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Author Topic: ACLr - Can't decide between hamstring autograft and allograft  (Read 908 times)

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Offline kneedown

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ACLr - Can't decide between hamstring autograft and allograft
« on: December 04, 2012, 04:28:34 PM »
Hello everyone!
I am an active 32 year old male and scheduled for ACLr on December 13th. I tore my ACL back in 2005 playing basketball and my financial situation at the time prevented me from seeing a doctor.† I have great benefits at my current place of employment and decided to finally see an orthopedic doctor.† He has recommended the hamstring autograft but advised me to do my own research as well.† I have been digging around on the forums and searching on google but I am undecided on which graft to choose.

Last week I sent an email to my Dr. with my concerns

Hi Dr. xyz,
I saw you for a pre-op back in October and I have been conversing with your assistant and finalized a surgery date of Dec 13th 2012.† To be frank, I am completely terrified as this will be my first surgery and the thought of possible chance of failure doesn't help.†

I have been reading message boards in regards to choosing a graft, but I am still undecided.† I know you favor the hamstring autograft, but I really do like the allograft option since I wonít be hurting my own (good) hamstring and allows for quicker recoveries due to it being one surgical site.† This is just here say, but is it true that allografts have a higher rate of failure due to the simple fact that people tend to jump back into sports from having a quick recovery and feeling great, and not necessarily the allograft being weaker than an autograft?†

When you get a chance, could outline some pros and cons between autografts and allografts?† Bottom line is, I have no need to rush to get back into any sports or activities for that matter.† †The most important aspect to me is I would like the most reliable graft with the least amount of compromise.†

Side note, I am fairly thin, and my legs have been coined as chicken legs, will a hamstring graft from a skinny person like myself be okay?

Thank you so much,
kneedown


He sent me a response shortly after

Dear Mr. Kneedown,

I think it would be a good idea for us to meet in the clinic to talk about the surgery, in order to calm down some of your fears.† I suggest we set a time for the week before your surgery (so either December 11 or 12).† I am going out of town next week, which is why I canít see you until then.† I copied Megan in my office to help set up an appointment for you.

It would be perfectly okay to use an allograft, and we can easily do that if it is your preference.† Nothing gets changed in terms of surgery scheduling / equipment / etc.† It is true that allografts take a bit longer to fully heal, but it sounds like that wont be an issue for you.† We can talk some more about the specific pros and cons when we meet in person.

Otherwise, if you donít want to come into the office, we can just plan on doing the allograft and we can chat before surgery on December 13.†

Take care, and try not to be petrified.† I appreciate that this is a big deal for you, and that it is your first surgery, but we do this all the time.

Sincerely,
Dr. xyz


Any advice before I meet with him and what questions I should be asking?


Offline Kaputt_Knee

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Re: ACLr - Can't decide between hamstring autograft and allograft
« Reply #1 on: December 04, 2012, 06:31:45 PM »
The golden rule is to always go with what your preferred surgeon chooses. We as patients really cannot make a anything other than an emotional decision. If you are still unsure after your talk with your surgeon, perhaps you should find a surgeon who prefers to use allografts.

Good luck, you have waited long enough to do this so why not seek out the opinion of a specialist who regularly uses allografts if that is the direction you are leaning towards.

I've only ever had autografts; 2 x patella tendon grafts using bone plugs to ensure a swift anchorage - both absolutely bombproof, one approaching it's 21st birthday in March 2013! And one revision of an incorrectly placed patella tendon graft using part of my hamstring tendons. I am not experiencing any problems as a result of any of them apart from being extremely uncomfortable when I kneel (so I sit to pray  ;D big deal!)

 :)
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















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