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Author Topic: ACL RECOVERY TIME (patellar graft)  (Read 16908 times)

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Offline dodgyoldkneezer

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ACL RECOVERY TIME (patellar graft)
« on: October 27, 2010, 06:38:32 PM »
I'm a bit confused regarding the recovery time regarding ACL patellar graft recon. rehab.

Yesterday I was told my ACL was had gone (don't know where was mostly there two years ago!) in my right leg.  Having had ACL recon using hamstring grafts in my left leg I was somewhat surprised to be told I would be in a splint for 6 weeks and wouldn't be able to play competative sport for 12 months! 

Compared to the hamstring this seems to be a very different rehab period and just wondered why it took so much longer and if it was really worth it. I'm having no major problem with my left leg.


Offline kaseri

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Re: ACL RECOVERY TIME (patellar graft)
« Reply #1 on: November 01, 2010, 06:28:15 PM »
The typical recovery time for an ACL reconstruction using the Patella autograft is between 9-12 months for unrestricted activity. Thats not to say you will fall into this time frame though as everyone recovers at different rates. You did not mention the type of Patella graft you are considering. Is it an autograft or an allograft? I believe the recovery/therapy protocol for an allograft is longer than it is for an autograft.

I personally had my ACL reconstruction done using a Patella tendon autograft. This makes the initial recovery (approx 2-4 weeks) more difficult but I am on track for a full recovery in 9-12 months. At 9 months I should be given the green light for "unrestricted activity".

Offline sherwooa

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Re: ACL RECOVERY TIME (patellar graft)
« Reply #2 on: November 02, 2010, 03:25:43 PM »
I just had a patellar tendon allograft ACLr last Thursday, and my OS tells me that I could potentially be cleared for return to sports after 6 months.  Full vascularization of the graft probably doesn't happen till 12 months, but that doesn't mean one can't return to sports earlier than that, at least as I've been told.

Here are some other articles that provide a guideline of 6 months:
http://www.kneeclinic.com.au/papers/documents/ACLRehabProgramme.pdf
http://www.eorthopod.com/content/patellar-tendon-graft-reconstruction-acl
Oct 7, 2010 - ACL tear, Medial Meniscus tear, MCL and LCL sprains
Oct 28, 2010 - ACLr (B-P-B allograft)  + meniscus trim

Offline kaseri

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Re: ACL RECOVERY TIME (patellar graft)
« Reply #3 on: November 02, 2010, 04:17:53 PM »
6 months is optimistic in terms of receiving the green light for full unrestricted activity. There are various benchmarks that you will have to attain through PT in order to progress to the next stage of PT. Here is the recovery & PT protocol given by the MGH Sports Medicine facility. The MGH Sports Medicine facility works with professional athletes and the doctors/therapists who have created this recovery protocol are pioneers in ACL reconstruction.

http://www2.massgeneral.org/sports/protocols/Anterior%20Cruciate%20Ligament%20Reconstruction(ACLR)%20protocol.pdf

Good luck with your recovery and above all don't get discouraged when things seem to be moving slowly. It will take time and you will recover.

Offline Kaputt_Knee

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Re: ACL RECOVERY TIME (patellar graft)
« Reply #4 on: November 02, 2010, 04:37:47 PM »
There are no "set times" for any recovery as we all heal at different rates. Also each operation, response time to that trauma and rehab protocol is unique to the person who underwent the procedure.

There are some guidelines: e.g. revascularization takes place in most cases between week 6 and week 12. This is when the graft itself is most vulnerable.

Cutting and pivoting exercises should not be introduced prior to 16 weeks (nobody has given me a good reason but that is what has been quoted ad nauseum). Sometimes I felt I could do them earlier, sometimes not.

There is a doctor here on the board who advocates immediate mobilization, full weight bearing and on the stationary bike within the first 24 hours. This is for Patella Tendon grafts with bone plugs. Others promote minimal weight-bearing, use of post operative braces and no activity for the first x,y, or z days/weeks.

Read up on as many protocols as you can, learn to understand the accepted limitations at the various stages of recovery and then ask your surgeon about your situation. Follow their protocol and the advice of the people who are treating you, i.e. physiotherapists post-operatively. If you feel you can do more then ask. If you feel the protocol is too conservative, ask why. Ultimately you can change therapists if you feel they are being too cautious, but remember that "caveat emptor" - buyer beware!

 ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline kaseri

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Re: ACL RECOVERY TIME (patellar graft)
« Reply #5 on: November 03, 2010, 04:08:18 PM »
Kaputt_Knee... well said and good luck to all of us with knee issues.

Offline dodgyoldkneezer

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Re: ACL RECOVERY TIME (patellar graft)
« Reply #6 on: November 13, 2010, 01:06:22 PM »
 :)
Thanks for the comments and advice.

It's an autograft I am having.  I didn't actually meet the surgeon who will be doing my op (NHS got to love it), the first chance I'll get to ask him these questions is Friday, when I go in for the op!  It wasn't supposed to be until January at the earliest!

Thanks
Iain















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