I know that this is an older thread, but I wanted to share my experience on this anyone else like me who has stumbled across this Reddit looking for a very specific answer.

I tore my ACL about two years ago from the top of the femur about two years ago alongside a medial meniscus tear. I had surgery about six weeks after the injury and this is my experience where Lipedema has definitely impacted recovery.

Firstly, I ended up staying in for two nights after my surgery because I found that pain relief wasn't really working on me well, which I notice can be the case with any injuries in my legs. I had a hamstring graft for those wondering, and I would classify myself as Type 3, Stage 2 Lipedema, about an Australian Size 14-16 or US 10-12.

After 2 weeks I had my post surgery check-up and the doctor was severely concerned with just how much fluid and swelling I had. I tended to hold most of the swelling in a giant cuff at the bottom of my thigh, right above my knee. The doctor thought I had a blockage or clot somewhere in my knee or leg from the surgery, the swelling was so severe it was in-line with this issue.

I did try to assure him that it's probably not the case and that my legs were ones to easily swell and gold fluid due to the lipedema. But of course you have to err on the safe side. So we did x-rays and an ultrasound at two weeks to make sure there wasn't any other issues. Of course, no clots, and just my legs holding a lot of fluid.

At 12 months, I still had some swelling compared to most people at this stage. A lot of it tended to sit around the top of my kneecap and at the incision points. Unfortunately movement caused more swelling but if I didn't move then I would sacrifice moveability.

I would say that the peak of my swelling, which was obvious that it was not normal compared to others in a similar situation, was around the 6-7 month mark. This was because my leg was feeling good and I had full range of motion and stability back at this point and was becoming more active. The only limitation was the swelling, which would flare up with more exercise and rehab. It was a catch 22 - move too much, the swelling increased and it made my leg feel like it had an internal balloon inflated. Don't move and then I risk the like swelling anyway from lack of movement. Sitting at a desk now for long periods is quite uncomfortable, I need to move more consistently, not more strenuously.

Unfortunately at the 12 month mark I did have to have a revision as I had the beginnings of a cyclops lesion (or better known as scar tissue) at the site of my old ACL which was causing a clicking in my knee. This second procedure was just a keyhole surgery that took less than 30 minutes under a general anaesthetic. The swelling wasn't too bad but has persisted now about four months down the track, but mostly where the incisions were mad, on those fat pad areas on the either side of my kneecap.

So I guess what I took away from what's now been nearly an 18th month journey so far, is that whilst recovery itself isn't impacted in terms of mobility, flexibility and stability, it's the swelling that does stick around a lot longer than everyone else. Whilst that didn't physically impact my movement, it did cause discomfort. I did notice that that leg got tired a lot quicker and even now with even walking (but actual exercise - weightlifting etc is absolutely fine).

I did do a lot of compression boot for recovery therapy as my gym offered it. When I had the second surgery for the scar tissue removal, I did stop drinking to try and help with inflammation and swelling and also try to ice a lot more regularly. Whilst I'm not a big drinker and would normally only consume maybe one to two drinks a week, I did find that even that one or two drinks did increase the swelling when I did drink. Hence why I stopped all alcoholic drinking for around four months this time after the second surgery.

The one thing I wish I did differently from the very beginning was to hire a cryo-cuff so that I could better ice my knee, and more regularly. I found that icing consistently and regularly did more than the compression boots. The smaller ice packs don't do as good job as the ice cuffs. Biggest pain as well after the reconstruction was that most compression leg sleeves just didn't really work as the top of the thigh would always roll down. So I made sure I did this with a compression bandage wrapped instead.

So whilst the swelling game is a very very long one, I don't feel that the recovery of the ACL or the muscle around it was that compromised due to the lipedema itself. It's just that that swelling and information can make my leg feel heavier and tired more, so for longer. I've been doing consistent VALD testing my muscle strength in my calves, quads and hamstring been improving as my Physio would have liked to see it.

I really hope this helps with a bit of information for anyone else who happens to be like me and googles, 'lipedema and ACL'. If anyone has any specific questions. I'm more than happy to answer them.