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Old 09-18-2014, 09:47 AM
Keep on Tryin' Keep on Tryin' is offline
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ACL Surgery Cadaver vs. My Own Tissue?

This was my first full season wakeboarding. My goal for the year was to learn to jump wake to wake. I'm 47 years old, so I was taking it slow, going a bit farther and adding ballast as I went.
Labor Day weekend I went for it, and managed two heel-side wake to wake jumps! I was pretty stoked. On what was going to be my last pass I tried to land a toe-side jump. I came up a bit short, landed sideways and felt a "Crunch" in my right knee. It hurt like h*** and I couldn't straighten my leg for a while.
Dr. says it's a complex tear of the meniscus, and complete ACL tear.
Dr. recommends patellar tendon graft for the ACL, where they use my own tissue.
A couple people I've talked to who have had it done say they would highly recommend the cadaver tissue option given my age, and much easier rehab.
I'm "torn" on which way to go. I really don't know how much difference there is in the rehab.
The doctor wasn't very specific, just said 4 to 6 months, and recommended my own tissue.
I'd be interested in hearing from anyone withe experience
Thanks!
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Old 09-18-2014, 09:57 AM
beef beef is offline
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Do you slalom? Do you plan on continuing to wakeboard? Does your Dr. know this?

I would be a bit wary of using part of a patellar tendon for this, unless the surgeon could reassure that you wouldn't have problems with that tendon afterwards. Seems like both of the above activities can put a lot of force onto the patellar tendon.

Not a medical professional - just some guy that had some knee problems in the past!
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Old 09-18-2014, 10:03 AM
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SJ. SJ. is offline
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I've torn both mine, partial on my right and complete on my left. My left I did when I was about 46, right was a few years earlier. First things first, I would see if you even need the repair. Your doc should've discussed this with you. About a third of the people really need theirs, a third maybe, and a third can do just fine without. I board, play lacrosse, bike, ski, Elk hunt, etc and have never had either repaired. That being said, if I was going to have the repair, I would NOT use the Patellar, specially at your age. I would only go cadaver. Rehab is absolutely the key, my knees and legs are much stronger than prior, and I have zero pain in my acl area. I had the meniscus tears repaired/cut out, that was the only surgery I had done for it. Good luck, the worst is the first 2-3 weeks after.
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Old 09-18-2014, 10:15 AM
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Miss Rita Miss Rita is offline
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I'm a Family Practitioner. While I've never had knee surgery, I've known lots of people who have, both personally and professionally.

While you don't need ACL repair, I'd recommend that you do. If you're going to remain physically active your knee will thank you in the long run.

On patellar tendon grafting v cadaver tissue: do the patellar tendon graft.

Last edited by Miss Rita; 09-19-2014 at 12:24 AM.
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Old 09-18-2014, 10:23 AM
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Do yourself a favor and talk to these guys...

http://www.shcdenver.com/
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Old 09-18-2014, 10:25 AM
Keep on Tryin' Keep on Tryin' is offline
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Quote:
Originally Posted by beef View Post
Do you slalom? Do you plan on continuing to wakeboard? Does your Dr. know this?

I would be a bit wary of using part of a patellar tendon for this, unless the surgeon could reassure that you wouldn't have problems with that tendon afterwards. Seems like both of the above activities can put a lot of force onto the patellar tendon.

Not a medical professional - just some guy that had some knee problems in the past!
I don't slalom yet, but would like to! Doc said I could continue to wakeboard after patellar tendon surgery although I'm not sure I'm really good enough to make it worth the risk.
I had meniscus surgery on my left knee last year which was not a big deal.
I'm in pretty good shape for 47. I do strength / conditioning workouts 3-4 times /week and intend to rehab to pre-injury condition. I don't play team sports, but enjoy outdoor activities, Wakesurfing, snowboarding, and staying active.
I guess the most strenuous "team-sport" I play is practicing field hockey in the back yard with my middle school daughters. They can get pretty aggressive!
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Old 09-18-2014, 10:29 AM
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mikeg205 mikeg205 is offline
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forget the wake board and go slalom - - more fun... your the third person chronicling about keen damage from a wake board dump.

yikes.. sorry to read this...
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Old 09-18-2014, 10:32 AM
mlawler34 mlawler34 is offline
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I have had 3 knee surgeries. 2 scopes on my meniscus and ACL surgery all on the same knee. I was 23 for my first scope and ACL tear (28 now). My doctor recommended the cadaver route citing shorter recovery period. Years later I found significant research showing that anyone under 26 generally has better outcomes strength wise with their own tissue graft and generally does not have a second ACL tear. However, after 26 and as patients got older there is significant evidence showing the cadaver is a better route. Even knowing this I would not go back and do anything differently.

I did not start wakeboarding until three years ago, and have cased the wake, taken back edges on landings, and many other awkward landings. My cadaver has held up great. But it is also a testimate to my workout regimen to keep my legs strong. I have snowboarded as well, and only had one issue on a hard landing. I tore my meniscus however my cadaver held up well.

Either way you go your health and success will be largely tied to how strong you keep your legs. I dont regret having a cadaver. Do your research. Ask your doctor why he prefers using your own tissue. Make an informed decision. I dont think you can go wrong either way.
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Old 09-18-2014, 11:30 AM
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JRW160 JRW160 is offline
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I had a hamstring autograft repair 5 years ago when I was 28, and I haven't had any trouble out of it. I was back playing soccer 6 months after surgery and felt 100% 9 months or so out. My surgeon did not recommend the patellar tendon graft. He said lots of people complain about pain when squatting afterwards. Recovery is supposed to be faster with cadever tissue, but I would be worried about the quality of the donor tissue. If I had to have the surgery again right now, I would go with the hamstring graft again. If I had to have it again at the age of 50, I would probably go the cadaver route.
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Old 09-18-2014, 11:30 AM
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JohnnyB JohnnyB is online now
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1st off, sorry to hear of your injury. With a group of several active adults on this forum that are in your age group, you will get lots of feedback.

I completely tore my right ACL in Dec 2012. I had it repaired April 2013 and was cleared to full activity in March 2014. Back to soccer in April, slalom skiing and footing in May.

My advice -- get recommendations on the top surgeons and go see at least two. It's your knee. I had 3 consults and heard two different philosophies -- 1 cadaver graft, 2 my own patella graft. Have them tell you what they recommend and why, based on your age and activities. Also, make sure you're comfortable with your doctor as you're going to see a lot of them.

I chose using my own patellar graft. I chose this because statistics I found showed the best tensile strength in the resultant ACL and lowest incidence in re-injury, regardless of age.

If you would've asked me at about the 6-8 month point of rehab, I would have told you that the biggest struggle of the recovery was re-strenthening and pain related to my patellar graft -- it is the longest recovery of your 3 options. At that point, I was more in the camp that I should've seriously considered the cadaver graft. Fast forward to today, I don't know that I'd say the same thing as I am at full recovery and think I chose the best option.

Let us know what you do and keep us posted on your rehab.

Commit to your Physical Therapy.

Also, another consideration is timing, had my surgery with much of my health insurance year remaining -- the prep appointments and surgery pretty much maxed out my deductibles and out of pocket for the year....if you span two health insurance years, you'll pay more
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