Donor tissue for ACL repair – which leg?

September 9th — admin

Should I have my ACL repair done using donor tissue from the same leg or the other leg? Which is better?

There may not be an easy, straightforward answer to this question. Let’s go over some of the considerations.

If the tendon graft is taken from the same leg, then only one leg is affected. The patient can shift the weight off that leg during the early days after the surgery.

Repairing the knee with donor tissue from the other leg means both sides are affected. There have been a few cases reported of problems developing from overload of the donor side.

This is more likely during the first 24-hours when the patient is still under the influence of anesthesia and drugs to limit pain. Without complete sensation, the patient can put too much load on the donor leg. The result can be an avulsion fracture. The remaining (weakened) patellar tendon pulls away from the bone.

On the plus side, taking donor tissue from the other leg leaves less trauma to the reconstructed knee. Rehab can progress along much faster.

Most surgeons use donor tissue from the same side. Talk to your surgeon about his or her preferences and reasons for choosing one over the other.

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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Torn ACL still causing pain two years after repair

September 7th — admin

I tore my right ACL two years ago. It’s still not right. I have continued pain and swelling that’s keeping me from enjoying the things I like to do. Will I ever be able to ride a bike again?

Knee pain, swelling, and giving way two years after ACL repair are signs and symptoms that the joint is unstable. If you haven’t gone back to your orthopedic surgeon, now would be a good time to make an appointment.

It may be a simple case of muscular weakness or imbalance. Sometimes such problems can be taken care of with a rehab program. In other cases there may be other (unknown) damage to the joint. Perhaps there’s a torn meniscus or some osteoarthritis developing.

Worst-case scenario: the repaired ACL may have failed. Further testing is needed to find out what’s wrong. The chances are good that treatment is available that can get you back to the activities you like.

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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Does delay affect success of ACL repair?

September 2nd — admin

I tore my ACL in a water skiing accident about 27 months ago. I tried rehab but it looks like I’m going to need surgery after all. Have I missed my chance for a good result by waiting so long?

Not necessarily. It’s true that the longer a person waits, the greater the risk of the knee becoming unstable. Once the anterior cruciate ligament (ACL) is torn, there is greater strain on the other soft tissue structures in and around the knee.

Studies have shown that repair of ACL tears can be successful whether done right away or years later. If you’ve spent the last two years in rehab you may even have a better chance of good recovery. The exercises may have increased your strength. This can give you a “leg up” in recovery, so-to-speak.

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 are closed-kinetic chain exercises?

August 25th — admin

Since I hurt my ACL, I’ve been reading a lot about doing closed-kinetic chain exercises after knee injury. What kind of exercises are these anyway?

Closed-kinetic chain exercises are done with the foot or feet planted firmly on the ground or some other surface. This type of exercise is preferred because it helps reproduce normal, everyday movements.

Squatting, stepping, and stair climbing are examples of closed-kinetic chain activities. The exercises are functional but also reduce the strain and shear force on the ACL. In fact, they also decrease the compressive force on the patella (kneecap), too.

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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Can the MCL heal without surgery?

August 17th — admin

I tore the medial collateral ligament in my knee. Is it true I don’t need surgery to repair it? I had to have surgery for a torn ACL. What’s the difference?

Studies show that the medical collateral ligament (MCL) heals faster and better than other ligaments. The anterior cruciate ligament (ACL) doesn’t heal well on its own. In fact animal studies have shown the MCL can be cut in half and still heal without surgery or immobilization. There’s even enough strength in the healed ligament to restore joint stability.

The joint can be restored to normal without surgery only when the MCL is the only ligament damaged. If the knee has a torn meniscus or torn ACL along with an injured MCL, then surgery is needed.

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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Do-it-yourself-rehab after ACL repair

August 12th — admin

I have heard that it’s possible to do my own rehab after an ACL repair. Is this true? It would sure save me time and money driving into town to go to rehab.

