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  1. #1
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    My ACL story part I....

    *****WARNING*****

    I'm bored out of my mind and decided to make my most elaborate post with hospital pictures and all! I think ANYONE will empathize with me whose had reconstructive knee surgery.

    I already posted this in the 'injury' forum but also wanted to post it here for my friends to read. Do you guys remember me complaining about the guy placing the rock near the 'stairs' on National last month? and me falling and dislocating my knee? Here's the story of my progress so far.

    [SIZE="6"]Official diagnosis[/SIZE]



    Approximately 5 days post injury, I had my appointment with Dr. Anikar Chhabra from the Orthopedic Clinic Association in Phoenix, Arizona:

    http://www.tocamd.com/doctors/chhabra.htm

    I was referred to him by a friend who is a former professional athlete. Dr. Chhabra is currently the orthopedic surgeon for the Phoenix Suns and the Roadrunners. Not to mention, a prior athlete and a great guy!

    As I laid on the doctor's table, he placed my injured leg under his armpit and placed one of his hands on my thigh. He then lifted my lower leg up and down, independant of the femur. This was an absolute diagnosis, despite having the MRI. The diagnosis was a full ACL and meniscus rupture. Surgery was scheduled in which I chose the Hamstring Autograft as my selection. The doctor went over all my options and gave me the 'pros and cons.' After discussing my love for mountain biking and the fact that I no longer participate in contact sports, I felt the autograft was the best route.

    As some of the other ACL posters have mentioned in the past, including my doctor, the "gold standard" for the use of the patellar ligament is becoming less popular. Meaning, that type of surgery has its place in the medical world, but it's not the 'only' way to go anymore for ACL surgery. Each patient has their own stories to tell regarding their injury and long term needs. Some choose no surgery and can live without an ACL for the remainder of their lives. Everyone is different and requires different needs and procedures.

    [SIZE="6"]Surgery Day[/SIZE]

    November 19th, 2008, I was up bright and early around 4:00am and had my wife drive me to the Gateway surgery center in Phoenix, AZ.



    Prior to arrival, the girls from the surgery center called and reminded me about the things to bring and not to bring. One of the things she told me was to NOT wear underwear. I thought this was strange since I was only having surgery on my knee. Her response was - "You'll be wearing a gown and it's standard procedure." OK - no underwear.

    Once I was escorted into my room by a fairly attractive female, she gave me my surgery gown, told me to undress, BUT keep my underwear and socks on!!!! I chuckled and asked her if she or her friends were the ones who called me and told me NOT to wear underwear. She laughed and thought I was kidding. She told me the "girls" at the scheduling center should have never told me this. SO......I stripped and laid on the bed in my gown with no underwear. Must I remind you that the gowns are short.

    In desperate fear that the family jewels and the 'copper penny' would be exposed during surgery, I called my wife into the room and DEMANDED she respond to WALMART and buy some underwear! LOL AFter buying the underwear and putting them on, I was more at ease.

    After speaking with the anesthesiologist about my 'pain control' options after surgery, I elected to have a femoral nerve block. This is a procedure in which the doctor numbs the nerve of your leg from the waist down by way of a big syringe. To be honest, I don't remember the actual shot because he gave me some thing prior which knocked me out within 3 seconds - literally. When I awoke, the procedure was done and I was off to the recovery room.

    My leg was completely bandaged with ACE wrap and the leg brace was already affixed. The ACE wrap couldn't come off for 48 hours and since the meniscus was repaired, NOT removed, I am to NOT bear any weight on that leg for 4 weeks!!!!!!!!!!!!!!!

    An hour later, my wife drove me home and I slept for hours. The nerve block worked wonders for 48 hours, but after that, the pain set in and I was miserable.

    Despite the narcotics they give you, there's no way around the discomfort of the first week. The days following the surgery were awful. You never get comfortable, the leg is always elevated, you gain 10 pounds the first week and you're sick to your stomach from watching TV.

    I was also given a 'Game Ready' icing machine which applies cold compression for 30 minutes on and 30 minutes off - 24/7. I use it religiously to lower the swelling and stop the pain.

