I was definitely quite nervous about going in for the revision surgery, although dead set that I wanted it done. But the prospect of doing the rehab for a second time, and this time with a toddler in tow and a bigger business to run, was certainly a little daunting. However, on the plus side, when you have a 20 month old (as she was then), the chance of a few hours kip in the day time is actually something to look forward to!
After all the usual pre-op checks, the first unexpected event was being asked to decide what type of graft I wanted to go with. I'd had a hamstring autograft first time around, and that's my surgeon's preference, but I wasn't expecting to be asked whether I wanted to go down the autograft or allograft route just half an hour or so before I went in for surgery. Luckily I'd read around enough to know that allograft's are often used for revision surgery and that would save having two legs operated on on the same day. However, cross-infection and rejection sprung to mind as immediate concerns and, after chatting it through briefly, I decided to go with the contralateral hamstring autograft as first port of call but, if my surgeon felt it wasn't going to be strong enough, I was happy for him to combine it with the allograft or use that on its own instead. (I've since done quite a bit of reading around the impact - or otherwise - of irradiation treatment on the integrity of allografts in ACL surgery but, like most issues in this field, the jury is still out).
We also discussed the possibility of supplementing the ACL graft with a Macintosh procedure to prevent excessive pivot shift but, again, I decided to leave this up to my surgeon to call when he got in there. No point having an extra procedure if the ACL graft looks good but, if it's still looking loose - and this is revision surgery after all - you may as well go for the belt and braces approach, even if that does mean a 5 inch scar down the outside of your leg (I've known since I was 12 that I'd never have the legs for short skirts so no matter anyway!)
I went into surgery around 9am and remember coming round in recovery. It was only on my way back to my room, when the nurses made comments about 'the wanderer returns', that I realised anything unusual had happened. A glance at the clock in my room, nearer to 2pm I think, suggested that whatever had gone on hadn't been straightforward - I was expecting a couple of hours maybe, not near on five - but no real pain and happily full of drugs, I felt as well as could be expected.
When my surgeon came to see me later that day, he explained that he hadn't been able to harvest a large enough strip of hamstring to use as the ACL graft so had tried bundling with some fibres of the allograft. That wasn't large/strong enough either so he eventually went with the full allograft option. There were some issues positioning and securing the new graft as we were limited by the existing bone tunnels and then, when they thought they were done, the graft seemed to be impinged (not good if you don't want it to wear and stretch) so they had to start again. After all that, he was still concerned by the pivot shift so decided to go ahead with the Macintosh too.
In for a penny, in for a pound, I say but my apologies to everyone else who was waiting to go into surgery after me!
I can't say I slept particularly well - not due to pain but a combination of drugs, only being able to lie on my back, and getting annoyed by an obnoxious old man across the corridor who was charm personified when his wife was with him during the day but turned into a cantankerous, racist old bar steward after she'd gone and was consistently rude to the nurses. Grrrr.
Anyway, a short fainting episode aside next morning, physio came along to fit my brace (thigh to ankle, nice!) and get me up on my crutches and, after the usual wait for follow-up appointments, pharmacy etc,. I was free to go that afternoon and ready to start my recovery and rehab.
My only advice at this stage to anyone going down the revision ACL route? If you live in a house with two sets of stairs, opt for the allograft rather than the contralateral autograft option. Trying to propel yourself up two flights of stairs, on crutches, with one leg in a brace and the other that has had part of the hamstring harvested is a very long way from fun indeed!!!