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Thread: Graft Failure

  1. #1
    mmm bacon
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    Graft Failure

    I am totally spun, I just got back from the doc, what I thought was my last visit to my doc for my ACL surgery provided real bad news. It appears that my ACL graft is no longer there, it was fine last month and now it's gone. The doc used a cadaver tendon, and thinks it might have degraded, I don't know at this point in time he's woried about the ammount of movement in the knee joint.It looks like another surgery in August. I will have now lost 2 skiing seasons and possibly depending on the damage 2 biking seasons too. Do you think I should do an MRI before my impending surgery.

    He suggested that I look for more relaxing forms of recreation

  2. #2
    mtbr member
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    Do an MRI.. just to be safe.
    My wrist didn't heal after 1 week in a splint and 4 weeks in a cast, mri now.. should have done 5 weeks ago Now i got to get surgery and 6 more weeks in cast.. half of summer.

    Pisses ya off when doctors don't do what they're supposed to do huh?
    Good luck!

  3. #3
    aka Dick Dangle
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    autograft

    Next time autograft

  4. #4
    Bodhisattva
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    If your surgeon doesn't recommend an MRI then you don't need one. Anything that the MRI will show will be seen at the time of surgery.

    it hurts is right....next time demand an autograft - either hamstring or patellar depending on surgeon's preference - they're equally good in the hands of a good surgeon.

    I'm sorry to hear that happened to you. Major bummer. But if you want to ski again then you really need that ACL (although I know some folks who ski without one but suffer for it)

  5. #5
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    I'm sorry for that bad news.

    I had a reconstruction 6 years ago and I remember how nervous I would be when the Orthopod checked the laxity of the knee each visit. They yank on it pretty hard with that machine to test it.

    Since your knee is clearly lax now, even if an MRI showed a perfectly intact graft, it isn't doing what it is supposed to do...and likely needs to be redone. So an MRI is of no use.

    Although an allograft can be very successful and it spares damaging another body part to mend the injured one, it may not be a good choice for you anymore.

    For one thing, do-overs with allografts have a significantly higher failure rate. A second theoretical reason would be your immune system may have rejected the foreign material in the allograft and that could happen again.

    Approximately 1/3 of the population can be quite active without an ACL, having to do with their anatomy. Strong quads and hamstrings can support the joint without the ligament. However, if you were unstable before the surgery, you do need to have it done, or risk a lot more damage to the joint.

    There are some decent prescription braces like CTI 2 and some Don Joys, that can save you from certain types of injurious movement..mainly hyperextension...which is the mechanism of many ACL tears. But none of them will work for every stress.

    Cycling can be done (and is a lot of the pre and post surgical rehab) but of course, it's those sudden twisty dismounts in mountain biking that are high risk.

    I'm a physician, but not an Orthopod. I've had to acquire most of my orthopedic know-how the hard way !

  6. #6
    mmm bacon
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    I know that I don't need a MRI but this is a workers comp injury so I need to cover all my bases. The allograft was due to this being my second knee surgery and I opted to not take ligaments from the other leg in case they were needed at a later date, lucky me . I could try to "live"without it after my accident but prior to my surgery I tried and my knee got realy bad. I do have a CTi2 brace just one month old and had two Donjoys before that. Regrdless I am giving myself two months to enjoy the summer, as much as I can and will be hopefuly going under the knife in late August/September. Looks like I've lost two ski seasons hopefully just one biking season.JK

  7. #7
    sixsixtysix
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    Man, that is bad news. I totally feel for ya. That is why my doc wont use cadaver grafts at all. I have had a hamstring and patellar graft before and now when I do finally get my 3rd ACL in my knee it looks like it'll be coming from my other leg, but that won't be until the end of the year at least. For now I am living without an ACL and honestly, not missing it much. I have gotten my leg strong enough to compensate for it in most situations, and my brace makes up fro everything else. The only time I really notice and have to be conscious of my movements is coming down stairs, then I can feel the joint shift forward. But for now I am riding as much as I ever did, and have done 50+ mile weekends the past 2 weekends in a row with no real pain or swelling. Just really focus on working you hamstrings in the gym as much as possible and don't work your quads except for riding.

    The other thing I have found helps immensely is massage therapy. I have been seeing a sports massage therapist weekly since I was 6 weeks post op and she has helped keep the muscles balanced and relaxed throughout my muscle rebuilding process. You may want to try it and see if it helps any, if not at least you will be relaxed

    Hang in there and enjoy the summer as much as possible, just be mindful of your limitations and you really shouldn't have many problems riding for the summer. Good luck too ya

  8. #8
    mmm bacon
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    Totally owned

    Yup I was thinking about just saying screw it and going the route of strength training and bracing an enjoying the rest of my season but my doc found out, the majority of my freinds are reps, nurses docs, etc. He sat me down and explained one glaring thing actually two. First I have an ACL, it is not performing the job its supposed too, additionally my knee shows and immense ammount of looseness from the LCL also. Since in theory I have an ACL workers comp could demand a second opinion but they are being really cool about it. The major problem with my sudden screw u plan, since this is a workers comp case and if I were to ride and damage my knee worse they could become extremely uncool and deny the additional damage as after the fact. Leaving me in a much worse position, probably wouldn't happen but I don't want to pay anymore than I have to which at this moment is 0 and the way my luck is going we all know who it would end. Enjoy the season for me and I might have a bike for sale.

  9. #9
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    knees suck.

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