My doctor is trying out a different way of doing my ACL surgery using a piece of my hamstring. Will this speed recovery?

December 26th — admin

I’m scheduled to have an ACL reconstruction in two weeks. The doctor is trying out a slightly different way of doing the operation. A piece of my hamstring will be used with a little piece of bone attached to give it greater stability. Will this speed up my recovery at all?

The use of multistrand hamstring tendon grafts and now hamstring tendon grafts with a bone plug to repair a ruptured anterior cruciate ligament (ACL) is gaining popularity.

Many studies have been done comparing the patellar tendon graft to the hamstring tendon graft. The results have been very favorable towards the hamstring tendon graft. Although the preparation of the graft takes longer, the stability of the knee afterwards may be worth it.

Patients have fewer problems at the donor site with the hamstring tendon graft. The patellar tendon graft is taken from the front of the knee causing painful kneeling afterwards. Sometimes the pain is severe. In most cases it never goes away.

Rehab is the same for both graft types. Recovery is not reported to be faster with one graft over another. Complications can occur with either method causing a delay in recovery. If no problems occur after the operation you should be back on your feet in two to four weeks. Full recovery and return to preinjury activities take longer (four to six months).

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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To repair my ACL, the surgeon used part of a tendon as a graft. Won’t that cause problems for the tendon now?

December 16th — admin

When the surgeon repaired my torn ACL he took a piece of my patellar tendon and used it as a graft. How can they do this without causing problems in that tendon now?

A very good question. First of all, only a piece of the hamstring tendon is removed. At least half or more of the tendon is left intact. The postharvest strength of the graft tendon must be strong enough for early rehab and daily activities.

If the graft doesn’t hold it usually pulls away from the bone with a little piece of bone attached. This is called bone avulsion.

Before these grafts were ever used on patients, scientists used animal and cadaver studies to test the strength of the tendons before and after grafting. This is how they know which tendons will hold up after a piece is removed for use as a graft.

They also found that ACL tensile strength decreased over 50 percent between age 20 and 50. This isn’t true of the patellar tendon. During this same time period, tensile strength of the patellar tendon doesn’t change. That makes the patellar tendon a good graft choice.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What causes loss of motion after a muscle strain?

September 14th — admin

What causes loss of motion after a muscle strain? I can’t seem to get full knee motion after a hamstring injury.

Studies show muscles can heal but it’s a slow process with a high rate of re-injury. The formation of scar tissue seems to slow up the recovery process of injured muscle.

Fibrous scar tissue forms when the body sends too much growth factor to the injured muscle. Some growth factor is needed to stimulate new cell growth. These new cells fill in the damaged area.

Too much of the growth factor TGF-beta leads to too much fibrosis. Fibrous scar tissue prevents full recovery of the injured muscle resulting in a loss of motion. Physical therapy can help in some cases. The use of deep heat, friction massage, and stretching may help restore flexibility. A program of resistance training can help restore full
strength.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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What to do about a hamstring injury

March 16th — admin

I play adult-league baseball in the summers. Every year I tear my hamstring muscle on the right side. I have done everything to prevent this from happening. I’ve used heat, cold, taping, stretching, and so on. What else can I do?

Hamstring injuries are common among athletes at all levels from amateur to professional. Once the hamstring muscle has been torn, it’s more likely to tear again. Some athletes report five or six injuries on the same side.

Researchers at the Monash University Department of Physiology in Australia studied this problem. They found when injured hamstring muscles heal the optimum length of the muscle needed for contraction changes. The muscle that was injured now operates at a shorter length. This can lead to microscopic damage from certain types of muscle action. These contractions are called eccentric contractions.

The answer to your problem may be to focus on eccentric activity. Instead of exercises to tighten up the hamstrings, it may be better to exercise while slowly lengthening the muscle. The eccentric contractions can shift the optimal angle toward a longer length in the hamstrings muscle.

An athletic trainer or physical therapist can help you with this type of rehab program.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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