    [SIZE="6"]Day 1[/SIZE]

    Bandages came off and I took this picture:



    [SIZE="6"]Week 1[/SIZE]

    The swelling has come down a bit and the pain isn't nearly as bad as it was during the first few days. You can actually see the right calf has atrophied already. But at least some definition is returning in my thigh.

    After coming home, they give you a sheet of post-operative excercises to do to prevent further muscle loss. The excercises are pretty general - leg lifts, tighten the quad of the bad leg, attempt to slide your heel towards you while sitting on the ground.

    Even though these excercises sound simple, they are TOUGH AS HELL - Believe me!

    The number one thing the surgeon said to do is always sleep with your brace locked in the straight position. This is critical in preventing scar tissue from forming and not being able to straighten your leg in the future. They say removing scar tissue to straighten the leg is MORE difficult than dealing with scar tissue upon flexing the leg.



    I'm currently approaching week 2 and will post more after several weeks.

    My first day of physical therapy is on December 4th and I'm ready to really recover.

    I have been doing all the excercises and more.....I currently pedal the recumbant bike at the gym for 20 minutes on top of the home excercises. My range of motion as become remarkably better during the past 3 days. I'm happy to say that I can bend my knee nearly as far as my good leg - with assistance of course! I'm hoping the PT will be "easier" with my progress.

    As I've read other posts regarding knee surgery, I understand that SIXSIXTYSIX is the ACL guru. Hey SIXSIXTYSIX, if you chime in, let me know how that Donjoy is working for you. Any issues with getting pads over it? For those who don't know what a Donjoy is, it's a top of the line athletic brace company. Nice but very expensive.

    My doctor says it will be 3 months minimum until I can ride my bike again.

    The worst part about this incident is the timing of the injury. The weather is great! Why couldn't this happen in June?

  2. #2
    wretch
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    Nice post mate. . . happy healing. Just tore my PCL and Hammy, luckily no surgery as there was no meniscus.

    I've just been fitted for a Don Joy Defiance III. I also elected to have the "patellar impact guard" which is a fancy medial term for a knee and shin guard that fits on the brace. 666 has one so he can tell you more. My scrip for the brace was sent to the company, they came to fit me and hopefully, fingers crossed, it will be here this week.

    Donjoy has off the shelf versions (what I can assume are sized sm, md, lg, etc.) which I would also assume are cheaper than the custom fits. The ordering of it will all come down to how your insurance will deal with it. . .

    and DAMN your f'in gimp leg is still better than my good leg. On the same note though I have a whole new will to get in better shape and back on the bike stronger than ever.

    Where do you plan on going for PT?

    Like you I couldnt be more bummed. (but your more than likely slightly more bummed due to your much more severe injury and operation) The weather is finally awesome, my skills were improving, and more over I was looking forward to a ripping winter season in Tahoe. . . now it's dealing with keeping my self occupied, and now that I can finally move, how to get in whatever shape I can / not get any fatter.

  3. #3
    Zipper
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    That sounds about right for an ACL Replacement and you do have a great doc. If they give you the option on rehap places chose Dynamic Rehab in Tempe. They have taken really good care of me over the last 16 months with my quad on 9-2-07 then ACL #3 on 3-17-08 and tissue Removal on 9-17-08 (been a bad year). Heather is Awesome (and cute) and Lisa is really good but a little more non forgiving. great people though
    Zipper aka Rob

  4. #4
    Don't believe the Hype...
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    Nice write up. Keep us posted on your progress. I have torn cartlege in my hip socket that needs repaired. I keep putting it off because I don't want to sit on my ass for 2 months before I can even take it easy...
    Last edited by luckybastard; 12-02-2008 at 07:17 AM.
    Made with real bits of Panther, so you know it's good...

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  5. #5
    sixsixtysix
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    Glad to hear your doing alright Looks like everything pretty much went by the book and yes, the first week after surgery completely sucks. I am sure once you get the full PT ball rolling you will start seeing results come day by day, and like I said before, at least one of the staples for PT for the knee is a stationary bike.

    My last knee surgery will probably be my last (knock on wood) until the time comes later on in life to have it replaced. They didn't give me a new ACL last time (3 strikes and you're out I guess) and I had a full Meniscus-oscopy to remove the remaining Meniscus that had basically sheared off the bone (I had previously had 3 other Meniscus ruptures as well as a ruptured MCL and torn PCL) so now the joint is bone on bone.

