Recovery Trip Report

Torn ACL + Meniscus

(Aug 20, 2020 - AUG 20, 2021)

Date: August 20, 2020 - presentTrip Report #: 450

An (Ongoing) Recovery Trip Report for a Torn ACL + Meniscus

In August 2020, after a pretty amazing summer of climbing, I tore my ACL and meniscus in my right knee, while descending from a climb in Rocky Mountain National Park. The injury was bad enough and the terrain rugged enough that I had to be helicopter evacuated off the mountain. A couple of weeks later I got surgery to repair my ACL and meniscus. Due to combination of a skilled surgeon and my dedication to physio, less than 4 months from surgery I was (carefully) climbing multipitch routes and hiking with a heavy pack, and back to full action by the time the alpine climbing season came. This page documents the recovery process.

Accident Report

(copy/pasted from my Goldfinger trip report)

In August 2020, while jumping from one boulder to the next coming down from the summit of Arrowhead, my knee buckled underneath me and it sounded as if a small explosion went off in my knee....$#!&....

I tried to stand up, but my knee buckled and a wave of excruciating pain shot through my leg. It was pretty clear that my knee would not support my weight. Nate and I had to make a decision: Do we try to self-rescue (which would involve me crawling a couple of miles of quite rugged terrain to the trail and then Nate piggy-backing me out from there) or do we call the Rocky Mountain National Park Search and Rescue team while we still had cell service? The summit of Arrowhead gets a bit of cell service (Verizon at least) and ever since my life-(or at least leg-)saving phone call for a serious tib/fib injury in 2010, I always bring my phone on a climb. Both Nate and I lean towards self-rescue if possible. I tried to stand up again, and again my leg buckled and and I yelped in pain. Okay, maybe I was less ambulatory than I thought. We decided to make the call to SAR. We wrapped my leg in my small climbing pack to attempt to stabilize it. I began to sideways crawl and butt-scoot along the summit ridge towards the rappel route while Nate passed on the necessary details to the SAR team (i.e. my status, our plan to self-rescue to upper McHenrys basin, and the approximate location of our bivy site there). What is normally a casual 10-15 minute romp from the summit to the top of the rap route became a rather butt-bruising 2 hour scoot. Once we arrived at the rappels, Nate lowered me while I used my good leg and two hands to keep my knee from hitting the rock. From the base of the two rappels Nate belayed me for another rope length while I butt-scooted down the steep granite slabs towards the bivy cave where we had stayed the night before. The entire descent from the summit, which typically would have taken under an hour, took just over 3 hours (which actually isn't too bad considering the circumstances). We re-established ourselves at our bivy site and waited for the SAR team to arrive. I wolfed down a handful of expired pain meds and tried to study some math and Nate tried to read a book. The 3-person ground SAR team arrived a few hours later. The medic assessed my condition and splinted my knee, and then the team assessed the best means to get me out. The main means of rescue in RMNP are foot, horse, helicopter land and load, and helicopter hoist. Due to the rugged location and my non-ambulatory status, the SAR team deemed it best to request assistance from a Colorado National Guard helicopter from Buckley Air Force Base to extricate me via a hoist operation, using a winch operated cable. It was too late in the day for the chopper to come that evening, so we all settled in for the night. The Blackhawk chopper arrived as scheduled the next morning at 8:00am for their first recon loop. They had to make two attempts to successfully lower a rescue personnel, who strapped me into a screamer suit, grabbed the swinging 100-foot cable, clipped us both in along with my pack, and signaled the chopper to begin winching us up as it flew off. Eight minutes later we touched down at Upper Beaver Meadows. Nate had hiked out early and was there to meet us. Part of the reason for this was to avoid the costly unnecessary ambulance ride, but the best part was seeing a familiar and friendly face. I made some calls to my insurance company to make sure the Estes Park Hospital was in-network, and after confirming it was, Nate dropped me off at the ER for the day, telling me to call him when I was ready to be picked up. I couldn't ask for a better friend and climbing partner.

Once more, I want to express my gratitude to the Rocky Mountain National Park Search and Rescue Team, the Colorado National Guard helicopter team, and most especially to Nate for executing this rescue with efficiency, precision, and compassion.


ACCIDENT/RESCUE TIMELINE

Hurt knee near summit: 12:05 pm, Thursday, August 20Phone call to SAR: 12:25 pmTop of rappels: 2:03 pmBack at Bivy: 3:20 pmSAR arrives: 6:48 pmHelicopter pick-up: 8:23 am, Friday, August 21Upper Beaver Meadows: 8:31 amEstes Park Hospital: 11:20 am


Photos from the successful evacuation below.

If the content appears to be truncated here, you may need to put your cursor in the region of text above the red line and scroll down to see more!

The Injury

(copy/pasted from my Goldfinger trip report)

The ER at the Estes Park Hospital was characteristically empty when I arrived, and a nurse rushed to meet me with a wheelchair as soon as she saw me hop out of Nate's truck. I spent the next several hours filling out forms, being prodded, getting x-rays and an MRI, talking with the attending ER doctor, scheduling some surgeries, and texting my parents in the interim periods. The news was not good (bold are the main ones requiring surgery and long-term recovery):

  1. Fracture of the posterior aspect of the lateral tibial plateau, predominantly a nonarticular cortical depression fracture, but there is also an osterchondral component involving the posterior articular surface.

  2. Cartilage defect (approximately 12x4 mm) within the posterior lateral tibial plateau at the osterochondral fracture site.

  3. Torn proximal ACL.

  4. MCL and FCL sprains. No high-grade tear identified.

  5. Large, displaced bucket-handle tear of the lateral meniscus with the handle displaced into the intercondylar notch, slightly greater anteriorly.

  6. Vertical longitudinal tear of the peripheral posterior horn of the medial meniscus (ramp lesion).

  7. Large hemarthrosis with posterior capsular tear and extensive hemorrhage and edema within the popliteal fossa.

  8. Bone contusion of the anterior aspect o the tibial plateau involving the medial and lateral aspect and a smaller bone contusion of the posterior medial tibial plateau. Small osterochondral impaction fracture of the anterolateral femoral condyle at the condylopatellar sulcus and bone contusion of the upper peripheral lateral femoral condyle.

  9. High-grade partial thickness tear of the mid substance of the quadriceps tendon at its patellar insertion measuring approximately 13 mm in length. The peripheral fibers, lateral greater than medial, are intact. (Note: This quadriceps tendon damage was likely a pre-existing and healing overuse injury I had developed the previous year from too much running.)

Well, that was why I couldn't walk. Seems like my knee basically exploded inside me. I'm pretty appalled at the level of damage from what had seemed to be a benign jump from one boulder to another, but it seems most likely to me that I had a torn ACL already, from 7 years previous when I had popped through into a crevasse, torqued my knee into such an unnatural position and heard/felt a pop, and proceeded to pay an ortho specialist $300 to tell me I just had a sprain; in the years since I had a few occasions where the knee "gave out" briefly but it always seemed okay immediately after so I didn't give it much thought. Until now. It was the (probably already torn) ACL that gave out first and then as my weight continued to come down on my knee the rest was just a cascade of snaps and tears. Needless to say, I am in for a long haul recovery....again...

Recovery "Trip Report"

If the content appears to be truncated here, you may need to put your cursor in the region of text above the red line and scroll down to see more!

Medical Bills (Approximate totals before insurance)

Medical Bills

previous and next adventures

Recovery. Goal is to be back to normal activity by 6 months from surgery (March 3), which would mean a good spring cragging season and another great summer alpine season. Just got to restrain myself from doing anything too stupid in the meantime.