Recovery Timeline for Tibial Plateau Fracture and ACL Tear

Left tibial plateau fracture and anterior cruciate ligament tear?

Hello, Doctor.
I was in a car accident at the beginning of August, which resulted in a fracture of the left tibial plateau and a torn anterior cruciate ligament (ACL).
In mid-August, I underwent surgery where they used artificial bone to fill the collapsed area and then stabilized it with plates and screws.
Currently, I am using crutches for mobility.

1.
It has been over 7 weeks since the surgery.
When can I stop using one crutch and walk normally? At 6 weeks post-surgery, I tried using one crutch, but I experienced pain at the site where the plate was placed.
I'm not sure what the reason for this pain is.
2.
The doctor mentioned that it will take three months for the injury to heal properly before I can undergo reconstruction of the torn ACL.
Is it really necessary for it to take that long?
3.
My job requires me to lift heavy objects.
How long do you think I will need rehabilitation before I can handle heavy work again? Thank you, Doctor!

wei, 30~39 year old female. Ask Date: 2019/10/06

Dr. Shi Guozheng reply Orthopedics

1.
Tibial plateau fractures typically take about 3 months to heal; walking or putting weight on crutches too early can be painful.

2.
After three months, it is appropriate to reconstruct the ligaments; the bone should be allowed to heal first before undergoing reconstruction surgery.

3.
Rehabilitation usually takes about six months.

Reply Date: 2019/10/06

More Info

Recovering from a tibial plateau fracture and an anterior cruciate ligament (ACL) tear can be a challenging process, and it’s important to understand the timeline and expectations for recovery. Based on your situation, here are some insights regarding your questions:
1. When can you stop using crutches and walk normally?
After a tibial plateau fracture, the healing process typically takes about 12 weeks or longer, depending on the severity of the fracture and the individual’s healing capacity. Since you are currently 7 weeks post-surgery, it is not uncommon to still be using crutches, especially if you are experiencing pain when attempting to bear weight on the affected leg. The pain you feel when trying to walk with one crutch could be due to several factors, including the healing of the bone, the stability of the fixation (plates and screws), or even muscle weakness from disuse. It’s crucial to follow your orthopedic surgeon's advice regarding weight-bearing activities. Gradually increasing weight-bearing as tolerated is essential, but if pain persists, it’s advisable to consult your doctor to rule out any complications.

2. Is three months a reasonable time frame for the bone to heal before ACL reconstruction?
Yes, three months is a standard timeframe for the bone to heal sufficiently before considering ACL reconstruction. The reason for this waiting period is to ensure that the tibial plateau has healed adequately to support the stresses that will be placed on it during and after the ACL reconstruction. Prematurely performing the ACL surgery before the bone has healed could lead to complications, including further injury or instability. During this waiting period, physical therapy focusing on range of motion, strength, and stability is crucial to prepare for the next surgery.

3. How long will rehabilitation take before you can return to heavy lifting?
Rehabilitation after both a tibial plateau fracture and ACL reconstruction typically takes several months. After the ACL reconstruction, most patients can expect to engage in a structured rehabilitation program that lasts anywhere from 6 to 12 months, depending on individual progress and the demands of your job. Since your occupation involves heavy lifting, it’s essential to ensure that you regain adequate strength, stability, and range of motion before returning to such activities. Your physical therapist will guide you through a progressive rehabilitation program that includes strengthening exercises, functional training, and sport-specific drills to prepare you for your work demands.

In summary, recovery from a tibial plateau fracture and ACL tear is a gradual process that requires patience and adherence to medical advice. It’s essential to communicate openly with your healthcare team about your pain levels and any concerns you have during your recovery. They can provide tailored recommendations based on your specific situation and help you navigate the rehabilitation process effectively. Remember that rushing back to full activity too soon can lead to setbacks, so it’s best to prioritize a thorough recovery to ensure long-term success.

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