Was released from PT at 4 months and went to functional rehab (core strengthening, movement, jumping/running (how to), quad strength) 3 x week. There is numbness a little but kneeling and playing sports has never bothered me. My history also included a meniscal tear one to each leg and history of ALOT of high impact/standard sport. I have to make my decision i need the strongedt possible! So now three weeks out I feel great! I am getting older but dont want to loose a step however I’m not a professional nor will I ever be. Played non competitive 5 a side 8 to 12 months later but unfortunately tried to play low level 11 a side at 24 months and found hamstring too weak to break into a longer distance full sprint. Noel, Does anyone have ideas what I can do – I tore my hamstring in gymnastics about 30 years ago, I’m in my mid 40’s. I think his doc ony took 1 tendon vs.2. I was told the first year I would have to use a brace. He recently had surgery from an ACL specialist. Compared with patellar tendon grafts, hamstring grafts have donor site morbidity, but Owens noted less knee pain. no pain, or instability issues, it was just very sore for about 10 mins. I’ve learned after having multiple recons that the quickest solution isn’t the best in the long run. My surgery was March 3rd, and I chose the patellar graft. I was completely devastated. The biggest problem i’ve had is instability in both knees, one seems to be compensating for the other and i really need my stability back. I hear most people come back at around 6 months but I dont really plan on playing actively until like 8-12 months. I knew something was wrong when I didn’t do the normal get up and brush off. The second time I was on them for only 8 days. I was a serious athlete and played soccer in high school and Div 1 college. I plan on playing basketball after a year. Thank you everyone for sharing their ACL stories and sagas! We are so concerned about her and need help. My right knee still feels ‘tighter’ (I guess from having more fluid? I have found and read just a few reviews on athletes with cadaver ACL repairs, and most of the entries here involve hamstring and patella repairs… If you have any words of wisdom, especially success stories (i.e. Its a no brainer. If they concur with this as a point of irritation then it should come out. I tore my ACL and had a bucket handle meniscus tear on my right knee in 2000 playing in-door soccer. Any tips out there to get the hammy strong and flexible again? I ask because I’ve heard conflicting info with some docs saying they do grow back and others say they’re gone forever. I have had two ACL reconstructions and used both the hamstring and cadaver methods. Also, the aching is a lot more minimal than patella because not as much damage was done to the knee itself. As per doctors post op instructions, I was not on a CPM at all and remained in the hospital for two days post op due to the femomal block I had been administered for surgery not wearing off. My son just tore his ACL, no other damage(miniscus or MCL) and absolutely no swelling. Can’t put into words how devastating it was, going through it again, missing not only Junior year of soccer, but Senior year as well, of a game she loved so much that she had come back after numerous other injuries. I don`t have any pain in my knee, i can run and jump, even when kneeling i don`t have any pain, just a little odd sensation, and that becouse taking out the pattelar graft they sectioned one nerve and becouse of that, a small portion of the knee you will feel it vague. I can do most anything but the speed isn’t there like it used to. Kevin, Anyone gone through the same situation? (bubbabravo@gmail.com), Last year i torn my acl in a motorcycle accident. I was under the impression (perhaps falsely) that patellar was the “gold standard” amongst the 3 methods. IT MADE A WORLD OF DIFFERENCE ONCE THE SCREWS WERE GONE…. I gave up competitive soccer long ago. With allografts from a donor bank, there are no painful symptoms or donor site problems to deal with. ACL graft fixation devices can be broadly categorized as intratunnel, cortical button (“suspensory”), or extratunnel fixation depending on where the ACL graft is fixed (Fig. ?