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Knee Injury- Best Options?

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jfkayne
Posts: 15 - Karma: 25

Hi everyone,

So I completely blew-out my knee at Targhee in late February resulting in the following injuries:

1.       Complete tear of the ACL

2.       Complete tear of MCL

3.       Partial tear of the LCL

4.       Torn Meniscus (multiple)

5.       Small fractures

6.    Complete tear of the posterolateral joint capsule

I tore my ACL & MCL in my right knee about 5 years ago but it was only grade 2 tears in both so I was able to recover without surgery and no problems since (still wear a brace though). I was wondering if you have had any experience with ACL replacement surgery, what option did you choose (ie patella, cadaver, hamstring....)? I hear cadaver will be the least painful/shortest recovery time but may not offer as much strength as patella in the long term.

Can any of you share your experiences with recovery time? I read estimates all over the place from 4mo to 2yrs. Also not sure what to expect considering the extent of the damage. Just got the MRI report sent to me yesterday so I was a bit taken-back. Main goal is to get back to 100% for next season.

In case you were wondering.... I was just going really fast in deep snow that had been baked by the sun all day. Got sloppy late in the day at that is all it took. Wish I was at least doing something cool to result in these injuries

Mar 8 2013 5:30PM
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.MASSHOLE.
Posts: 7472 - Karma: 11,419
Where are you getting the surgery done? If you live on the EC (which I doubt), check out the Alpine Clinic in NH. Bunch of my friends have gotten their knees done there (one dislocated her entire knee cap and has a few pins in there), and Nick Martini has gotten it done there as well I believe
Mar 8 2013 6:22PM
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40oz.
Posts: 1758 - Karma: 555
The tendons suck to tear but fucking up your Meniscus will cause your problems for life.  I tore my MCL and Meniscus 3 years ago and had surgery and my knee never really causes me pain, but since they removed 2/3 of my meniscus due to it being dead and not able to regrow my knee often catches and I can feel the deference from my other knee.  Hopefully one day they will have artificial cartilage to replace it with, but good luck man.
Mar 8 2013 6:31PM
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MilaKunis
Posts: 1480 - Karma: 3,646
I would say go with the patella. The cadaver is a good option but not as strong as the patella. Yeah it may suck to have to wait for a little while longer but it will feel more like your old knee did and will be much stronger.
Mar 8 2013 6:38PM
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40oz.
Posts: 1758 - Karma: 555
My recovery time was about 6-7 months for full recovery but like I said it feels strong and normal and good now (3 years later) but it catches sometimes due to lack of cartilage.
Mar 8 2013 7:03PM
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blueberrymuffin
Posts: 194 - Karma: 51
I've torn my acl twice and a meniscus transplant all in the same knee. First time around I had patella. 10 months later that tore and I opted for the hamstring. It has felt much better this time around. Plus if u use patella it will hurt to kneel on that knee for years (I'm 3 years out and its still a pain in the ass). I would recommend hamstring and definitely not cadaver.
Mar 8 2013 7:29PM
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.Brink.
Posts: 1622 - Karma: 188
my brother had almost the same injury, full tear of acl, mcl, partial meniscus and bone contusions. With hard work in physical therapy and a good surgeon he was back at 100% after about a year.
Mar 8 2013 8:59PM
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jfkayne
Posts: 15 - Karma: 25

Thanks guys. Surprised to hear that no one opted for the cadaver. I always thought that was by far the most common. I had a buddy that had his ACL done about a year ago and opted for the cadaver. He said it took almost a full year before he felt confident to ski again but now he is back on it. Although he also mentioned that he could have worked harder at PT.... His fault

The comments about meniscus scare me. Rehab is just different this time. Range of motion should be coming back by now but it is just stalled and it kills to try and improve the angle of my knee. I definitely worry about never getting back to 100%. When I first injured it, I was so pissed that the rest of the season was over. Now I am just bugging to think that my knee may never go back to 100%.

Have to wait four more weeks for my MCL to heal and then surgery. .MASSHOLE, I am getting the surgery done at the hospital for special surgery in NYC. I live downtown so it is the easiest to get to and supposedly the best center in the country. Just keeping my fingers crossed that they can get me back on my feet in short order.