    Basically now I have a "Unstable Knee" which means it is incapable of supporting deceleration forces such as walking down stairs, or inclines and it has a greater tendency to want to "slide". The Femur slides forward over the Tibia since there is no ACL to support it. Also, my leg is very prone to twisting at the joint which further increases the chances of re-damaging the still existing PCL and MCL.

    All this brings me to your question about the Donjoy brace. I had the option of going with the Donjoy Defiance or a CTi, both of which are full custom braces. Having gone through several Donjoy Defiance's and one CTi in the past while still playing Hockey, I preferred the way the Donjoy's fit and knew the ins and outs of them. The main problem I saw with going with a full custom brace for getting back on the bike is they are insanely expensive. I believe the Donjoy Defiance 3 is in the neighborhood of $1000 and the CTi is almost $1200.

    That being said, the technology of braces hasn't changed much except for the fact that you can buy off the shelf braces which work as well as a full custom for much less money. Thats where the Donjoy Armor came in. It is designed for the most serious of knee instabilities, which are rated on a scale of 1-4 (4 being the worst) and the Armor is rated a 4. It is also designed with 2 notorious knee destroying sports in mind, Motocross and Skiing, which is why it has a very low profile and has a cut away inner thigh section so that it doesn't hit the top tube of a bike or rub against your other thigh when pedaling.

    I am on my 2nd Armor since my last knee surgery, the 1st one lasted almost 2 seasons before the hinges finally blew up, but just trying to figure out how many cycles those hinges went through in 2 years of riding (5 hours of riding average per week) roughly worked out to 2.65 MILLION times they had to bend. So I am in no way unhappy about having to replace it. This too ties into the decision to not go full custom, if you know you are going to be beating on it, falling on it and relying on it every ride, there is not reason to spend the money on a high dollar brace which will inevitably get destroyed when the Armor is roughly half the cost of the Defiance at about $650 with the knee/shin pad attachment.

    I never ride without my brace. If I for some stupid reason forget it, I don't ride, no exceptions. That being said, having ridden the last 2 years with the Armor, I don't even notice it anymore. It doesn't impede your pedaling and basically just feels like a knee/shin guard with a little more lateral stiffness.

    Sorry for the long winded answer, but hopefully it helps. Heal up and you'll be back on the bike before you know it

  6. #6
    mtbr member
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    Quote Originally Posted by sixsixtysix
    That being said, having ridden the last 2 years with the Armor, I don't even notice it anymore. It doesn't impede your pedaling and basically just feels like a knee/shin guard with a little more lateral stiffness.
    I've ridden with SixtySix quite a bit.
    The brace never seems to slow him down. Sometimes I wish it would...
    Even on 30 mile epics in Moab, he had no problem motoring away on his big bike. That alone is a great endorsement for these braces.
    Quote Originally Posted by azdog View Post
    I think he was born around the time of the Chernobyl fallout which would explain a lot.

  7. #7
    mtbr member
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    I think I saw a homeless guy try on those underwear that you got at Walmart. He put them back in the package when he realized he wouldn't have enough cash left to get some Steel Reserve. Don't worry though, it's probably just a rash....
    .....

  8. #8
    Nothing can stop me now
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    This brings back memories....

    I ruptured my ACL and MCL in March of 2005 playing basketball. I had the surgery in June of 2005 and was back "riding" January of 2006. The "riding" I was back doing was mostly spinning around the neighborhood. It took a long time before I was comfortable riding trails again, probably about a year from the surgery date. YMMV. The atrophy of the muscles in the repaired leg is the biggest obstacle to being comfortable on the trails again. It seemed like it took a LONG time to get the repaired leg back to the strength of the non injured leg. From your pictures, you seem to have been in pretty good shape prior to the injury which should help speed the recovery. The good news is that I am back stronger than I was before my injury and that is after the addition of 3 kids since the surgery. The bad news is that it seemed to take a LONG time to get to this point.

    I have one of those Donjoy braces, but have only used it a few times. My doctor's thought process was that the brace is there for your confidence, but the point of the surgery is to not need the brace. I only use the brace when I do something stupid like playing flag football.