-I need to ask my doctor) than my other ‘normal’ knee. Both surgeries may have their benefits but in the end it comes down to the hard work and dedication of the individual for recovery time and strength. This surprised me as it was contrary to all the information I gleamed from this website prior to the appointment. Request An Appointment Online or Call Now. Risking the loss of strength in his hamstring, and the time it would take to regain that strength has a cost/risk. After extensive, extensive, I mean super extensive research, I have come to the conclusion that I wanted to have the hamstring allograft reconstruction done. ... Anterior cruciate ligament graft fixation. At a glance the options seem fairly balanced, with pros and cons on either side, but our two polls have shown a slight leaning toward hamstring graft. Hey, Anyway, I just wanted to make that point very clearly- recovering from knee surgery is a major deal, regardless of age and regardless of graft choice. Make you’re you wait a few months prior to surgery to make sure your swelling is down and make to strengthen and get your flexibility back up as much as possible prior to surgery, then after surgery, you have to rinse and repeat. I went to a sports related physical therapy group for 3 months before my surgery and for over 1 year after. I am so pissed and feel lied to about how much strength would be permanently lost. I hope this might be helpful to anyone trying to make a decision on which graft to get. Good luck! Although I have knee pain and extension is very tough, my knee feels a lot stronger now (at 39) than when I was fully recovered from my first ACL back when I was 27. On the plus side, the knee has held up well and I continued to play all sports including basketball. I had ACL reconstruction using hamstring graft around 6 years ago at 26 years old. I am a 60 year old very active male who completely tore my ACL when I was 28. I’ve had 3 acl surgeries and always wanted to toss the crutches away after the first few days also, however swelling and the incision being somewhat relatively fragile I was hesitant and more so used the the crutches as partial weight bearing. at this point i’m not sure if i would have this graft again (i didn’t have a choice) but maybe i’ll know in a year. Im having same surgery in august any advise u can give me? Adam, let us know how your allograft heal? The hamstring tendon is where two of the tendons of the hamstring muscle are effectively removed and bundled together to create a new ACL graft. I have had acl surgery on my left knee on december 8. If you think like that, you will be fine. Someone posted this earlier by the surgeon is VERY important! I also had latteral miniscus repair on the left knee in 1994. I had my surgery on 4/1/09 – missed only 3 days of work. He said the strength between the two is debatable, with no real advantages to patella. How long is the recovery time ? Sooo…. My heart tells me to choose Hamstring (cause there is less cons, more scientific proof on andvantage using Hamstring and as long as i dont overdo my active lifestyle then there is less risk on 2nd tear on ACL) but the doctor preferred me to choose Patellar? A study published in this month's AJSM compared the long term (17 year) outcomes between ACL reconstructions with BTB autograft and hamstring autograft.Graft choice for ACL surgery is an interesting topic in the sports medicine world. Less painful initially following surgery. this was all about 6 years ago. Some people are predisposed to tears, so if you don’t rehab your @$$ off, then there will always be a risk. I couldn’t be happier with my selection….maybe I shouldn’t say that yet because my surgery isn’t until August 3!!! She said they remove them by cutting open the original incision near where the graft was taken, then cutting through a small layer of tissue to get to the screws. The physical therapy is intense – but she recovered and played her senior year. They caused me too much pain (I know the feeling of pain coming from the 2 screws are) so I decided to get them removed and everything went fine. I used to play at point guard and could dunk also before the injury. Save my name, email, and website in this browser for the next time I comment. I’m planning to survive this season too, my last year of prems team at ‘high school’ before having surgery in September after nationals even though it’s showing symptoms of arthritis, may be only my imagination. Too bad there’s not more conclusive studies on this. Thanks for sharing that. Listen to your doctors and read in on what the surgury means and what’s expected of you when it coms to physiotherapy and comitment. I took it VERY easy for about a year. This is very helpful…nice to see people who understand the pain and suffering we are subjected to. So I decided to go with the hamstring, since it has a smaller chance of arthritis than the patella ( no matter how minute that may be). It takes forever to warm up the hamstring to be able to run without thinking about it but I’m still improving. It is no means intended to be a substitute for one’s clinical decision making It’s 11 days after surgery, and no more oxy or tylenol 3’s, only on advil now which is great. I continued playing for a full season without knowing extent of damage (went through 2 doctors and 2 physios who didn’t pick anything up), finally went to see a specialist and had an MRI early this year. I just scheduled my surgery for the 27th and have the choice between a hamstring graft or cadaver. My doctor said that since i was a freshman he would use the hamstring graft because the extended