Unless the surgeon advises otherwise, most people return to enjoying both of these sports with the use of a brace. However, remember every individual injury is different. Following the recommendations of the surgeon is of utmost importance.

The anterior cruciate ligament, or ACL, is one of four major ligaments in the knee that provide stability to the joint. When a patient sustains a tear to the ACL, a sensation of instability, or giving out, may develop in the injured knee. In order to restore stability to the knee, your doctor may recommend an ACL reconstruction to insert a new ligament in the place of the damaged ACL.

Early surgical intervention to repair a torn ACL is not recommended in the vast majority of cases, and physiotherapy for at least four to six weeks is almost always recommended first in the amateur sportsperson. This approach has the advantage of allowing any other associated injuries to settle, and any inflammation to subside. Taking time to have physiotherapy also gives the patient and physiotherapist the opportunity to assess whether they feel there is a genuine need for reconstruction.

Compared with surgery for meniscal tears, ACL reconstruction is a much more involved procedure as it involves taking a tendon graft as indicated (usually the hamstring) from another part of the leg and using this to substitute the broken ligament. The time taken to recover from this type of surgery is much longer than for meniscal tears, and it may take up to nine months before you are able to undertake full sporting activities again.

Most ACL reconstruction surgeries are done using a single-bundle reconstruction. A single-bundle ACL reconstruction uses a tendon graft to replace the torn ACL. Unfortunately, ACL tears cannot be repaired, or sewn together, and a graft must be used to reconstruct the ligament. When the ACL is reconstructed, the graft is placed in the position of the anteromedial bundle. Grafts are held in place by making a hole in the bone called a tunnel. One tunnel is made in the femur and one in the tibia.

Instead of placing just one larger graft, the double-bundle ACL reconstruction procedure uses two smaller grafts. Therefore, there are essentially two ligament reconstructions, one for each bundle. The double-bundle procedure requires two additional bone tunnels to accommodate a second graft, and one additional incision. Studies have demonstrated some advantages of the double-bundle ACL reconstruction.

This is a new procedure, and as is the case with any new procedure, the long-term results are not well understood. It is possible that this procedure will be an improvement on the standard single-bundle ACL reconstructions, but it is also possible that these patients may have the same, or even worse, long-term results. No one really knows just yet. The double-bundle is technically more demanding of a procedure, and there are fewer surgeons with experience in this surgical technique.

It is not clear that the double-bundle ACL reconstruction is a better procedure, but some patients are willing to try a new procedure in an effort to possibly improve their long-term result. Standard single-bundle ACL reconstructions have excellent results, with about 90% of patients able to return to activities at their pre-injury level. However, the results are not 100%, and some patients have persistent instability after ACL reconstructions, and may develop problems later in life.

A graft is the tissue we will use to give you a new ACL. The choices available break down into two large categories. Autograft, your own tissue; or allograft, cadaveric tissue. If you elect to utilize your own tissue, the three grafts available are bone-patella tendon-bone grafts, quadriceps tendon grafts, and hamstring grafts. There are many different allografts available to reconstruct the ACL.

One of the main priorities after ACL reconstruction is to regain the knee range of motion. This along with establishing a good strengthening program is usually best done two to three times per week for the first four to six weeks. Because many insurance policies will not cover this many visits to the therapist, an independent home program may need to be instructed earlier. Compliance in performing the exercises in and out of the clinic is the key.

If conditions are such that there is not enough snow cover to skiing or snowshoeing to the yurts all reservation proceeds will be refunded in full. No other refunds or changes will be allowed. Lottery fees will not be refunded.

Because it is made from a very slick, very tough plastic called HDPE (high-density polyethylene). Even with adult riders and no ski wax, we have found that one kick in most snow conditions will propel the rider several feet over flat snowy ground before another kick is needed. The degree of "kick-and-glide" will depend upon both snow conditions and the rider's weight. Ski wax is not necessary.

The water on Folsom Lake and the Delta is great. They are both cleaner than private lakes and the scenery is amazing. We enjoy smooth water all week long because everyone else is working while we are out having fun. The water temperature stays in the 70’s to 80's throughout the summer, so you will not need a wet suit.

Each ski resort will have a different policy on that. Some will say "no," others may say "yes." At one time, ski resorts did not allow snowboards up the mountain, either. Some ski resorts have special "snowparks" where you may be allowed to ride the Ski Skoot snap-on snow ski attachment. At the very least, you can ride it on the small hills and slopes that typically surround the ski resort village or lodge, or at the bottom of ski runs once they have closed for the day.

Link uses the Automobile Association (AA) Breakdown Service which is available throughout New Zealand. We have our own freephone number which you can call for assistance should you encounter any problems.(top)

Activities include sledging, paragliding, ice diving, showshoe outings, horse drawn sledges and snowmobile excursions. See off the slopes.

was the driest year of the three previous runnings, and there were short snowbanks to cross over most of the major passes, with a substantial amount (thigh deep) below Virginus Pass. In '95 almost the entire course was under snow, and the run was cancelled because of it. Expect anything in between. We'll post periodic snow reports here, as the season progresses. You can also check them yourself. There are unseasonable bare spots on the peaks above Silverton.

Two mechanical engineers from the University of Washington who now work at a U.S. national engineering laboratory. They are shareholders in our company and design new products for us.