Cruciate ligaments :

ACL reconstruction options - - Posted by Michele36 (Michele36), 7 October 2004

Last year I had my ACL reconstructed using an allograft patellar tendon. My knee is very small and this proved to be too large a ligament to create (8mm was used). I had to have my knee scoped to make room for the ligament to move properly. Now I am told that I need to have the surgery redone, but it is suggested that a hamstring tendon be used this time.

Does anyone know about this option? My previous surgery was very apinful afterwards. Is this option much better for pain? Rehabilitation?
Posted by jbluestein (jbluestein), 7 October 2004

I haven't read or heard of a revision due to the wrong size ligament being used.  I've only read of a revision when the ligament is re-torn. Those, mostly due to returning to sports too soon.

Is there too much laxity in your knee? Is that the problem? That seems to be an issue with some  allografts.  Have you spoken with your physical therapist? A 2nd opinion from a surgeon?
Posted by Michele36 (Michele36), 8 October 2004

I did get a second opinion. Both my doctor and the second doctor say to have the ACL repositioned, which means putting a new one in. The second doctor says a hamstring will work better. Both doctors have said that my knee is just too small for the 8mm patellar tendon to move properly in the tunnel.
It's getting very loose now and the second doctor feels the ligament is fraying.
I'm going with the second doctor's suggestion. My knee hurts now and has buckled twice recently, so I know I need to get it repaired sooner than later.

Michele
Posted by jbluestein (jbluestein), 8 October 2004

I have read that allografts do have issues with weaker tensile strength than autografts, due to sterilization issues.  Also, allografts do tear when the patient returns to sports too soon. Because the patient is feeling less pain sooner than other grafts.

http://www.orthoassociates.com/ACL_grafts.htm#Allograft

You can expect the same level of pain and rehab time with the hamstring graft. Perhaps some more pain because they are taking a graft from your hammie. Some say the hamstring graft holds it's strength over time better than the allograft.

How experienced are your surgeons? How many of these surgeries do they do? How often?

good luck
Posted by Michele36 (Michele36), 9 October 2004

My new surgeon has performed several ACL replacements using hamstrings, including allograft hamstrings. My previous doctor used patellar tendons. I am more confident that the second surgeon is going to help me. I'll find out the first week of December!
Posted by rodrigo (rodrigo), 9 October 2004

best acl reconstructions options info i~ve found is on this site.  it has everthing.

http://drjonhyman.com/archives/knee/acl_reconstruction_torn_acl_about_acl_injury_acl_tear_acl_surgery.php


Posted by Michele36 (Michele36), 10 January 2005

I had ACL reconstruction and my knee has been locking up. The doctor and therapist finally diagnosed that my tibia no longer rotates when I go from a stance to walking. My popliteus tendon is too tight. Has anyone heard of this before?

Posted by Gab (Gab), 10 January 2005

on 10/09/04 at 15:12:02, rodrigo wrote:

Oh my God, some of the ACL-injury videos are NASTY!!!   I can't believe my knee did something like that (although it certainly did feel that way lol)

Michele, I'm really sorry to hear you have to go through this again..What's the state of your muscles right now? The only thing I wish I had known was to try to get some of my muslces back before surgery instead of focusing solely on keeping the swelling down..

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