recovery time wouldn’t affect my high school sports experience. Accelrated programs were designed for elite sportspeople who generally have the ultimate in consultation, support, therapists and supervision. Has a slight risk of getting a disease transmitted through the … Hope I helped!! What is your opinion about him wrestling in January, since you tore yours wrestling. good choice ? I recently had a bike accident and my ACL was cut on jan 16 2012. But don’t let that scare you, all you athletes, a re-tear isn’t common…I researched the heck out of that too. My rehab was going great until one day i had tore my acl again in my left knee. Everyone reacts differently to surgery and medication, so don’t take my word for it, you know your own body better than anyone. I am 2 days post op and man does it hurt. With patella grafts rehab can be quicker in the beginning stages after pain levels decrease. This is easier said than done. I bring this up because my first surgeon who did my left knee for the first time did not do this correctly which is why I tore my ACL again for the second time.”. To me, the gold standard of ACL reconstruction is the patella tendon autograft and should be considered for most people in their teens, 20’s and for many in their 30’s or 40’s. Can you describe the pain you feel in your knee now it has healed?? He said my surgeon is one of the best in the country and that he is on the “cutting edge” with ACL repairs. The surgeon uses either a piece of the patient’s patellar tendon or hamstrings tendon. The other is the hamstring tendon graft. I had my right knee reconstructed in 1994 using the patellar method. I am leaning towards patellar…I just don’t want anymore surgery after this one, I want it to be the best, its not like I’m planning to go back to rugby or any high level sport, I would like to be able to run again, to lift weights, hike, biking, all that stuff! It seems like the safest option because there aren’t shortages of cadavars but I only have so many hamstrings or patellas. He has had serious knee issues for the past ten years. Totally ruptured my ACL this yr .. at 32. Would wearing an ACL brace for casual weekend flag football, volleyball, or basketball be enough to keep the hamstring graft from getting stretched out? I’m happy with my hamstring graft. I had a … Cons: Weaker- a low percentage of patients have the allograft break, requiring a 2nd ACL surgery. Both graft sites have their pros and cons, however the hamstrings are now used most often for first-time ACL reconstructions. I’m so sorry if I’ve scared anyone…you will get through it and be running, biking, etc. In my mind, it is an absolute no brainer—- HAMSTRING IS THE BEST OPTION! Cons. We are debating between Patellar or Hamstring (Double bundle) graft. I am 21 years old and in top shape. So I went back to the surgeon two months ago and had a arthroscopy with found the hamstring graph has gone loose over time and has now damaged my miniscus, So I have had a meniscus repair and also having a patella graph repair, If I could go back I wish I went for the patella the first time then I wouldn’t have to go through this again. He has been practicing with team but no live wrestling yet. I had my ACL surgery with the latter doctor and was glad I did. As you can see, there’s good reason to hesitate when making a choice with potential long-term health ramifications. Father to daughter. This time my OS will perform a patellar graft. I plan not to rush and take the PT very seriously. I am 27 and an athlete(primarily basketball). Which graft is best for my situation If I want to compete in cross country again ??? Thanks for your posting your experience on the patella option back in 12/09. My 17 yr. old ski racer son just tore his left ACL & MCL on Saturday. I’ve had basically no patellar tindinitus (not yet at least) so that’s good..good luck to everyone who has questions or who’s healing! A professional martial artists. He is scheduled for surgery in 2 more wekks and had full mobility in the affected knee with the physical therapy he has started. It was never as good as the left knee, and for example I always felt weakness climbing up stairs (when compared to my good knee). But the injury wasn’t any way near as bad as the other knee – and I was better prepared both physically and mentally. I just tore my ACL last week skiing and I’m trying to decide on the type of graft. The pain meds were the worst for me, my body started showing withdrawal symptoms 4 days after surgery so I just stopped taking all the meds. The main goal of ACL surgery is to keep the tibia from moving too far forward under the femur bone and to get the knee functioning normally again. However, if I had to do it all over again, I would choose Patellar. My experience right now is that this graft has been fantastic… The surgeon I had was head of department at the facility I attended and he only does hamstring