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8/30/2008
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Stockholm, SE
Edited Date/Time
2/18/2016 2:35pm
A friend of mine had the misfortune to torn his ACL a couple of weeks ago (racing incident), and I trying to give him the best advice here. I know there are at least four approaches for surgery (grafts): synthetic, hamstring, cadaver or the patella and were I'm pretty sure the patella and hamstrings are more suited for athletes as in being stronger than the cadaver and don't get weakened after a while as in with the synthetic one. But choosing between the best two, maybe most important factor is having a skilled surgeon...
So do you guys know what the pros' like RC and RV chose, or do you guys have any personal experience with any of these reconstructions?
The irony here is that prior to the injury (like two weeks earlier) he tried to get knee braces paid from the insurance company (Blue Shield), like the Asterisk or the MX Pod, but they didn't want to do that. Sure he could have paid for them himself and we don't know if those would have saved his knee, but based on reading tons of stuff around the knee braces and this type of injury I'm pretty sure they have a point and I would newer ride without them. I don't want to debate that, we are all free to choose here.
So do you guys know what the pros' like RC and RV chose, or do you guys have any personal experience with any of these reconstructions?
The irony here is that prior to the injury (like two weeks earlier) he tried to get knee braces paid from the insurance company (Blue Shield), like the Asterisk or the MX Pod, but they didn't want to do that. Sure he could have paid for them himself and we don't know if those would have saved his knee, but based on reading tons of stuff around the knee braces and this type of injury I'm pretty sure they have a point and I would newer ride without them. I don't want to debate that, we are all free to choose here.
I used Dr. Eric Eifler in Denton, TX (http://www.txsportsdoctor.com/) and would recommend him to anyone.
http://www.thumpertalk.com/forum/forumdisplay.php?f=48
My knee has held up fine for six years, riding bikes, and playing sport such as squash and touch rugby.
A lot of people choose not to have the surgery, and you can get away with it for the most part. However the knee joint will occasionally collapse, even under normal use, and each time it does there is the potential for more serious damage to cartilage (meniscus) and early onset of arthritis etc. Over time this continued damage will accumulate and if severe enough your only option is a total knee replacement.
My surgeon told me this story, although I had already made up my mind to have the reconstruction done anyway. Funny thing is, when I was in the hospital room after surgery the guy on the bed next to me had just had a total knee replacement, and told me a story almost identical to the one the surgeon gave me.
There is also divided opinion (and very little supporting data) on whether knee braces do much to prevent ACL damage, although they probably do something for MCL protection.
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Many people choose the Patella graft due to the fact when they remove the middle section of the patella they also take a small chunk of bone off with each end, so you have a bone graft healing inside the holes drilled in your Femur and Tibia. The Patella graft is also said to be the "strongest" of the different kinds of grafts, but ALL the grafts are still stronger (when healed) than your original ACL.
I used Dr Laith Jazrawi of NYU in NYC. He is a fantastic Dr, if you are within 2 hours of NYC use him !! I live 100 miles outside of NYC and still chose to make the drive.
The use the achilles from a donor cadaver. Its just tissue so no rejection issues. Going strong now for 5 yrs with no issues at all. Age can also be a determining factor. I was 39 at the time and they said you have more issues with the donor site recovery.
Who was that dude on here that went patellar and got all fucked up? It was gruesome. swizcore maybe?
Great answers are still coming in, so I will wait to write a general answer and what I decide to recommend. Tnx lads!
Pit Row
I was in PT for about 3 months. I ride my stationary bike for 1hr at least 5x week at a certain HR and my knee feels strong. I do have that weird feeling in my knee when I kneel, but other than a little bit of stiffness I am good to go.....I did get a CTI through my insurance company.
Uncle Arthur has shown up over the past year; at the ripe age of 30. Alieve and glucosamine not really doing much anymore.
What are you guys doing for the constant ache and acute pain at the end ranges of flexion/extension?
That being said my doctor was great. I handed him a total mess and he salvaged what he could. It took time but I got back to doing everything I had done before, just a little more tender. Good luck and have him go hard in PT.
Different surgeons have different opinions, have their set way of doing procedures and have relationships with certain instrument companies and reps. Some ACL sets are no frills and to the point, while others like to incorporate different steps and alternative instruments to make the doc feel all warm and fuzzy that this way of doing it is better than "Dr. So &
SO's"
The process for patellar grafts is definately more invasive as they are getting into your patella (you will be missing a chunk of it) as well as your tibia. Rehab hurts....but JUST DO IT.
www.mxsportsmed.info
As I would tell a friend, find the doctor, then the procedure. I was lucky to have a pretty renowned sports Dr. that is published for being innovative but I ended up with a different procedure for each leg. I got a hamstring graph on the right leg and ultimately a cadaver on the left because I had a damaged hamstring on my left and already used the patella in 1991.
One of the things explained to me was the hamstring is every bit as strong as the patella but where it falls short is the way that it is fastened. The patella carries a bone graph with it and the hamstring does not. The patella fastens easier but has less blood cells to make it regenerate. The hamstring has no bone on bone fastening but has more blood cells and is more adept to surviving and regenerate. The solution, was to have a hamstring graph but instead of using screws, my doctor drills a big hole in the your tibia and femur and inserts a type of dowel pin and glues it in. The bone grows and fills the void and the hamstring is secured inside the hole.
From my experience, screws, pins and rods hurt. These dowels didn't hurt after the surgery and they don't hurt today. You can't even feel them as sometimes you can feel a screw. The biggest incision is about an inch long. In 1991 I had one that was about 7 inches and one that was about 4. Night and day. I would rate the pain factor on the modern ACL as about a 4.
Comparing modern to modern surgeries from two different Doctors. I had therapy with a guy that had a patella graph done 3 weeks ahead of me. When I was on my second week, I had passed him up in therapy. When I left therapy for the last time, around 10 weeks, he was still there. But I did work a lot harder than he did and I had been injured before and knew the rundown.
Now I just read a study saying that ACL surgery could even be pointless if you right away do the right PT that makes you build up adequate strength in the remaining tendons and muscles.
They did a 20 year follow-up and seems those with only PT had less cases with arthritis. BUT, this was when reconstruction surgery was done on the meniscus as well...
So many factors...
Now I had a buddy that put off having surgery. He has more of a muscle man build and is a surveyor for a logging company. The guys got some leg muscle. He went basically with the idea that your Hamstring, Quads, and Calve muscles hold your knee in place, and it does. Strengthen those and you will have no trouble..... Not true. He built up his muscles and his knee did not come out on him like mine did but he did have problems later. Basically like an animal that regrows a tail when you cut it off, the body tries to heal itself. In order for the muscles to hold the knee in place without an ACL they have to be strengthened and strengthened evenly. If one muscle for instance is also damaged or weakened, the other muscles will grow bigger to try and compensate. This is what happened to my buddy. He had a muscle group that was being compensated by another. When he did have surgery it gave him a lot of problems. It might have been the least of his worries but I know they had to adjust his therapy because of it. It really extended his recovery.
Have any of you guys gone years after an ACL tear before having surgery?
For you older guys, what type of graft did you choose?
Does your knee feel better than it did before surgery?
Does anybody here regret doing an ACL reconstruction or feel that it has not benefitted them as much as they anticipated? In other words, was it worth the time off from work, riding, etc?
Thank you for your time on this!
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