A few studies have been done showing how rehab can be done at home. Most researchers advised patients to have some supervision by a physical therapist. They reported a need for quality education before and after the operation.

Patients at home need good handouts with detailed instructions about the exercises. Patients must be motivated to do their own program for it to work. Not all patient types have been studied. Most studies have included athletes. A recent study from Canada only included athletes with chronic ACL tears. Anyone with a recent injury wasn’t included.

Talk to your surgeon about your options. There may be a way to work out a program with some supervision that cuts down the number of trips you make. It’s important to follow some kind of rehab program to prevent joint problems later.

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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Hamstring vs. patellar tendon graft for ACL repair

July 19th — admin

Two years ago I had a hamstring graft to repair a torn ACL. There was a lot of controversy then over whether a hamstring or patellar tendon graft was better. I’m still wondering if I made the right choice. What’s the latest thinking on this issue?

If you are satisfied with the results then you have nothing to regret or wonder about.

Researchers agree the two methods have equally good results. There may be complicationsfrom time to time. These differ between the two types of repair.

The hamstring graft is a little nicer looking cosmetically. It gives a strong graft fixation early on. The hamstring may not be able to tolerate motion right away.

The patellar graft seems to help athletes get back into high-level action more often. There are still some problems with kneeling and quadriceps muscle weakness after a patellar tendon graft.

Overall patients report satisfaction with function and results after either type of graft repair.

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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Will surgery fix trick knee?

June 27th — admin

I have a trick knee that goes out on my every now and then. It’s from a torn ACL from an old football injury. If I have it repaired surgically will that stop it from giving way?

It should but there are no guarantees. It may depend on the condition of the rest of your knee joint. Are the other ligaments okay? What about the cartilage? Are there any signs of advancing arthritis? How much strength do you have in the muscles around the knee joint? These are all important factors.

There are two popular ways to repair a torn anterior cruciate ligament (ACL). One of these methods called the bone-patellar tendon-bone graft has been shown to be 22 percent more stable. In other words, it’s less likely to give way because of joint laxity. The increased graft strength may come from the small piece of bone plug that’s used along with the tendon tissue to make the repair.

The choice of graft material must be made on a case-by-case basis. It’s an educated decision based on the condition of your joint, your activity level, your goals, and the surgeon’s level of expertise.

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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Will wearing a knee brace prevent an ACL tear?

May 19th — admin

I think I might be prone to knee injuries. Would wearing a knee brace during volleyball practice help prevent an ACL tear?

Anterior Cruciate Ligament (ACL) injuries are a problem for many athletes in noncontact sports. Volleyball players are at increased risk because of the landing, turning, and pivoting required. Female athletes are up to eight times more likely to injure the ACL compared to male athletes.

Many studies have been done trying to find out the specific cause and ways to prevent ACL tears. Researchers have looked at weather conditions, playing surface, and footwear. They’ve examined hormonal differences between boys and girls. They’ve compared anatomy from head to toe as a possible reason for differences in the rates of ACL injuries between the sexes.

So far no single factor has been linked to ACL injuries. Bracing hasn’t been proven to prevent knee injuries either. Balance training and improving the joint’s sense of position seem to have the best record so far in preventing these types of knee injuries.

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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How to tell if knee injury is acute or chronic

November 12th — admin

What’s the difference between an acute and chronic knee injury? I have a torn ACL that is several months old, but still flares up. Is it acute or chronic?

Acute usually refers to how recent the injury occurred and the symptoms present. Redness, warmth, swelling, and pain are signs and symptoms of an acute inflammatory reaction. This can happen months after the original injury when the joint is overused or reinjured in any way. Chronic describes a condition that has been present past the normal time expected for healing. Most soft tissue and bone injuries heal completely within the first six weeks. The tissue will continue to remodel itself much longer, but strength and movement are restored. So, it’s possible to have an old injury that’s considered chronic, but with acute flare-ups.

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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