KNEEtalk

The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: HovaK on October 17, 2011, 07:15:25 PM

Title: how long for an allograft acl to re-vascularize?
Post by: HovaK on October 17, 2011, 07:15:25 PM
I recieved an allograft (tibialis tendon) acl reconstruction 6 months ago.
Rehab has been going great, with no complications (knock on wood).
My surgeon has told me that i can be released for full activity at the 8 month mark, Dec. 8.  He has said "8 months" since before the surgery, stating that if all goes well, thats when i could be released and i have already made an appointment on Dec 8 to see him and get released for full activity.

My question is: is the 8 month mark his own timeline that he abides by (meaning, he is being cautious)?  Or can someone be ready for sports prior to 8 months if they have regained >80% muscle mass/strenght back in that knee?

I know allografts takes longer to re-vacularize than autografts.  But I cant seem to find any data as to exactly how long that process takes.

Thanks!
Cheers.
Title: Re: how long for an allograft acl to re-vascularize?
Post by: Snowy on October 18, 2011, 03:06:10 AM
Here's some useful reading from the Information Hub:

Dr. Frank Noyes notes that allograft ACLs take approximately twice as long to revascularize as autografts: http://www.kneeguru.co.uk/KNEEnotes/courses/acl-reconstruction-failure-and-revisions/acl-graft-failure-due-graft-inadequacy (http://www.kneeguru.co.uk/KNEEnotes/courses/acl-reconstruction-failure-and-revisions/acl-graft-failure-due-graft-inadequacy)

There's more information in the same article about how long the vascularization and ligamentization processes typically take: http://www.kneeguru.co.uk/KNEEnotes/courses/acl-reconstruction-failure-and-revisions/what-happens-acl-graft-after-implantation?action (http://www.kneeguru.co.uk/KNEEnotes/courses/acl-reconstruction-failure-and-revisions/what-happens-acl-graft-after-implantation?action)

Eight months definitely does not seem cautious for an allograft - in fact it seems slightly shorter than standard. I was strictly instructed by my surgeon not to return to full activities prior to 8 months, and that was with a hamstring autograft. He explained that there's more to the rehab timeframe than just strengthening of the graft. Healing of the bone tunnels around the fixation is a very lengthy process, and if you put the graft under too much strain before the tunnels have filled in completely the risk is that it will simply tear away from the fixation. With a bone-patellar-bone autograft the healing is quicker and it's certainly possible to go back to sports sooner, but both the hamstring graft and allografts are somewhat slower because of the different healing processes.

If your surgeon is saying eight months, stick to his protocol. It's not worth taking a chance and wrecking all of the work that you've put into your rehab so far.
Title: Re: how long for an allograft acl to re-vascularize?
Post by: mollyc on October 18, 2011, 04:20:21 AM
I had an allograft (achilles tendon, actually). My surgeon had different timelines for different activities. Interestingly, tennis was the last thing he allowed. I was told I could resume everything, including tennis, by 9 months.