graft. I told him I would like to get back to playing basketball. So far this is the best Patellar vs Hamstring conversation I have ever saw. ” Eighty-four patients (37 with autografts and 47 with allografts) were enrolled….At final followup, we found no difference in terms of Tegner, Lysholm, KT-1000, or International Knee Documentation Committee scores. It may be beneficial to take a look at the strengths and weaknesses of these grafts. EVEN your doctor. I used to run :58/2:16. First blew my knee out playing baseball at age 22. The only issue I have now is trying to stop myself from pushing too hard and sticking to what my PT has told me to do, as I used to compete in Judo I am a very competitive person and always pushed myself, but the true test now is not pushing myself too early and resting as much as possible. But either way with an ACL tear your going to develop arthritis whether you like it or not. hi everyone i m a 25 years old sportsman from turkey who makes all kind of sports all the time and as most of people in here i has my right acl torn 3 months ago hopefully no other injuries, i read whole thing its very interesting ð but i can say you one important thing about the debate: dereck rose ( guard of bulls) had his left acl torn few weeks ago and you know how talented how atlethic guy he is and its sure that he has the best doctors(Chicago Bulls team physician Dr. Brian Cole. Am continue with PT but still getting pain in both the knees so i started heavy waight exercisel. My injury happened back in early october, and had surgery December 18th. I was told no one over 54, not to disciminate but its because everyone younger than that was trained with a orthoscope in college and through med school, not just on weekends. Our son felt his right knee is stronger than ever and it has held up fine to the rigors of soccer & ski racing. In an ACL reconstruction, the surgeon makes a new ligament with an ACL graft – tissue from the patient or tissue from a donor. I it is put in more horizontal it will prevent both from ocurring. Pros: Less or no knee pain, comparable strength to patellar. I’m in the process of looking for a surgeon. I didn’t have problems with it until 2008 . He had patellar tendon graft and is doing great. 7 months post-op. Two tendons are harvested for a hamstring graft… They had used the hamstring graft and the surgery was successful. Have read and read and read… Don’t have the skill set to decide what’s best for my 16yr old son… Great basketball player, with torn ACL, and partially damaged meniscus… Our Dr. of choice only does and swears by cadaver ACL repairs, our second opinion – another great surgeon – only does hamstring ACL repairs!!! I regret not doing it the first time and now I am back for round 2. I had the surgery on the other knee 4 years ago and used the hamstring. However, the use of donor grafts in young patients has … The patella graft was recommended by the next surgeon. i stopped using crutches after a week. I’ve talked with a few PT’s and they all prefer hamstring because the rehab is easier. – Nacho. I, too, was given a choice. I was back to playing basketball in the fall/winter of 2001 and played softball and flag football every year until I tore my right one this last September in a softball game. The patellar tendon and hamstring autografts are the most common choices for ACL reconstruction. So, when you choose a doctor, you’re also choosing what graft you want. Hey Bret, The aftermath was pretty painful and that knee still feels unstable. Because of my dad’s arthritic problems and while researching the issue, my brother had to go in for another procedure where they found some arthritis. Then there’s the low risk of getting a disease or having your body reject it. I wish you all the very best with you surgery and recovery! GOOD LUCK to all of you!! but while the ACL has felt fine so far, the knee I feel was generally weakened by the affected patella. I hope I make the right decision. My first ACL surgery used a harvested hamstring graft when I was a teenager (I recently tore this graft). I went w/ the patellar. Most studies show patella grafts have tighter holds and can be the stronger of the two grafts. I do not have constant knee pain. For most, the choice of donor site graft tissue is either the hamstring tendons or the patella tendon. Doctors usually stay away from cadevers (allografts) b/c of 3 times more likely of the probability of rerapture in younger altheles. Kaplan Meier survival curve comparing 3 types of graft: 4-strand hamstring (HT), bone-patellar tendon-bone (B-PT-B) or combined ACL-ALL reconstruction by hamstring tendon (HT + ALL). I had the same surgery, and I got my screws out about 6 months afterwards. And if your knee swells greatly, ask about getting it drained. I did not regain full range of motion in my right knee for years and there was a lot of pain with kneeling. I am hoping my doctor