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Author Topic: My graft vs. cadaver  (Read 1858 times)

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June O

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My graft vs. cadaver
« on: September 12, 2005, 06:25:47 PM »
Okay...I did it...I have a complete tear of my ACL...surgery is scheduled Oct. 21...I need to make a decision on whether to use my own graft or that of a cadaver...any info. pros or cons will greatly be appreciated.

I am trying not to freak out about the surgery...but I am not looking forward to post-op and P.T.

Thanks for your help.

June O

Offline lenny

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Re: My graft vs. cadaver
« Reply #1 on: September 12, 2005, 07:27:28 PM »
A friend of mine had cadaver ACL replacement October '04, and he was running around playing softball this summer without a hint of a limp or any indication of pain.  Obviously his surgery went well, but I don't know anyone who has used their own graft. 
37 y.o. male

shadehawk

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Re: My graft vs. cadaver
« Reply #2 on: September 13, 2005, 11:19:50 AM »
June O,

Here is a site that might help you some....

http://www.aclsolutions.com/surgery_4.php

Good luck on Oct 21.

Shade

Offline jhvan

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Re: My graft vs. cadaver
« Reply #3 on: September 19, 2005, 08:16:20 PM »
Hello!

I am two weeks post op from acl reconstruction and meniscus tear.  I had gotten 3 opinions and all three said that an allograft (cadaver tendon) is what they would recommend and would do that themselves if they were in my situation.  I tore my acl in Feb 2005 in a downhill skiing accident.  I decided not to do the surgery right away as I feared the recovery would be too lenghy and I didnt want to ruin my summer.  I chose to go with the allograft and scheduled surgery for Sept 6.  In surgery, my OS also found I tore my meniscus so that had to be repaired as well. I had trouble kneeling down completely so it didnt surprise me when I heard this.  I went to the hospital and was home in the early afternoon.  I was very very afraid to have the surgery but I have been pleasantly surprised at how well it went.  I came home wearing a huge brace and a cuff (looks like a hand held cooler hooked to the blood pressure cuff.) This was actually really nice and convenient but you may want to check with your insurance company to see if they cover this.  I didnt find this out until later but some dont cover this and they can be quite costly ($200-300).  The only drawback to using this versus just standard ice packs is that the cuff didnt stay cold for too long.  Anyway, the next day was rough.  I didnt do very well with the vicadin(pain killers).  It made my stomach upset so I chose to just use ibprofen.  I didnt have a whole lot of pain just a lot of ankle swelling/brusing.  My physical therapist recommended wrapping my leg from foot to just above the knee to keep the fluid away from my ankle.  The first day of PT (2 days post op) I could bend my knee 60%. Then 90% and now I am up to 110% which from what I understand is good.  I am now with only one crutch and only use my brace to protect my knee when out in public.  Had I know the recovery would have went this well, I would have done it right away.  Before the surgery, I had no pain, great stability and wondered why I was having surgery.  My children are 3 and 5 and just learning how to ski.  I didnt want to sell them short because I was too scared to have surgery.  I know I will have a hard time getting back on the slopes because of fear of the same thing happening again but at least I know that the worst is over.  I have had friends who have had the autograft (your own) and they said they would never do it again.  Alot of pain and a lot of PT..6-8 months worth.  I had very little pain and 4-6 weeks of PT....it was well worth it for me!
Good Luck!

Offline SKOM

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Re: My graft vs. cadaver
« Reply #4 on: September 19, 2005, 08:36:16 PM »
Save your good parts. You'll need'em. Allografts are generally strong and safe lig alternatives nowadays. just an opinion.
ACL/PCL Reconstruction (96)
Partial Medial Meniscectomy (03)
Post Lateral Corner reinforcement (too help with Laxity issues) (03)
Partial Lateral Meniscectomy (05)
ACL/PCL Revision (05) Hamstring, Achilles Allografts.

Leader of the "Lax" Knee Clan!

Offline KneeD34

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Re: My graft vs. cadaver
« Reply #5 on: September 19, 2005, 09:40:59 PM »
My son (16) just had ACL recon on Aug 25th and we had to make the same choice.  We went with the graft.  He'll be 4 wks Post op on the 22nd and is walking in his brace. 
Logic we used for this choice:
1. Cadaver - How old is the tendon they will be using?  Would you buy a used set of tires for a new/newer car that had 20-30k of use on them?  If you use a 40-50-60 year old tendon how much longer should it last?
2.  Cadaver - Can you truely be assured it's "clean".  Yes they can freeze, irradiate, ect, but who knows.
3. Graft - It's yours!