    I do remember my doctor warning me that about 3 months from the surgery that the graft was at its weakest and to be careful because doing the surgery again would be below average....

    Good luck with the rehab. A year from now you will be feeling a lot better. Maybe sooner.

    bobo

  9. #9
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    i have had two knee surgeries on the same knee, pretty much debilitated it and had to have everything repaired. the knee is as sixsixsix says "unstable" i blew it out again trying to run out of a rocky downhill when my bike got jerked out from under me and now wear a Donjoy Armour. i never ride without it and am totally happy with it!!!! it is comfortable and light weight and has done its job more than once. i would highly recommend it!!!!

  10. #10
    wretch
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    Makes me wish I got the armour, but the rep was like . . . uhhh your insurance is going to pay for the better more expensive one, he was pretty insistent. We shall see. . . Looks like the beef factor of the armour would be the selling point for me. But I do have long chicken legs so sizing could be different. . .

  11. #11
    In the rear with the beer
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    Quote Originally Posted by daugela
    *****WARNING*****


    As some of the other ACL posters have mentioned in the past, including my doctor, the "gold standard" for the use of the patellar ligament is becoming less popular. Meaning, that type of surgery has its place in the medical world, but it's not the 'only' way to go anymore for ACL surgery. Each patient has their own stories to tell regarding their injury and long term needs. Some choose no surgery and can live without an ACL for the remainder of their lives. Everyone is different and requires different needs and procedures.
    :
    I blew my left knee out in 1990, in high school, 3 days later, my teammate (and our teams other starting linebacker....man, was coach pissed after both of us went down...) blew his out too. He had the patella ligament option, i had the hamstring. I actually recovered a little faster. Neither of us returned to football, so we never really 'tested' the knees.

    Unfortunately 10 years later, i was diagnosed with osteosarcoma in my OTHER leg, which had grown into my knee which required a full replacement of the knee,distal femur, and top of the tibia, plus removal of most of the muscle top and bottom. So now the reconstructed knee is actually my "good" knee, since the other knee is on its 3rd replacement in 13 years......but that's a whole other story.

    I thank God every time I get on my bike that I am still able to turn the cranks!!
    Salvation Outdoor
    "Take it Outside...Again!!!"

  12. #12
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    Quote Originally Posted by daugela
    *****WARNING*****

    I'm bored out of my mind and decided to make my most elaborate post with hospital pictures and all! I think ANYONE will empathize with me whose had reconstructive knee surgery.

    I already posted this in the 'injury' forum but also wanted to post it here for my friends to read. Do you guys remember me complaining about the guy placing the rock near the 'stairs' on National last month? and me falling and dislocating my knee? Here's the story of my progress so far.

    [SIZE="6"]Official diagnosis[/SIZE]



    Approximately 5 days post injury, I had my appointment with Dr. Anikar Chhabra from the Orthopedic Clinic Association in Phoenix, Arizona:

    http://www.tocamd.com/doctors/chhabra.htm

    I was referred to him by a friend who is a former professional athlete. Dr. Chhabra is currently the orthopedic surgeon for the Phoenix Suns and the Roadrunners. Not to mention, a prior athlete and a great guy!

    As I laid on the doctor's table, he placed my injured leg under his armpit and placed one of his hands on my thigh. He then lifted my lower leg up and down, independant of the femur. This was an absolute diagnosis, despite having the MRI. The diagnosis was a full ACL and meniscus rupture. Surgery was scheduled in which I chose the Hamstring Autograft as my selection. The doctor went over all my options and gave me the 'pros and cons.' After discussing my love for mountain biking and the fact that I no longer participate in contact sports, I felt the autograft was the best route.

    As some of the other ACL posters have mentioned in the past, including my doctor, the "gold standard" for the use of the patellar ligament is becoming less popular. Meaning, that type of surgery has its place in the medical world, but it's not the 'only' way to go anymore for ACL surgery. Each patient has their own stories to tell regarding their injury and long term needs. Some choose no surgery and can live without an ACL for the remainder of their lives. Everyone is different and requires different needs and procedures.