will give me the guidance to make the correct choice. But I am older and only want to trust the knee again and be capable of working out, running, backyard sports, and snowboarding. I spoke to my doctor now he suggested to go with Hamstring Graft. and hopefully being able to maintain a fitness level through elliptical or swimming. This time it felt a lot worse when I hurt it, and since it was the second time the doc ordered an MRI. The longer you wait the harder the recovery will be. I know that most people here seem to prefer the Hamstring graft and that there isn’t alot of discussion about the Allograft method but…. Having an experienced surgeon that believes in the graft you choose is also a huge aspect of the surgery. It is tough to call but if you want to return to high level sport I would go patella tendon as it is supposed to be strongest (Dr Steaman – The World’s No1 Knee Surgeon) or hamstring if stability and recreational is good enough! Please help. Background: The quadriceps tendon (QT) autograft is known as an effective graft for anterior cruciate ligament (ACL) reconstruction and shows a similar functional outcome to the bone-patellar tendon-bone (BPTB) in randomized controlled trials, with a lesser incidence of complications. Would the hamstring method be a decent choice for these two activities? doc says it is the acl but is not sure how bad. There are however some consistencies amongst the different studies and medical circles. Abstract. Help! So my honest opinion I recommend go the patella graft for those who play physical sports such as H.Duncan and myself. Because sports were such a huge part of my life, and I knew that they would continue to be, I decided that a little longer recovery time was worth it to escape the possibility of life-long knee pain. If you call an ortho clinic and ask who is the best knee guy there, they just tell you which of their docs work on knees and if you would like to make an appointment to see one of them? The MCL heals by itself given time (hopefully! Dr. Chad Carter is a chiropractor practicing at Rebalance Sports Medicine in downtown Toronto. Thanks, this is a great site! I was in great shape when I tore the ACL and I did all of the therapy. My second time around I will not mess this up! I think I will opt for the hamstring graft this time. What do you all think? But as i am writing this right now, there is not much pain. I may have to find a new doctor depending on what i finally decide. I was lucky enough to have the orthopedic surgeon for a professional hockey team and professional basketball team perform mine. I tore my left ACL skiing in 1987, and had it replace in 1993 with the patellar autograft. ACL graft fixation devices can be broadly categorized as intratunnel, cortical button (“suspensory”), or extratunnel fixation depending on where the ACL graft is fixed (Fig. This was also 5 years ago though, which now a days in medicine mind as well be 10 years. The strength of the graft after a few years will be equal to all the other grafts as far as I understand. I will update my return to sports and see how well my knee handles it if anyone is interested. Here is a table to help you decide, based on research and outcomes of thousands of other people who have had ACL surgery. I never found the rehab hard at any point, and I was typically ahead of schedule for the majority. Did you use anti inflammatories, ice or cooling kit, compression, how was your range of motion progress etc? Please help, any input would be greatly appreciated! I played sports on a daily basis. She healed alot faster and got back in shape to run in track her senior year. I had ACL surgery in 1998, I did the cadaver petellar tendon and it was fine. I decided to go with the hamstring graft. I would also love to hear about double bundle ACL reconstruction and if anyone knew of a doctor in Seattle who performs it. Go with what was successful the first time in your body. Retear rate is 2-fold greater with B-PT-B graft and 2.5-fold greater with HT graft compared to combined ACL-ALL reconstruction by hamstring tendon ( p < 0.05). I want to return to weightlifting, and anyone who has ever seriously squatted or deadlifted knows that your hamstring and glutes play just as big of a role as your quads. I figure I’m ready to put up with the pain for a stronger knee. I used the patellar pendon and i have to say that it holding up pretty well. This pain was a lot worse than the first and it was significant swelling. Physio therapy is the most important according to my surgeon. How did you solve this thing? It was like rebirth! He has also gone in for surgery two more times to “fix things up”. I’m able to walk/going up and down the stairs right after i remove the stitches. Tore my acl this week (day before my 23rd bday) and am looking to get the surgery done ASAP. I was off the crutches on the 3 days after my surgery and I’m now able to ride the