Blew out my second ACL this weekend

Did my right knee 7 years ago and just did my left knee this past weekend, both happened skiing. Not looking forward to another surgery and 6 months of rehab. Not to mention that my insurance sucks.

Who all has had an ACL reconstruction? Which graft did you get? How did it turn out? Do you wish you had chosen a different method?

 

been there done that!

cadaver all the way!
works great, happy with my choice.

 

Blew mine out in college... had a patella tendon graft. glad i went that route myself... i know they were experimenting with synthetic, but i also heard they were having problems with them over time. good luck!

 

wow sorry to hear that
My first ACL reconstruction was many years ago (79) & it was hamstring graft.
The surgery was archaic as compared today. Talk about muscle atrophy.
I had a couple other scopes on that knee through the years but since I had severly damaged my medial mensicus, the surgeon removed it.
Staying very active due to my job (military), my knee never was the same.
Last June, I had a total knee replacement & gotta say I love it. It was tough but nothing like what I went through in 79!

In 2005 my "good" knee suffered a MCL tear/ACL rupture skiing. The MRI was inconclusive on whether it was partial or full tear so I opted not to have surgery, just PT the heck out of it. Its been fine, knock on wood. I do not wish knee injuries on anyone!!

I wish you the best this time around. It totally sucks to have to got through it and feel my knee injuries really messed with my emotionally well being so post up to keep the spirits up! Hang in there.

 

That sucks. I blew out my right ACL/MCL three weeks ago. I was bringing an appliance (stove) from Sears home in the back of the Taco. I got into the back of the truck and gave the box a little 'push' to see if it would be easy enough to jockey to the back of the truck. I slipped when I did this and started to fall out of the truck but my left foot got caught between this box and the side of truck. At this point my body was getting sideways and quickly my face was heading towards driveway concrete. I stuck my right leg out to try and break my fall and as soon as my foot planted on the driveway, my knee gave way. Felt like a cracking a big knuckle and breaking a bone at the same time. I laid there in the driveway for about 1 minute before it started raining on me so I hopped into the house to lick my wounds. Wish I had a cooler story but at least the Tacoma was there

Been in my brace for about 3 weeks now going to PT trying to get the MCL to heal. ACL surgery is scheduled for the 28th. I was told the graft would be taken from hamstring. Not at all looking forward to rehab. Do you think deer season this fall will be at all possible for me? How long did it take for you guys take to walk, jog, hike?

 

Thanks Jude/Judy!

So what does a full knee replacement feel like? Can you still do athletic stuff with one? Like hike, jog, ski, etc?

 

Awww man, that suuuucks. Talk about a freak accident. At least mine happened doing something where knee injuries are somewhat common.

I had a hamstring graft when I blew my right knee 7 years ago. I ask myself frequently if I had to do it over again would I opt for the hamstring and my answer is "I don't know". On the plus side, the hamstring graft is the strongest graft on the market once it fully recovers (these days they use a quadruple-stranded semitendinosis-gracilis graft as the new ligament). A lot of studies show that it's 2.5 to 4 times stronger than your original ACL.

The drawbacks are that it takes longer to heal, because it's soft tissue that needs to bond to the bones in your leg, compared to the patellar graft which is bone-to-bone and heals quicker. So you definitely do need to be extra careful for the first few months of rehab with a hamstring graft. I would say if your surgery is on the 28th you will easily be fit for deer season. I did a road bike race 3 months after my surgery (against my doc's urges to not do it) and I did fine. Was mountain biking hard 5 or 6 months after surgery.

The biggest bummer about the hamstring graft though (for me at least) is that my hamstring has never been the same since. They say you can recover 98% of the strength with rehab, but I call BS. Standing upright, if I try to curl my lower leg up such that I try to touch my foot to my butt, I can't even come close. I can get my lower leg up about parallel with the floor before it starts to cramp, and that's as far as I can get it. This is 7 years after surgery, mind you. Also, I lost some range of motion. I can no longer kneel comfortably because I lost flexion in the affected leg, and it feels like I'm stretching something really hard when I try to kneel.

So that's why I want to see what other people have to say about their experiences with other grafts. I'm sure the hamstring graft can work out better than it did for me, but I'm just wondering if the drawbacks of other grafts are worse or better than the drawbacks for hamstring graft, given my lifestyle.

My advice to you is make sure you are 110% dilligent with your rehab exercises, particularly those involving stretching to regain your range of motion. And I don't know if you ride a bicycle at all, but it's one of the best knee rehab activities out there. Hope you have a smooth surgery and recovery.

 

sorry to hear about that man, knee injuries are the worst. I blew out my ACL, MCL, and PCL, all at the same time, close to about 6 years ago, and fortunalty i didnt need and surgery. I have been surgery free, and i can still play lacrosse, run, workout out, all that stuff (with the assitance of a knee brace). Just did the rehab for a year and i was back to it. Good luck. Dont give up

 

At first it felt funny, like mechanical & getting the my range of motion was the hardest. I had developed lots of survival habits to make up for the instability & weakness in my old knee. So I had to relearn to walk properly without limping, using full range & all my leg muscles on the left side over again. My surgeon who is great said the sky is the limit & I believe him. He was top notch! (Dr. Huber, Mt Mansfield Orthopeadics).