    [SIZE="6"]Surgery Day[/SIZE]

    November 19th, 2008, I was up bright and early around 4:00am and had my wife drive me to the Gateway surgery center in Phoenix, AZ.



    Prior to arrival, the girls from the surgery center called and reminded me about the things to bring and not to bring. One of the things she told me was to NOT wear underwear. I thought this was strange since I was only having surgery on my knee. Her response was - "You'll be wearing a gown and it's standard procedure." OK - no underwear.

    Once I was escorted into my room by a fairly attractive female, she gave me my surgery gown, told me to undress, BUT keep my underwear and socks on!!!! I chuckled and asked her if she or her friends were the ones who called me and told me NOT to wear underwear. She laughed and thought I was kidding. She told me the "girls" at the scheduling center should have never told me this. SO......I stripped and laid on the bed in my gown with no underwear. Must I remind you that the gowns are short.

    In desperate fear that the family jewels and the 'copper penny' would be exposed during surgery, I called my wife into the room and DEMANDED she respond to WALMART and buy some underwear! LOL AFter buying the underwear and putting them on, I was more at ease.

    After speaking with the anesthesiologist about my 'pain control' options after surgery, I elected to have a femoral nerve block. This is a procedure in which the doctor numbs the nerve of your leg from the waist down by way of a big syringe. To be honest, I don't remember the actual shot because he gave me some thing prior which knocked me out within 3 seconds - literally. When I awoke, the procedure was done and I was off to the recovery room.

    My leg was completely bandaged with ACE wrap and the leg brace was already affixed. The ACE wrap couldn't come off for 48 hours and since the meniscus was repaired, NOT removed, I am to NOT bear any weight on that leg for 4 weeks!!!!!!!!!!!!!!!

    An hour later, my wife drove me home and I slept for hours. The nerve block worked wonders for 48 hours, but after that, the pain set in and I was miserable.

    Despite the narcotics they give you, there's no way around the discomfort of the first week. The days following the surgery were awful. You never get comfortable, the leg is always elevated, you gain 10 pounds the first week and you're sick to your stomach from watching TV.

    I was also given a 'Game Ready' icing machine which applies cold compression for 30 minutes on and 30 minutes off - 24/7. I use it religiously to lower the swelling and stop the pain.

    [SIZE="6"]Day 1[/SIZE]

    Bandages came off and I took this picture:



    [SIZE="6"]Week 1[/SIZE]

    The swelling has come down a bit and the pain isn't nearly as bad as it was during the first few days. You can actually see the right calf has atrophied already. But at least some definition is returning in my thigh.

    After coming home, they give you a sheet of post-operative excercises to do to prevent further muscle loss. The excercises are pretty general - leg lifts, tighten the quad of the bad leg, attempt to slide your heel towards you while sitting on the ground.

    Even though these excercises sound simple, they are TOUGH AS HELL - Believe me!

    The number one thing the surgeon said to do is always sleep with your brace locked in the straight position. This is critical in preventing scar tissue from forming and not being able to straighten your leg in the future. They say removing scar tissue to straighten the leg is MORE difficult than dealing with scar tissue upon flexing the leg.



    I'm currently approaching week 2 and will post more after several weeks.

    My first day of physical therapy is on December 4th and I'm ready to really recover.

    I have been doing all the excercises and more.....I currently pedal the recumbant bike at the gym for 20 minutes on top of the home excercises. My range of motion as become remarkably better during the past 3 days. I'm happy to say that I can bend my knee nearly as far as my good leg - with assistance of course! I'm hoping the PT will be "easier" with my progress.

    As I've read other posts regarding knee surgery, I understand that SIXSIXTYSIX is the ACL guru. Hey SIXSIXTYSIX, if you chime in, let me know how that Donjoy is working for you. Any issues with getting pads over it? For those who don't know what a Donjoy is, it's a top of the line athletic brace company. Nice but very expensive.

    My doctor says it will be 3 months minimum until I can ride my bike again.

    The worst part about this incident is the timing of the injury. The weather is great! Why couldn't this happen in June?
    Thanks for the story and the anecdote. I'm scheduled to have my Achilles' repaired on Thursday. I'll be sure to bring underwear, despite what they might tell me.