Thanks again for the feedback guys +k

Mar 8 2013 10:41PM
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40oz.
Posts: 1758 - Karma: 555
vibes bro!!
Mar 8 2013 10:49PM
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skier_07
Posts: 326 - Karma: 51
I have had both the patella and the hamstring. As someone else said the patella graft causes it to be painful to kneel for several years. But on that note I would also do whatever your dr is most comfortable with. Some drs prefer one over the other and accordingly have a lot more experience with that one. On another note TJ had a LARS ligament put in insteat of a hamsting or patella graft. Not sure if they are approved in the USA yet or not. It is a synthetic ligament that is stronger than a normal acl but performs in the same way. The huge benefit is the decreases revocery time. If you look at TJs blog he had some information about them on there.
Mar 9 2013 2:51PM
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Kreech
Posts: 4178 - Karma: 3,024
I've heard that the hamstring route can perpetually weaken your hamstring and after surgery pulling it becomes much more common and easy to do. Just something to think about; I've never torn my acl so I don't have any firsthand experience.
Mar 9 2013 3:00PM
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Edward.
Posts: 9366 - Karma: 445
I tore my left ACL about 6 years ago and my right ACL 4 years ago. ACL reconstructions always tend to be season enders (assuming a typical ski season lasts from late november into mid april), so you shouldn't try so hard to get back into skiing that same season.

I had the same surgeon both times at NYU hospital. He chose to go with the hamstring option for me both times. My recovery times for both were around 6-7 months until I personally felt comfortable doing everything. PT twice a week for a month, then once a week for the rest of the 4-5 months.

Different surgeons will produce different outcomes, especially if you go to a teaching hospital. Because chances are, a resident will be performing surgery on you with your doctor standing by making sure everything goes right (it could even be their first time ever doing that surgery). And then after that, its all up to you and how hard you work to get back to normal during your recovery phase.
Mar 9 2013 3:04PM
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SloanKettering
Posts: 691 - Karma: 465
That must have hurt
Mar 9 2013 8:57PM
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rememberscott
Posts: 1291 - Karma: 5,201
dude that sounds terrible, I hope you can get back to 100% best of luck
Mar 9 2013 9:46PM
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jfkayne
Posts: 15 - Karma: 25

Thanks for all of the feedback guys. I spoke to a good friend who is an orthopedic surgeon this past weekend and his recommendations were the following: 1) Patella 2) Hamstring 3) Cadaver. I was surprised to hear it because I always thought Cadaver was the most popular. He recommended against it because it was an unregulated industry and you never know what you are getting. The example he used was that the ACL could have come from an 80yr old man after sitting in the freezer for a couple of months.

The patella recovery sounds like it sucks but he said that is the best route to take. A large part of this seems to be trusting the Dr's judgment. Thanks for the advice about LARS Skier_07. Never heard of it before. Seems to make sense that there would be some synthetic option that could be used. Current surgical options seem like taking from Peter to pay Paul. Not thrilled about removing part of my Patella and the potential consequences.

BROSF... yes it really f'ing hurt. I tomahawked down a bit and could feel my leg flapping around behind me like a rag doll. Pain was unbelievable for 5-10min and I just laid there screaming "my knee" 100 times. Once the pain subsided I was kind of laughing because all I could think about was that video of TH breaking his ankles. Had to drive 1.5hrs back to Jackson after doing it. I am sure everyone that has done this can attest that it is not a fun experience.

Broke 2 ribs a couple of months before this slamming into a tree.... Real sh!tty season for me

Mar 11 2013 3:08PM
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Capernicus
Posts: 382 - Karma: 218
Hey man, I'm sorry about your knee. I got a hamstring graft the first surgery, cadaver the second time, and for the third (meniscus clean up) I had PRP treatment wrapped on my cadaver graft (ACL). Graft placement is more important than type of graft and no matter what, take rehab seriously.

Here is my non-professional opinion.

If I could do it all over I would get cadaver or patella first. Cadaver is great because the Dr. does not need to harvest anything from your body meaning a shorter recovery time. The down side is that the graft does not vascularize for a longer time so you might feel good but the graft might be weak even at the 8ish month mark.

Patella great is super strong (see NFL, particularly Adrian Peterson) but the downside I've heard is there can be numbness and pain with the harvest area.

Hamstring graft worked for me (16 months) until I didn't work out as much as I was before. The problem I have with concept of the hamstring grafts is that the hamstring is one of the most main muscles (along with quads) that prevents knee injuries so why would you take a tendon from an important muscle? I feel like, even with serious gym training, I only got my hamstring back to like 95% and now I still work on it quite a bit. With this being said, I have many friends that have got a hamstring graft and continued to play college sports, etc. Maybe I'm just not a beast like them.

And I'd wait awhile before going with the LARS graft. There is not enough long term data (my opinion).

Also, each surgeon will have their own specialty (hamstring, patella, cadaver). Ask around and find a reputable doctor that you are comfortable with. Make sure to let him/her know that you plan on skiing hard for the rest of your life. Maybe find a ski team doctor. Same goes with the physical therapist.

Wish you the best of luck. You'll be back on skis before you know it.

Pro Tip: Do physical therapy before surgery. It will make your recovery so much easier.


Mar 11 2013 7:49PM
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