stationary bike for cardio, do exercises and I’ve shot the basketball everyday! You Already Have A History Of Patellar Tendonitis Or Patellar Tendon Issues. I just wanted to share my experience in case it could help someone else. This time it was no pain at all post-op and the the recovery was much easier. I really took to heavy weightlifting after I had the surgery, especially heavy squats and deadlifts. Many different graft options exist for ACL surgery. Still having issues with hamstring strength but I see improvement each week. Does anyone that has a similiar lifestyle make a recommendation? I was totally off Rx meds 6 days post op and have virtually no knee pain other than where they harvested the patella tendon, but the pain can best be described as minor considering the cut the front of my knee open. The graft feels very strong, but I have knee pain there and will not be able to kneel comfortably for the rest of my life most likely. So far so good, and right on schedule for full recovery. On the bright side – this whole ordeal has given her a direction – she is studying to become a physical therapist ! i have next to no instability issues in daily life, but i have not been stupid enough to jump back into gymnastics. Update since my 2/14/13 surgery: I’ve seen lots of improvement but my hamstring strength is lagging. Each surgeon knows my son has full intention to go back and play his favorite sport, each surgeon says his technique is better, and we are left as confused as hell… Surgery scheduled before Thanksgiving. I wanted the best graft, even if that would result in some kind of payn. I have a very important question: Who told him it was ok to play basketball? This blog has been extreamly helpful, so thanks to all of you for providing your stories. A week ago I tore my right ACL skiing. May struggle to regain full hamstring strength from donor side. We are not sure what to do. I am being told I might have to it replaced now! All the arthritus was gone – no pain now other than just the healing process. Looking back at this I was younger and I don’t think anyone explained things very well to me, I would have chosen the patellar graft back then, and am thinking about doing it this time for my second ACL operation because the first graft is loose. He is a wrestler and junior in high school. If you are a small framed person or not returning to high intensity sports then hamstring or cadaver would work fine. I’m a 41 yr old fitness instructor, avid tennis player, cyclist & runner. The main issue I have heard concerning cadaver (allograft) is that they are not as strong as autografts. At any rate, I’ll be 38 this year, and tore my ACL/MCL back in Aug. ’10, after conducting research, my doctor gave me the extensive pros and cons to all 3 precedures (patellar autograft, hamstring autograft, cadaver allograft). I tore my left ACL playing flag football in 2004 and had patellar replacement surgery in May 2005. Please help. The most critical element of this discussion is the importance of proper rehab. If u had the patella graft how did it go? Note: Doctors generally specialize in either patellar graft only or hamstring graft, and generally don’t perform both. I ruptured my ACL and torn my cartilage 3 years ago! Recovery was lengthy back then, and it took 9 months to return to full activity. Thats cool, can you provide your location and doctor details? Years of softball, raquetball and gymnastics caught up to me while jogging. It is commonly recommended to reconstruct a torn anterior cruciate ligament in active patients; however, there is no consensus concerning the tissue source to use for the reconstruction. Now with my left knee ACL gone, my new surgeon recommends an allograft. You should feel comfortable with the surgeon doing the procedure and feel as best informed as possible. 5 mos post op and doing great she tore it again while on vacation on the beach. I hope you made the right decision. Also, make sure you take all the pain meds post-op, even if you’re typically anti meds. The main factor is the potential of patellar tendonitis/arthritis with the patellar graft. It is, however, an ideal graft to go for as a 2nd choice, should a harvested hamstring graft turn out to be too thin, too short or suboptimal in any way (1 in 20 times). It took me nearly a full year to recover and I’m still not at 100%. We had chosen hamstring after extensive research, to avoid her having knee pain. What do I do. Had an mri 6 weeks after that surgery and was told it was a really bad torn meniscus, which I opted to have fixed since my knee was swollen and painful for 8 weeks. http://acl.info/Graft%20Choice/hamvsbptb.html. I’m 33 I had an ACL recon when I was 17 I had the Patellar Tendon graft I am a 22 year old male, I tore my acl about a month ago playing soccer with some slight minimal damage to some cartalidge and mcl.
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