronger. Get information from your doctor, physical therapist, The KneeClub, but above all, don't forget to ask your peers about what to expect.

To conclude: health care providers treat people and not knees. Each person has their own wants, needs, aspirations and goals, and they cannot all be described in a blog. After reading this information and talking with your health care provider, scheduling surgery remains a decision of your own.

If you have any tips of your own for determining the best time for anterior cruciate ligament surgery, please leave your tip in the comments.