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Author Topic: Shinking the acl instead of recon  (Read 4429 times)

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Offline BBall12

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Shinking the acl instead of recon
« on: June 04, 2004, 10:53:57 AM »
Does shinking the acl instead of recon work.  Anyone had any success with this procedure.  I talked to one person i know who had it done and told me it only lasted for a few months and it streached back out again.  Im a bball player and put alot of work in on my knees and not sure this would hold up.  Any sport players out there who have had this done and found success.  
Thanks
Jason

C.J.R. HEATING

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Re: Shinking the acl instead of recon
« Reply #1 on: February 10, 2005, 02:36:15 PM »
HI, IHAVE JUST HAD ACL HEAT SRINKAGE, ABOUT 67% SUCCSSESS RATE , IT IS TO EARLY TO KNOW FOR ME BUT YOUR SURGEON WILL KNOW AFTER 3 MONTHS , HE WILL CHECK THE MOVEMENT IN THE KNEE IT SHOULD FEEL MORE STABLE, WHO WANTS ACL RECONSTRUCTION  BEFORE TRYING THIS?
ITS NO HASSLE JUST DONT TWIST ON KNEE AT ALL FOR 3 MONTHS!

Offline cassie70

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Re: Shinking the acl instead of recon
« Reply #2 on: May 12, 2005, 09:05:30 PM »
Hello
I had thermal shrinkage done on the PCL. Not too helpful. I am not a ball player but I love sports.

shadehawk

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Re: Shinking the acl instead of recon
« Reply #3 on: May 29, 2005, 12:38:27 PM »
Hi,

This is an older thread, but thought that I'd still post this info about thermal shrinking & one of the newer papers out there on the process.....one of the other kneegeeks (Thanks, Missy) sent this info to me while I was debating my surgery as thermal shrinking was to be part of my procedure also.......


ORTHOPAEDICS TODAY INTERNATIONAL 2004; 7:1  September 2004

Thermal Shrinking - No longer recommended
Clinical studies presented in the last year have shown a high rate of unsatisfactory overall results with thermal shrinkage, Rodkey said.

“Due to the very high long-term failure rate, we can no longer recommend thermal shrinkage for partial tear of the ACL [anterior cruciate ligament],” said Jeffrey L. Halbrecht, MD, at the American Academy of Orthopaedic Surgeons 71st Annual Meeting in San Francisco. A report on that study appeared in the May issue of Orthopaedics Today [“Long-term results poor for thermal shrinkage”].

Halbrecht and colleagues from the California Pacific Medical Center in San Francisco conducted a study to determine if thermal shrinkage using a radiofrequency technique could successfully stabilize partial tears of the ACL.

The study was designed as an uncontrolled prospective study with one-year and five-year follow-up with strict inclusion criteria. “We only performed thermal shrinkage on patients who had bony attachments at the femur and tibia and less than 50% disruption of the ACL,” Halbrecht said. “We had to be able to visualize tissue response to thermal shrinkage intraoperatively, and patients had to be willing and able to comply with rigorous postop rehab.”

Patient evaluation
Patients were evaluated with KT1000 arthrometer preoperatively and intraoperatively before and after the shrinkage, and at one and five years, he said. Researchers determined clinical scores using Lysholm, Cincinnati and satisfaction criteria. “Failures were determined either by verified disruption or more than 5 mm difference KT1000 manual max compared to normal,” Halbrecht said.

There were 19 patients who underwent thermal shrinkage — 14 had partial tears and five had stretched grafts. The average age of the patients was 36 years (seven women and 12 men). Researchers performed the procedure using a monopolar radiofrequency probe.

At five years, 11 of the 14 patients (79%) had failed, requiring complete reconstruction. “When we look at the three patients who had not failed, they still had some improvement in their numbers [according to] the KT1000, Lysholm and Cincinnati tests,” he said. “But there was a clear trend toward decreasing scores between one and five years.”

Tissue status
The initial degree of shrinkage may have no effect on the long-term or even short-term status of the tissue, which should lead to protection and immobilization concerns. Thermal wounds take longer to heal than incisions. “You have to attempt to balance the stresses that you need for remodeling against those which may actually disrupt the tissues once they’ve been shrunken,” Rodkey said.

The “one-wound, one-scar” goal still holds when it comes to rehabilitation. “It suggests that the soft tissue response to trauma will actually contribute to the joint stabilization,” Rodkey said. With atraumatic arthroscopy, thermal modification may be a way to add trauma and stimulus to get to the one-wound, one-scar concept.

A year after the shrinkage, researchers can observe capsular thickening and cicatrix formation. Scar tissue can develop perpendicular to the normal pattern of the capsular fibers. “That makes you wonder if you’re getting the scar at 90º, how long will this actually last and how functional is it?” he said.

“We need to worry about modulations of the scar formation during the remodeling. … Perhaps we can do the initial shrinkage just to initiate a secondary response that would start a cascade of healing rather than just a gross shrinkage of all the tissue.

“Until the basic science and the clinical research have been conducted, the use of thermal energy to treat degenerative cartilage or lax ACL should be considered experimental and should be done with a great deal of caution,” he said.

I was really surprised by the long-term results from this surgery...  ???

Hope the info will help other people make their decisions regarding thermal shrinking surgery.

Good luck,

Shade


« Last Edit: May 29, 2005, 12:45:21 PM by Shade »

Offline jodster412

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Re: Shinking the acl instead of recon
« Reply #4 on: October 25, 2007, 10:06:15 PM »
i know this is about a 2 year old thread..but maybe you still read it...

I would NOT suggest having your ACL shrunk. I had it done after i tore my ACL playing basketball. I could tell that it did not work, and after about 6 months, i re-tore my ACL playing tennis. My new doctor said that that procedure is not used much any more because it is not usually successfull. Again, I would NOT recommend shrinking your ACL.
18 years young =]
female

2.09.07 - Basketball
Thermal Shrinkage of right ACL
[didn't work ^]
Medial Meniscus Trim - right
9.20.07 - Tennis
ACL Reconstruction - right
Medial Meniscus Removal - right

we aquire strength in what we overcome















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