I was cleared for everything in November 2010 but opted not to ski this season though I snowshoed & pounded on it snowmobiling.
I love to hike and bike too & have started that since Spring is now here in VT.
So yes you can do anything since prothesis mimics a normal knee minus the swelling & pain.

 

I broke my ACL out of my Tibia. So I kinda understand how much it sucks. Gl with the rehab. I hope they still do the electronic shock muscle rehab. That stuff is awesome!

 

OP - thanks for the great advice! I'll be sure and work my PT with diligence, especially my hamstrings. Coincidentally, the PT said today (not my regular PT) to work on my hamstring exercises more than my regular PT has assigned. He said that people with stronger hamstrings and able to reduce swelling have the most success in their recovery.

My doctor gave me the option of hamstring or cadaver, with a high preference for hamstring. He pointed out that blood flow is restored sooner with donor from your hamstring. Donating from my patella tendon was not even discussed.

I have friend who donated from their quad. His surgery was 10 years ago. He didn't seem to have any complaints except for the depression he has on his quad from where the donor was removed.

Finally I have a co-worker who got his from a cadaver very recently. He didn't have any particular complaints either. He got unlucky because he started playing basketball again a year after his surgery and after just 3 games, he blew his achilles tendon.

All the people I spoke with said similar things like, 'I was golfing fairly soon but didn't play basketball or soccer for at least a year." I didn't actually go seek any other opinions. This doctor is well regarded and used to repair a lot of knee injuries for athletes at Navy. I suppose the fact he is a provider for my insurance plan made the greatest difference at the time.

Thanks for the well-wishes! When is your surgery date scheduled? Do you know if Quadricep/Patella/Hamstring/Cadaver are the 4 widely recognized options for ACL? Let us know when you decide.

 

OP - I'm actually getting my surgery at Overlake Hospital. Dr is located just north of the hospital. Where you getting yours?

 

Hey Ben, heal fast man! Take care and as said, be diligent about PT. Dr.'s orders!

 

bummer man. i've had acl and meniscus reconstruction done on both knees. the right one was done in 2004 with the pcl graft and my left was done in 2009 with the hamstring graft. if i had to do it again(which i pray to god i dont) i would want the hamstring graft. overall it was much less painful and felt much more stable right off the bat which gave me more confidence during therapy. both are knees doing equally well now. good luck with everything

 

I've assisted with hundreds of ACL reconstructions over the last several years and I must say that bone tendon bone grafts definitely seem the most stable and the benefit of bone to bone healing is hard to beat. We do a lot of college football players and that seems to be the preferred method. Hammys can stretch out a little more and some ham weakness and donor site pain is common. Patellar tendon btb graft patients occasionally complain of pain along the front of the knee for the first couple years, but this is typically minimal. There are pros and cons to each method and graft type.

 

Cadaver FTW. You'll heal a lot faster. I was walking in 7 weeks after my surgery

 

Actually cadaver tissue takes longer to incorporate than autograft. Most of our ACLs are off crutches and walking fine in their hinged brace in 5 to 10 days.
The nice thing about cadaver is no incision from graft harvest and one less dissection site to cause pain. Also, the tissue that comes from the bank is usually huge so you get a heartier chunk of tendon with which to make the new ligament (my job ). I love power tools at home and work.

 

Thanks for all the good vibes everyone!

Besides the [slight] risk of getting some kind of infection from a cadaver, what are the drawbacks to getting a cadaver graft? I've read/heard they aren't as strong as autografts (as in overall tensile strength) but that never really made sense to me, as like you say, they have more material to choose from and to work with.

I would love to not have to give up my other hamstring but only if I can have a graft that is of comparable strength to the semi-t/gracilis graft.

Also, what's up with gore-tex ligaments these days? Why do we never seem to hear about them being used? Are they just really expensive?

 

I'm not sure about GoreTex, but I think that fell by the wayside in late 80 and into the 90s due to graft failures and joint inflammation. Cadaver tissue is very expensive for one and some insurances may not cover it. As far as strength deficiencies, I would guess this is due to longer healing time or perhaps weakening of the tissue due to processing/sterilizing and freezing.

 

Finally met with my surgeon today and set up a surgery date. I think I'm going to go with an opposite knee (contralateral) patellar graft, harvested from the knee that I had reconstructed 7 years ago. My logic is that my previously-reconstructed side is already somewhat comprimised from the hamstring graft harvest on that side -- my hamstring never regained full strength, and I lost range of motion on that knee. I can't even fully kneel on my previously-reconstructed knee because I lost so much flexion in that leg. So I figure if I'm going to risk comprimising a body part from this upcoming surgery, I might as well further comprismise a body part that is already comprimised rather than comprimise second leg that has the potential to be pretty much 100% after surgery. I'd rather have one shitty leg and one good leg than have two so-so legs.

I talked to my surgeon about it and he seemed fine with the idea, although he usually does hamstring grafts, so I hope I didn't talk him into doing something that he's less than comfortable doing.