    I was told to expect to be in a cast for 6 weeks, and a boot for another 6 weeks. Not looking forwared to being off the bike this long (especially this time of the year).
    Nobody gives a s#$t you singlespeed.

  13. #13
    parenting for gnarness
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    I have fortunately not had ACL, but 2 scopes have taken out a good hunk of my right meniscus. You attitude towards your PT is great, and completely key for your happiness. stay positive, find enjoyment in new athletic and workout challenges. I was a very sporadic lifter prior to surgery #1, but it got me paying attention to my body and how it worked. yoga can be a good total body workout, even for your lower body. stretch, take care of your back and core, you will be compensating and throwing off your alignment for months to come (maybe forever).

    I had my 2nd surgery at Gateway (Dr. Ott), and its a good facility. Amazing how much better, more efficient, and more affordable a privately-run surgery center is. They quoted me for my knee (so I could budget FSA money for it) within a few hundred dollars, and the whole thing was about 5k. 3 months later i had a k-wire pin put in a displaced fractured thumb at the hospital on a planned, out-patient basis and it was over 10k charged to my insurance. Makes you appreciate a good medical facility and staff, where you feel like a customer and not a hunk of meat or an uninsured charity case. There used to be a sushi buffet in the Chinese cultural center next to Gateway, but i think it went out of business. Not great sushi, but pretty darn good for $12 lunch buffet! Made seeing the doctor much better

  14. #14
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    I tore my ACL in Whistler on July 11 the in the bike park doing a giant step-up on Freight Train below Original Sin. I RICED for four days and started to ride my downhill bike on the flat asphalt trails near the Village for four days.

    After the fall I decided I needed a brace due to instability concerns. So I went on Ebay and checked out the different braces being sold. Decided on the Armour and purchased a medium for $161 plus $15 shipping. Got the brace a week later and rode the park conservatively until August 26th.

    Came home and saw my general practitioner on August 28th. then the surgeon on the Sept. 6th. had the patella tendon surgery on the 18th. I had two physio appointments post op and am doing my own physio now.

    Mostly hiking, trail maintenance, stationary bike and riding my bike on the road and easy trails. I hike up the steep sections and coast down the downhill sections. Hope to be riding the gnarly in six March.

  15. #15
    mtbr member
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    Thanks for the post. You have an excellent point regarding the wear and tear of an expensive brace compared to an 'off the shelf.' In fact, I'm going to take your advice - it's too logical. If you were to golf for the rest of your life, maybe the Defiance would be more appropriate.

    I looked on the Donjoy website but coudln't find any info on the shin/knee guard for the Armor. Do they attach by straps and are they suffice for full protection of the leg in place of body armor?

    How about sizing? I emailed the Donjoy rep but her email is now bad?

  16. #16
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    Quote Originally Posted by daugela
    Thanks for the post. You have an excellent point regarding the wear and tear of an expensive brace compared to an 'off the shelf.' In fact, I'm going to take your advice - it's too logical. If you were to golf for the rest of your life, maybe the Defiance would be more appropriate.

    I looked on the Donjoy website but coudln't find any info on the shin/knee guard for the Armor. Do they attach by straps and are they suffice for full protection of the leg in place of body armor?

    How about sizing? I emailed the Donjoy rep but her email is now bad?
    Options:

    http://www.donjoy.com/index.asp/fuse...l/cat/1/id/146

    Sizing (what's your measurement?):

    6" above the mid patella

    http://www.donjoy.com/index.asp/fuse...g/cat/1/id/146

    Note: The new brace comes with several different knee pad widths to allow for a custom fit of the knee.

  17. #17
    Kathleen in AZ
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    video get well card

    Heal up Time passes no matter what - sounds like you have a good attitude that will help with healing.


    daugela on SoMo from DurtGurl on Vimeo.

  18. #18
    wretch
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    The Patellar Proterctor / Patellar Impact guard is an accessory, its listed on the Armour series but fits with most of them. . .


  19. #19
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    That was very nice!!! I appreciate the video and support through this ordeal. I also wish you a fast recovery on your spill from Goat Camp. Never got a chance to really hear the details.

    I guess if you ride aggresively, at some point you can expect an aggresive injury?

    jd

  20. #20
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    Great post babe!- Sheila

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