ACL after 3+ years - still feeling instability in knee despite full muscle mass and graft intact
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I'm in need of some advice to improve stability in my knee so I can function normally and hopefully play sports casually. I'm in very good physical shape and in my early 30s. I've had a lot of personal experience with ACL tears. I've had 3 ACL surgeries on one knee. First surgery after an initial tear (cadaver), second surgery after a re-tear (patellar), and then a 3rd (patellar) after the prior surgery was unsuccessful - which took me 2 years to figure out. My meniscus is pretty well gone. I've also had a separate surgery before my 3rd (most recent) one to essentially build back the bone that had been drilled through during my first surgery, as it was too wide. I've never torn the other ligaments, though.
I'm 3.5 years out now from my last surgery. I haven't played sports since, just a lot of lifting, biking, running, classes. I still have issues with the stability in my knee. 2 years ago, I went back to a surgeon who said my knee is a little loose (but not that bad), and an MRI came back showing my ACL was intact. I recently had a little discomfort in my leg and realized my hamstring wasn't strong enough, and since focusing on that it has gone away. Over the past year or so, I've gotten the diameter of my quad muscles to be equal (in fact, the quad on my bad knee is now slightly bigger than my perfectly good knee).
However, I still have instability in my bad knee. When I skip a step walking up stairs, my bad knee feels unstable and has difficulty carrying my body when I shift my weight on it (I think I end up compensating by turning my knee inward or pushing off more forcefully with my good knee from the lower step). If I do a one-legged squat on my bad knee, it shakes a little and feels unstable. My good knee is fine. When I do a lateral shuffle, my bad knee again feels unstable when it takes my body weight. When I flex my knee straight and bent, it has a little tweaking sound (not the big popping sound that people often experience initially after surgery - although I had that before).
I've done so much PT in the past that I incorporate some of the exercises in my workout routines. So I'm not sure PT would be the answer (including the fact that my bad knee has more muscle mass than my good knee at this point). Although, I don't do one legged bosu ball type exercises for stability.
**What am I missing? How can I get the stability up in my knee? ** I want to get back to playing soccer and basketball.
Thank you
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