Offline Nails

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Re: My graft vs. cadaver
« Reply #6 on: September 19, 2005, 10:11:04 PM »
Supposedly the you graft does not get as elastic as maybe a cadaver would.Your graft would also be at least two times stronger than the cadaver. My doctor told me this: "You're young and involved heavily in sports. Using a cadaver graft is out of the question. Your best bet is your own tissue..."
He also said that if I wasn't so young and wasn't heavily involved in sports then a cadaver graft would be good option.
So you should base your decision on how old you are and how much you're going to be playing sports and what's your overall purpose that you hope to accomplish with this surgery.. If it to just live normally again, then the cadaver is great because its a fast return.
Hope this helps
Nails
ACL Reconstruction June '05 (Hamstring Graft)
MCL Tear Grade III
Bone Bruise
Cyst
Dried up cartilage on bone
"Its time to release the beast.. Let me play!"
*18 years old*

Offline SKOM

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Re: My graft vs. cadaver
« Reply #7 on: September 20, 2005, 01:47:12 AM »
*Your graft would also be at least two times stronger than the cadaver*-NAILS

I Don't believe this is true. Please show me where this would be found.

And there is no way to tell how old the person was who donated the cadaver either. This is a risk but this member above has a valid point.


You know the internet has many sites that explains the pros and cons. Do some research and this should help you better from a medical perspective. Just GOOGLE it! Good luck!
ACL/PCL Reconstruction (96)
Partial Medial Meniscectomy (03)
Post Lateral Corner reinforcement (too help with Laxity issues) (03)
Partial Lateral Meniscectomy (05)
ACL/PCL Revision (05) Hamstring, Achilles Allografts.

Leader of the "Lax" Knee Clan!

Offline jhvan

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Re: My graft vs. cadaver
« Reply #8 on: September 20, 2005, 03:08:47 AM »
all three of the med opinions that I got said that if I would use my own graft there may be the potential for a "tighter knee" depending on the size of my own ligament that they used for the reconstruction.  That was one benefit in using a cadaver...the doctor could use as much of the tendon as he found necessary to give me full range of motion later on.  I have young kids where I need to bend down and get to their level quite often so I found this issue to be of importance to me.  Also he wanted me to consider my activity level.  If I were to play "professional sports" I would strongly want to consider using my own graft.  I stay active but not that extreme.  My biggest concern with the cadaver was infection and from everything that I read and discussed with my doctor there is always that risk but it is very very low.  They test it over and over and over.  I guess you have to discuss your options with your doctor and decide what you are more comfortable with. 

Offline Nails

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Re: My graft vs. cadaver
« Reply #9 on: September 21, 2005, 01:31:40 AM »
My doctor told me that it would be two times stronger than a cadaver... Cadaver ACL that is. I didn't mean to mislead anyone but I guess I left that out...
ACL Reconstruction June '05 (Hamstring Graft)
MCL Tear Grade III
Bone Bruise
Cyst
Dried up cartilage on bone
"Its time to release the beast.. Let me play!"
*18 years old*

Offline ski bum

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Re: My graft vs. cadaver
« Reply #10 on: September 21, 2005, 03:33:23 AM »
The standard of medical practice out here in Northern California is allograft--for normal folks and professionals.  The logic goes as follows:  it is stronger (folks out here use achilles tendon--inherently much stronger in the first place) and it avoid trauma to the patient in harvesting the graft.  When I asked the 3rd OSs I've dealt with over the last year about this (plus 3 fellows),  all were quite outspoken: they won't under any circumstances do other than an allograft.

That said, I think it is really a location and OS-specific range of options.  Different OSs have different opinions and experience.  In the end, in the case of a good successful surgery, it all ends up much the same.  Allografts used to have a bad rep due to concerns about infection--but that is addressed by newer techniques for sterilizing them.  For me, it was a non-choice:  I didn't want to weaken one part of me to strengthen another part.

Andy
12/23/04:  complete ACL tear, partial LCL, tibia bruise
1/19/05:  allograph ACL
7/8/05:  AIR-scar tissue & ACL graft girth reduction
8/4/05 nearly full ROM-released to ski
8/11/06: AIR-scar tissue, grade 3 cartilage potholes on femur
10/13/10:  Mfx, L knee to fix 3cm pothole