Which graft for ACL reconstruction?

[hebegebes]

Much thanks to all of you who have replied to my "ACL, MCL, meniscus" thread!

I just returned from getting a second opinion on the condition of my knee. It's unanimous: ACL reconstruction is required for a full return to moto, running, hiking, etc.

I have been doing a lot of research on the web and have talked to both doctors about which type of tendon graft to use. The choices are: 1) Patella, 2) Hamstring, 3) Cadaver Donor. Does anyone have any opinion on which is the best? The Dr. said he would go with the cadaver tendon if it was his ACL that needed to be reconstructed. It requires the least amount of recovery because the tendon doesn't need to be harvested from your own body. He said that a lot of people don't like to use the cadaver tendon because there is a very, very, very slight chance of HIV or Hepatitis C transmission if the cadaver was infected. He said that the screening process is so good now that this is highly unlikely, but he is required to inform me about it anyway.

 

[AnneBrooks]

I went with the Cadaver parts (I have 2--PCL & ACL) and have not had any problems. My Doctor said the less stress on other parts of your body, the better off you will be. The cadaver parts are very strong, but take quite a while for the blood flow to get up to speed. Good luck, and let us know what you decide to do.

 

[612]

I had the patella graft. I've had no problems yet, but I'm only 9 weeks post op. The only thing about the cadaver that worries me is the chance of infection. The CDC (center for disease control) recently put out a notice/alert on cadaver ligaments etc. It appears that organ harvesters are leaving the cadavers out some 18-24 hours and infections get into these parts. There has been at least one confirmed death and numerous confirmed infections from this practice.
In the positive light, if your knee is suffering from too much trauma, this will be the quickest way for you to get back. My doctor told me that due to the severity of my knee, it really didn't make that much difference as for as recovery.

Good Luck!


612

 

[dduff73]

I work as a physical therapy assistant and see about 2-3 new acl patients a week. Most are patella and have a 4 to 6 month rehab. With minimal pain and swelling. But that also depends on the doctor. The hamstring seems to be more painfull but have only seen a couple of them. Both methods have had great success were I work. Sorry no cadaver cases to report on. All I can say is go to PT and work hard at what they say, its for your own good. And its never too early to start working on quad strength before the surgery, it makes the recovery faster.

 

[Dennis Meyers]

I'm 6 weeks post-op from my ACL reconstruction. I had the hamstring graft, and recovery has been fast. The only problem I have had was a hamstring tear, but it wasn't on the same muscle head as the grafts were harvested from. I never really spent a full day on crutches, I went to the hospital at 6am, was home before 1:30pm and was walking w/o crutches that evening (until the anesthesia completely wore off :eek: ). I returned to work after 6 days, and PT is going very well. I pick up my new brace on Tuesday and I can start Mountain Biking, so I have had excellent results with the hamstring graft. The stronger your legs are going in, the quicker your recovery will be! I can't comment on the other grafts, I'm sure each one has it's upsides and downsides, but I hope my experience with the hamstring graft helps. Best of luck! :aj:

 

[Cisco43]

I had arthroscopy ACL reconstruction with an autograph, which consisted of harvesting the central third of my patellar tendon. It’s been almost 4 weeks post op and each day is a slight improvement. I felt it was the least invasive method. I was uncomfortable thinking about using a cadaver, it just seems creepy to me, and I’d rather use my own parts if they were available. There are always risks using cadaver parts. Just think it through and find a very good surgeon. The less time you are under the knife the faster your recovery.
Good Luck with you decision and if you want to e-mail me feel free. Post op is pretty boring, no fun outdoor activities.

 

[NVR FNSH]

I had a patellar graft on my left knee in Nov '99. I can't kneel down on my left knee w/o a hard shell knee pad. Installing ceiling fans - wiring in the attic - has been real fun. Most people I know w/patellar graft can't kneel even after >5years. The few people I know that had a hamstring graft do not have this problem. One of the guys w/hamstring graft is an ex-ski patrol member so I don't think the strength of a ham string graft is an issue.

If I had it to do again I'd probably go with a hamstring graft.

Brian

 

[yo its matt!]

i did lots of researh before and after my petella tendon graph, if i could do it over id go with the cadaver tendon, what i have read there is so little blood flow in tendons that infection is a very low risk, and i have had lotes of trouble with mine since, im one year post op and knee still gives trouble kneeling hurts and knee pops and creaks all the time, but i can finnally ride again!

 

[NVR FNSH]

Originally posted by yo its matt!
...and knee pops and creaks all the time...

Both my knees popped & creaked before surgery - eople hear me coming down the hall way so I can't sneak up on anybody.

Now only my 'good' knee - the non-reconstructed one - pops & creaks...... go figure.

Brian