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Author Topic: Surgery coming up this month. Auto or Allograft?  (Read 1122 times)

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Offline DRTMaverick

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Surgery coming up this month. Auto or Allograft?
« on: May 03, 2011, 06:34:24 PM »
Last month I tore my ACL skiing, (3.12.11) had the MRI done, and have gone through the swelling and regaining mobility.   I've got the results back and discussed with the doctor my situation.  He suggests surgery if I'm going to remain active, and I, being who I am will have the surgery.  The ACL is torn off the femur but is starting to scar to another ligament, giving limited stability apparently.

The doctor wants to know if I want a cadaver ligament or if I want my own tissue harvested.  He says he prefers the cadaver as he hasn't had any problems with any that he's put in for the past 5 years, and he said he's been slowly shifting his opinion from preferring patient's own tissue to preferring cadaver.
What do you guys think about this?  I don't have any fears about another body part that isn't mine in me, I'm more concerned about strength and the future of my knee.  What do you think I should do?
« Last Edit: May 03, 2011, 07:50:59 PM by DRTMaverick »

Offline soozles

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Re: Surgery coming up this month. Auto or Allograft?
« Reply #1 on: May 04, 2011, 02:32:28 AM »
If you're comfortable with the surgeon you chose, I would just go with what he's more comfortable with. I had an allograft for my pcl recon, I don't think an autograft is as populAr for pcl because it's a thicker ligament. But from my understanding, there is a slightly higher risk of infection with an allograft, but it's not much concern in someone who is healthy with a normal immune system. I've also heard that with an allograft, return to full activity takes longer but the graft is supposed to be stronger for longer. I would discuss with your surgeon, and ask why je prefers one over the other.

For what it's worth, it's sometimes a little freaky knowing you have some part of a dead person inside of you. That thought tends to pop into my head At random times, and then I almost feel like I need to be more careful because someone gave me this precious gift and I need to protect it. How would you feel if you gave someone a part of your body and then they trash it? But then at other times, limewhen I had a good run that I couldn't do before, I imagine they're looking down gladthat they made a difference. Maybe I'm just a weird one that thinks about stuff like that.
May 2005: Torn PCL, misdiagnosed as chondromalacia
April 2010: pain worse, lots of instability
Nov. 23, 2010: PCL reconstruction
progress here: http://pclrecovery.blogspot.com/

Offline Kmcsmiles

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Re: Surgery coming up this month. Auto or Allograft?
« Reply #2 on: May 05, 2011, 01:29:04 AM »
I had a mpfl reconstruction in September.  My surgeon recommended a allograft for my surgery unless I had religious restrictions.  With a autograft that part of your leg will also have to heal.  I was a bit uncomfortable with a cadaver hamstring at first, but now I appreciate it.  my surgeon didn't question it, she suggested it and I have had no problems. 

Kendra
12/20/89: diagnosed hypermobility joint syndrome
88-96 numerous checks/mri's on knee pain
91- left knee dislocate
93-96 rt and lt knee lateral release, plica removal
12/09 dislocated rt knee
09/10 rt knee mplf and lpfl reconstruction
06/11 rt knee repair nerve damage and ligament
10/10 MUA
6/11 r

Offline DRTMaverick

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Re: Surgery coming up this month. Auto or Allograft?
« Reply #3 on: May 05, 2011, 04:26:26 AM »
Thank you both for your replies!  My main concern I guess is that through research, for active sports enthusiasts that are young (I'm 25), everything is recommending an autograft, BUT all of them are from 2007/08.  For medical (especially in the area of orthoscopics and knee reconstruction) I imagine they're outdated.  They're also comparing the autograft and the allograft from the same tendon, the doctor I am going through is using the Achilles I believe?  I've had surgery through him before, for a torn TFCC, which other doctors would have completely removed, he managed to carve out a 'cup' (or a sort of weird shaped divot for the bone to slide through?) in the tissue without completely removing it, and I'm pretty happy about that. (Don't armwrestle, especially when you're drunk).


Offline mollyc

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Re: Surgery coming up this month. Auto or Allograft?
« Reply #4 on: May 07, 2011, 05:45:16 PM »
There are a lot of different opinions on the board here about the relative benefits of auto versus allografts. Although I had an allograft and had no problems at all with it, I'm not an advocate either way. I just wanted to comment on the research on allografts and age. The issue here, as I understand it, is that you feel better initially after you have an allograft. You don't have an additional harvest site (ie, they aren't taking the graft from your body, requiring an additional incision and additional healing), so you tend to feel ready to get up and go sooner. But, you're not yet healed. Folks who are older and less active don't push it as much, thereby allowing time before ramping up the activity and thus have more success with allografts. Younger and more active folks often push it and increase their activity level before the graft has fully healed, leading to slightly higher failure rates. So, the lesson I take from that is: if you have an allograft, follow your OS and PTs advice about rehab activities and returning to sport. Don't go by your instinct or how you feel, as you feel better before you are fully healed.

BTW, my allograft was an achilles tendon too. People also use the patellar tendon and apparently that's the strongest. I haven't heard of folks using allografts of ACLs, but that doesn't mean that it doesn't happen.
Ski accident 2/14/09
Ruptured ACL, MCL sprain, bone bruise
ACLr allograft 5/27/09
Knee now 100% fine...skiing and playing tennis regularly















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