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Funny Thing about ACL replacement surgery. (Added Pic)


SpaceGhost

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May I ask a few questions?

 

1) Who was your surgeon?

2) Why did you not opt for a donor graft? If you chose the donor, you would have 5 small, small incisions. Plus, you would not have to worry about the therapy required to heal the patella tendon area.

 

The good news, they did not graft from your own hamstring. Quad and hamstring therapy is a big key when going through PT. With the strand of hammy gone, I have heard horror stories.

 

 

 

the original poster had a bone-patellar tendon-bone procedure. the 'donor graft' surgery, uses a completely different tendon (tibialis anterior), and still leaves a fairly decent sized incision. it also does not incorporate in and heal as quickly as your own tissue does.

 

finally, the hamstring procedure produces excellent results, with very little if any hamstring weakness. the horror stories you've heard are probably misconceptions.

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the original poster had a bone-patellar tendon-bone procedure. the 'donor graft' surgery, uses a completely different tendon (tibialis anterior), and still leaves a fairly decent sized incision. it also does not incorporate in and heal as quickly as your own tissue does.

 

This is Fact.

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the original poster had a bone-patellar tendon-bone procedure. the 'donor graft' surgery, uses a completely different tendon (tibialis anterior), and still leaves a fairly decent sized incision. it also does not incorporate in and heal as quickly as your own tissue does.

 

finally, the hamstring procedure produces excellent results, with very little if any hamstring weakness. the horror stories you've heard are probably misconceptions.

 

I must disagree completely.

 

1) My largest incision, using the donor pateller tendon, only required 4 staples. The other four incisions used two staples each. The pateller tendon was researched to have higher strength capabilites than original tissue, adn other forms as well.

2) When using strands of the hamstring, recovery is proven to take much longer. With any ACL surgery, your quad and hamstring shut down due to the trama of surgery. When pulling strands away from the hamstring, you are weaking this muscle further. Hence, when going through PT, your goal is to strengthen the quad and hamstring while the healing process takes place during PT.

 

Your view may be wise, provided the patient is not an athlete. Therefore, you can get away with the other processes. However, any athlete is advised to chose the pateller graft.

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Dr. VanStein, I've been told by some of his peers he is the best around here.

 

I opted against the donor graft because with a donor graft you run the risk of having the procedure done again pretty soon because your body can "reject" the graft. You have the risk of disease even though they are screened. With my own tissue I think it will be stronger and last longer and no chance of disease. I play disc golf at a high level and I want to do so in the future. I know it is not NFL but with the way I throw the knee is an important part of throwing far. I guess what I am saying is I have more confidence with my own tissue than I do with someone else's. I know my lifestyle, I don't of a donors. Being that I am 32 I should recover well. If I was 10-20 years older I guess I would have done the donor tendon maybe.

 

Ok, thats cool.

 

I have not heard of Dr Vanstein. My surgeon was Dr. Randy Wroble, of Sports Medicine Grant. He is the team physician for the Columbus Blue Jackets.

 

I am almost 6 months removed from surgery and am back to 100%. You can not see the incisions whatsoever. He did a hell of a job.

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I must disagree completely.

 

1) My largest incision, using the donor pateller tendon, only required 4 staples. The other four incisions used two staples each. The pateller tendon was researched to have higher strength capabilites than original tissue, adn other forms as well.

2) When using strands of the hamstring, recovery is proven to take much longer. With any ACL surgery, your quad and hamstring shut down due to the trama of surgery. When pulling strands away from the hamstring, you are weaking this muscle further. Hence, when going through PT, your goal is to strengthen the quad and hamstring while the healing process takes place during PT.

 

Your view may be wise, provided the patient is not an athlete. Therefore, you can get away with the other processes. However, any athlete is advised to chose the pateller graft.

 

 

1st: quadrupled hamstring tendons have the highest load to failure of ANY method of ACL fixation. higher than any 'donor graft' tissue, and also higher than bone-patellar tendon-bone---this is proven, don't challenge me on it

 

2nd: the bone-patellar tendon-bone procedure typically has the largest incision (who cares how big the incision is, as long as it does not fail). donor graft surgeries typically have smaller incisions (slightly) because you don't have to harvest the patients' tissues.

 

3rd: there is an EXCELLENT surgeon at children's hospital who does several ACL surgeries per week, who prefers to use the patients' own hamstring tendons--he operates on high school and college athletes primarily. the reasearch has shown that running speed and hamstring strength decreases minimally, if at all. the patients who have donor graft surgeries have not been shown to recover faster. you have to read literature very carefully, as people try to prove things that they want to do. in other words, there are many studies that ARE TRYING to show that the donor graft surgery recovers faster. why are they trying to do this?? read #4

 

4th: the reason it has become popular to use 'donor grafts' for ACL surgery is that the surgery can be done DRAMATICALLY faster--the surgery time can be literally cut in half. also, some surgeons are not comfortable harvesting the patients hamstrings (it is very easy to accidentally cut them while harvesting them). sorry, but that is the real reason to use donor graft surgery---its easier to do--trust me.

 

5th: donor tissue does not incorporate into your body and heal as fast as your own harvested tissue. so while the donor tissue may be just as strong at the time of surgery, it's strength decreases with time, until it finally heals and incorporates into the body, when compared to your own tissue.

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the critics of bone-patellar tendon-bone surgery claim that you can have long term knee pain from this surgery, as well as an increased risk of breaking your patella with a hard fall onto your knee. otherwise it is a fine surgery to do
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kirk- are you a dr or a wana dr or something???

 

your saying dont challenge your reasons but if your not a dr and they are why would you challenge them? i'm pretty sure they know what they are doing.

 

i had Dr. Tezneir (spelling) from grant sports med do mine about 8 yrs ago. had surgery on nov-4 and jan 15 i was wrestling again with the big brace on and he used my hammy and have had no problems at all from it. also had pop-ribbits in one minicuis and 30% of the other takin out b/c they got messed up also. thats just my expereince with acl surgery though.

 

still not understanding the staples though. thats gotta be a bitch in the machine you have to get on like 3 days after surgery that moves your leg for ya. PAIN!

 

but good luck man.

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Tezner is a great DR also. Yep it hurts, had PT tonight and it was painful but felt good too. Sounds stupid but it does. Kirk knows what he is talking about, we have spoken in person. Pretty much what he has written was explained to me by my DR. so I could make an informed decision about my surgery. I really like Vansteyn. He has been great!
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in reality, the hamsting procedure and the bone-patellar tendon-bone procedure are both good, and have excellent track records---when done correctly. so it comes down to which way the surgeon was taught to do the surgery. the comment i made about the donor graft surgery is correct---it is mostly done to cut down on surgery time and difficulty associated with harvesting the patient's own tissue. i know of all the surgeons who have been mentioned and they are ALL very capable of doing an excellent ACL reconstruction. others to consider: Dr. Klingele (children's), Dr. Kaeding (OSU Football Dr.), Dr. Grant Jones (OSU b-ball Dr.), Dr. Steensen (Mt. carmel), Dr. Westerheide (Mt. Carmel)-----these are all master technicians when it comes to sports orthopedics, specifically the knee (Jones does a lot of shoulder too).

 

as far as my background i'm currently in my last yr. of training in ortho surgery, and will be going to tampa to do a year of training in total joint replacement surgery, before i go into private practice. i don't claim to know everything, but i know a lot on the topic at hand.

 

kirk

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