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Author Topic: Anatomical / footprint ACL reconstruction. (new method).. has anyone had it?  (Read 1622 times)

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Offline JWA

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Hi, I am new to the forum and would love to hear from anyone who has tried the new form of ACL reconstruction called "Anatomical" or "Footprint?"
I had an ACL reconstruction to my left leg using my left leg hamstrings many years ago. I snaped it some years later and now need to have it fixed. I have had the first stage ACL bone graft and clean up in preparation and am now ready for the 2nd stage. I have read about the new method and am considering it as an option and would be pleased to hear what anyone's experience of it is?

Also,  they need to use the hamstrings from my right leg this time  and I'm not really happy to have my other knee interferred with as have chondromalacia patellae in it and dont want to stir things up and have two sore knees so I'd welcome anyone's experiences of similar?

Thanks for your help.

JWA

ese230167

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Hi JWA
I had a patellar tendon graft for ACLr on my left knee 21 years ago! It was cutting edge at the time! Rehab did take a long tome and for many years I had a fixed flexion deformity. But I got back to skiing and running and am now a very fit and healthy person. It is a really healthy knee now.

However, in April this year I ruptured the ACL and MCL in my right knee (what was my "good" knee). I had an anatomical ACLr in June using an allograft. Graft choice was due to not wanting to upset the left knee in any way after so long, and not wanting to de-stabilise the right knee any more. The graft was good and procedure straightforward. Unfortunately the graft has failed due to continuing MCL instability and I too have just had the bone grafting stage done (5 weeks ago) and need to wait for the second stage. I am expecting to have an alllograft again, and another anatomical ACLr. I will also have an allograft MCLr at the same time.

So, although the recon on my left knee was not anataomical I have had no real problems 20+ years on and no signs of arthritis. Having said that I think the supporting evidence for anatomical recon is compelling and my surgeon only offers this now.

Hope this helps
Bunny

Offline JWA

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Hi Bunny

Thank you SO much for your quick reply and great information.... really helpful. Sorry to hear your graft failed and I hope the next one goes well and stays fixed. I am only aware of one surgeon around here who does the anatomical method so really glad to hear that you rate it and are happy to have it again, that's a big help to me thank you. I'm interested in th allograft although confess to feeling a bit gossed out by the thought.... did you have any issues with infection or have to take any additional medication because it was a donor graft?

Thanks again.

Juliet

ese230167

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Hi Juliet

There was no problem with the allograft - it comes from the freezer! They are all completely "inert" which is why there are no infection or rejection issues. In fact my understanding is that within 2 yrs of implantation the DNA of the allograft will look like your own. I don't know where the donors come from - try not to think!! I just hope mine will be an athlete!

I'm interested in your two-stage process if you can help. I was meant to have the last ACLr and MCLr in October as a one-stage but the bone tunnels were too soft to use from the previous (failed) graft. So we just did the bone-grafting bit. I am using EXOGEN bone healing to try and stimulate growth but am still looking at probably March before my surgeon will be happy to operate again. That will be a whole year since the original accident! How long has it been between the two stages for you, and how do you know you are now "ready"?

Hope to hear back from you

Bunny

Offline JWA

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Hi Bunny

Thanks on allograft info, very helpful. I'm curious though why they didnt use your hamstrings from your right knee when you had the ACL repair in April ... that is the usual method these days although I think the surgeons each have their preffered methods.

Re your 1st stage... I assume they took bone graft from your hip? I had mine at end of April this year and surgeon said 3 to 6 months for graft to take so I was due for 2nd stage in oct. I opted to wait the full 6 months as I am a skier and so the load on the knee is quite heavy and in addition I had time to wait it out to be sure I got best results. Until you have a scan you can't actually tell how well the graft has taken but I think the indication is in how your knee feels generally, ie, do the scars still sting... does it hurt like hell when you bang it... does it still ache or swell up on overuse or extreme temperature? I had a two level ACDF (neck fusion) in September (which is why I have not yet had my ACL) and have been told to wait a minimum of 7 months for good fusion in that so about the same timescale as the knee. I don't know about Exogen but they do advocate suppliments in protein, Vit C, D and B12 for good grafting. Mainly, I think when you've had several knee issues, you are at greater risk so the more healing time you can give it is probably the best way forward. Like you, my first ACL was 20 years ago and that was a brilliant reapir which lasted 15 years but now I'm that much older, it's probably going to take a bit longer despite good fitness levels and lots of deternination.

Can I ask if you are UK or USA?

Hope this is helpfull.
Best wishes
Juliet

ese230167

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I'm in the UK. You?

I'm also a skier! Have skied all my life and both knees were damaged doing that! Don't think I'll be doing any this season though. I also run half marathon distance so not sure when I'll be back to that.

Your message about interval times between stages is really helpful. Thanks. It just seems like such a long process and I was gutted to wake up from the operation thinking I had had an MCLr and ACLr.....to find I had a bone graft! The EXOGEN is an ultrasound device which I have to wear over the grafts for 20 mins a day and it's supposed to speed up bone healing by 22%. Fingers crossed.

Hamstring graft is the norm in UK too but due to the extensive damage I did to my right knee (no MCL or ACL, and torn meniscus) they didn't want to potentially de-stabilise the knee by taking away the hamstring. I wanted them to use the one in my left knee but they didn't want to mess with that after 20 years. So I'm stuck with allografts. My surgeon is doing some really interesting new stuff and is talking about augmenting the allograft with Kevlar. I asked my husband if he wanted to donate me a hamstring...but he said no!!

Do keep in touch. Would love to see how you progress.

Elizabeth

Offline JWA

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Hi Elizabeth,

Yes, I'm UK too ... Hampshire and looking at Mr Wilson's work although he's not my current surgeon (who doesn't do the anatomical method). Skiing is SUCH a great sport but not so good on knees and let's face it, you can't give it up right?! I re-snapped my replacement ACL 8 years ago and didnt have time to fix it until now so I got a Donjoy knee brace which has seen me through skiing and all other sports in the interim and is pretty indestructable, easy to wear and really does the job so you feel no instability at all. You could opt for that whilst you wait out the graft?

best wishes  Juliet

ese230167

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ahha! well Adrian Wilson is my surgeon!! Who is yours?

Elizabeth