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Got a buddy who went left and his knee went right. ACL went kaboom. I had this done about 13 yrs ago by Nygard in Denver and they used the patellar splice to replace the ACL. I know you guys are equal opportunity body abusers so I figured I would ask, even though its not really a kayaking injury. Whats the latest procedure? Who's the best doc?
 

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There's a whole host of good ortho docs up in Ft. Collins at OCR--Orthapaedic Center of the Rockies.
 

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i live in Vail and have been to Steadman Hawkins for 3 separate injuries. I'm currently 12 days into ACL reconstruction as we speak.

Three options -
Hamstring graft, Patellar Tendon Graft, Cadaver

easiest - Cadaver, but you have a good risk of your body rejecting the tendon.

middle - Hamstring - this has the fastest recovery time. In year's past, it used to be the weaker graft, but now they cut a longer piece of ligament, fold it in half, then graft it using bone plugs (as opposed to stapling the ligament to the bone and hoping it heals

hard - Patellar tendon. Lots of swelling, tough recovery, and a shitload of pain. This used to be the preferred graft because of less incidence of relapse. However, now that the hamstring procedure has been improved, this is not the recommended path unless you're Herman Maier.

Steadman Hawkins does about 500 a year. I had Dr. Sterett - easier to get an appt with and does about 20 a week. They are sort of an assembly-line clinic, but they are the pros. 970.476.1100. Make sure your insurance covers it - they're expensive.

Also- percocet and a budweiser makes for great pain relief.
 

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I've posted before about ortho docs, if you're in denver I put my money on Dr. Steve Traina for ACLs. He is the Denver Nuggets doc and I would think those guys knees get the best available. Also, the OR nurses are good sources and the ones I know at Rose (where he is) all recommended Traina.

My own experiences: I tore my ACL back in the early 90s in GA and then re-tore it (same knee) a few years back here in Denver. Its been rock solid since the redo. One warning though, Traina may not have the best bedside manner. Do the hammy graft and take it from your "good" leg. Otherwise your knee and hamsting from the same leg will hurt pretty badly and lots of rehab on the same leg is tough.
 

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My friend is flying to visit me in Colorado from California next week specifically to have Dr. Gottleib in Vail do her ACL.

He has been recommended by several to me and I have experience with him relating to snowboard injuries and other problems.
He has a better demeanor than many doctors I have seen.

My recent research for my friend on the ACL topic somewhat disputes paddbizzle's post.

The problems with cadavers are said to be low.
Most people who avoid the cadaver do so because they are squeamish about putting the tissue of another into their body, and there is an almost infinitesimal risk of contracting an illness from the cadaver.

The hamstring version of the surgery is said to be the more painful recovery option, because they actually cut 10% of your hamstring off to use for the surgery. The muscle has to subsequently heal.

There are some great resources on the web.
I will include the content of an email I sent to my friend with a ton of ACL links in it.
GENERAL ACL INFORMATION
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1
Making the decision about surgery for an anterior cruciate ligament (ACL) injury
http://my.webmd.com/hw/health_guide_atoz/aa54360.asp


2
Best Cure for Some Knee Injuries? Postpone Surgery
http://my.webmd.com/content/article/17/1676_50305

3
Anterior Cruciate Ligament (ACL) Injuries
http://www.informationtherapy.org/kbase/topic/major/hw124401/trtover.htm


Making the decision about surgery for an anterior cruciate ligament (ACL) injury http://www.informationtherapy.org/kbase/dp/topic/aa54360/dp.htm


PATELLA vs. HAMSTRING
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This is one of the best unbiased technical information sites covering the different procedures.
Graft Choice for ACL Reconstruction
http://www.isakos.com/innovations/graftchoice.html

Misc. Sites - Some Biased.
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http://www.factotem.org/cgi-bin/kneebbs.pl/noframes/read/198759

http://www.angeloc.com/FAQ.htm

http://66.102.7.104/search?q=cache:1PDLegxcKVYJ:www.aclstudygroup.com/Powerpoint-pdf02/acl-famales-Barrett.pdf+patella+vs.+hamstring&hl=en&ie=UTF-8

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This is one of the better personal story sites with links to many other people's experiences.
Also, he links to some of the same medical sites that I preferred.
http://www.financeprofessor.com/funlinks/running/aclsurgery.html
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-Dan
 

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Dr. Chipman did mine 13 years ago with a hamstring graff and that knee is much stronger than my supposed good knee, he is partners with Gotleib. I just had my shoulder done this winter by a doc who is with Dr. Traina's clinic either way Vail Ortho, or Denver Ortho centers are both very good.

My recent research for my friend on the ACL topic somewhat disputes paddbizzle's post
I beleive he was refering to your body rejecting someone else's parts (not catching some sort of disease) which does happen I have two friends who ran out of their own parts and had to go with the cadaver but had big problems with their body accepting it.

Danny
 

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Yes, but I think the rejection issue is a statistically small concern.
Actually, it must be. Because otherwise I am sure the cadaver option would be phased out by now.

But science marches on. That new ACL technique mentioned in the Steadman Hawkins link above is interesting. I wonder if that bone drilling/clotting technique must be undertaken relatively early after the injury for it to have a chance. Apparently it is not effective always.

Personally, I am hoping for reliable cartilage replacement technology to show up on the horizon. That's what my injured joints could really benefit from.
-Dan
 

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we can talk about statistics all we want, but if i were my knee... you won't reject your own tissues. it might be a more difficult rehab, but i think it's worth it. you don't want to even think about how bad your rehab is gonna be if they have to go back in to deal with cadaver rejection.
 

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steadman hawkins clinic did mine and it is BOMBER. the doctor that did mine had 6 more surgeries that day. they do tons of em.

pateller graft is the only way to go.. period!

a cadaver graft is out of your price range(unless you are a pro athlete)
my doc said he recomends hamstring grafts to non-active ladies who are concerned with scarring. no joke.

kobe came to vail to get a knee fixed by steadman hawkins.
 

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I'm going to have to caution folks on the patella graft (sorry I chose not to do it twice!), I've been told by the docs (yes thats plural) that you run a higher risk of arthritis in the knee you pull the patella from. If you do the hammy, get the doc to pull it from your other leg, this will help considerably with the rehab and pain. The only downside is you'll have more scars (which I could care less about). Don't be fooled with any choice, the rehab (physically and mentally) is going to suck! Good luck!
 

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i am eight weeks out of ACL surgery with a hammy graft. my doctor is the equivalent to steadman, but in utah...he does tons of these surgerys. he almost always uses hamstrings. my advice, go with the graft that your doctor does best. tell your buddy good luck and to start rehab before the surgery- spining, streching, strengthing, whatever he can tolerate.
 

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Who cares. . .
Modern medicine is great. You don't even really need your ACL if you can properly train and strengthen the surrounding muscles. Fortunately most surgical techniques make this a relatively easy procedure so most with health insurance opt for surgery.

Just get a reputable doctor, let them make the decision based on a professional analysis, and then make sure you get on a good physical therapy program. Sheesh!!!
 

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Thanks for all the great info and I appreciate it. I disagree with not having the surgery. Have seen some people who didnt have it and in the long term they had other tissue damage from the 'extra' movement. I am glad I had mine but the rehab is a bitch. Thanks again.
 

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Just did a number on my knee a week and a half ago...waiting for the MRI to totally confirm the ACL. I'm getting tons of names of orthos to use, but my one question is (assuming the worst): how restrictive is it to paddle with a torn ACL. Does one go and do the rehab and everything else before getting back in a boat?

I'm dying over here not being able to paddle...or much else for that matter!!!

Thanks,
Rebecca
 
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