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Old     (wakesetter_WW)      Join Date: Jul 2010       09-01-2010, 2:45 PM Reply   
Is this the right choice? After confirming my assumptions the doctor informed me that I have torn my ACL and partial MCL tear. So anyway just wanting to know if anyone else has done the Patellar tendon graft procedure vs. the hamstring. Doc told me the Patellar is stronger. Surgery is the 16th. Also any advice to make surgery go smoother.

Keep ripping for me for the next 6 months
Old     (hco)      Join Date: Jun 2006       09-01-2010, 2:48 PM Reply   
Is getting a cadaver replacement an option?

Last edited by hco; 09-01-2010 at 2:48 PM. Reason: rewording
Old     (wakesetter_WW)      Join Date: Jul 2010       09-01-2010, 3:00 PM Reply   
Yeah doc mentioned it. He made it sound like if you choose that option that you don't really know how strong it would be.
Old     (superair502)      Join Date: Mar 2010       09-01-2010, 3:09 PM Reply   
I was told that the hamstring allograft is the strongest option available and that the hamstring heals itself far better than the patella tendon can. I originally tore my acl in 2004 and had a cadaver. It never really felt right or strong. Joined the army and tore it again in 2007. Had hamnstring graft which was extremely painful but the military doctor told me it was my strongest option if I wanted stability to return to normal. I went home on leave and was doing inverts 4 months out of surgery. prolly a bad idea but no real pain or problems. Got out of the army last year and started riding seriously again last summer and it holds up great! I wear a brace also. Do all my tricks into the flats including raleys, hs fronts and scarecrows with no real problems. not to mention I ride with about 3500 lbs in my 210 and my knee feels great. the pain was 10x that of the cadaver but the benefit was just as great.
Old     (superair502)      Join Date: Mar 2010       09-01-2010, 3:12 PM Reply   
Main thing to keep in mind in recovery is do every exercize to your best ability even if you think it is not helping or doing anything. I was forced to take it seriously in the army being that my pt was a super hot staff sergeant who yelled at me and told me what exercises to do.
Old     (wakesetter_WW)      Join Date: Jul 2010       09-01-2010, 3:22 PM Reply   
What brace do you ride with?
Old     (captain_vilfo)      Join Date: Apr 2007       09-01-2010, 4:53 PM Reply   
this is what my doctor told me:

cadaver = easiest and fastest recovery but weakest
patellar = stronger than cadaver, tougher/longer recovery than cadaver
hamstring = strongest option but longest/most painful recovery

He told me I should go with the patellar since im young (which I did) and I had no issues with it. As long as you hit the gym and stay in shape your riding will only go up from where you left if you get over the mental aspect.
Old     (btr1)      Join Date: Feb 2002       09-01-2010, 5:13 PM Reply   
I've had all three types and my least successful was the hamstring. The left hamstring was used on my left knee and failed a little less than a year out and then the other hamstring was used and that failed. I finally had a cadaver done and it has been rock solid but my hamstrings never recovered. They are definitely weaker and cramp more easily now.

On the other knee I had patellar and it felt awesome after just a month out (never had patellar pain at all, even now) and then hyperextended the knee about 2 months out and tore it. It was replaced with a cadaver and still going strong after 12 years.
Old     (aliwake)      Join Date: Dec 2006       09-01-2010, 5:22 PM Reply   
I've heard that the cadaver graft has a much greater risk of infection also - isn't that what happened to parks?

I've had 2 hamstring grafts and I'm very happy with them. I have no idea which way I'd go if I ever do this again, cos I'm out of spare hamstring...
During my first rehab I met a few people who'd had the patellar graft, and it sounded much more painful, and a much slower rehab, which is why I refused to consider it for my 2nd surgery. my physio isn't a fan of the patellar tendon graft either, which made my decision easier.

Like Britt, i will admit my hamstrings are a little weaker now. I think if I stretched more I probably wouldn't notice it though!
Old     (detonate69)      Join Date: Apr 2001       09-01-2010, 6:32 PM Reply   
I had a patella tendon done and it's rock solid. I was told it was the strongest option because it is the only one that has bone to bone healing. basically they take a bit of your patella tendon and a small bone plug on each end. then drill holes where your ACL was and insert the new tendon. This option has your own bone grafting to itself which in the end is very strong. The only down side I had was it took about 2 years until I felt comfortable kneeling on that knee. I was back wakeboarding 100% after 6 months of rehab. Wore a CTI2 knee brace for the first year and now don't wear any brace. It's been 4 or 5 years now since my surgery and it's all good.
Old     (superair502)      Join Date: Mar 2010       09-01-2010, 6:59 PM Reply   
I bought a pair of Evs web braces and I wrap the straps w electrical tape when I ride so there is absolutely no way they can come loose.
Old     (superair502)      Join Date: Mar 2010       09-01-2010, 7:04 PM Reply   
Pulled this up online. Summary
Many surgeons have a preferred technique for different reasons. The strength of patellar tendon and hamstring grafts is essentially equal. There is no right answer as to which is best, at least not one that has been proven in orthopedic studies. The strength of allograft tissue is less than the other grafts, but the strength of both the patellar tendon and hamstring tendon grafts exceed the strength of a normal ACL. The bottom line is 85% to 95% of patients will have clinically stable knees following ACL reconstructive surgery.
Old     (spicychalupa69)      Join Date: May 2005       09-01-2010, 8:35 PM Reply   
Im a physical therapy student who has previously had ACL surgery (2006). I assure you that by now, my opinion is not bias in any manner, but I suggest you get a patellar graft. It is clinically more painful, but actually a faster rehab and you will not lose any quadriceps strength, whereas you will lose some hamstring tensile strength when you get a hamstring graft. Without getting too technical, we must remember that the "hamstrings" are made up of 3 muscles so think if one of those muscles lost some of its ability to contract, you may or may not have problems down the road. Feel free to PM me if you wish, but that is my opinion. Best of luck to you.
Old     (hco)      Join Date: Jun 2006       09-01-2010, 11:37 PM Reply   
With my cadaver that was just done, he said it ends up being very strong and has almost zero chance of infection. They take the ligament at the top of your foot, double it over to increase the strength/thickness, and then radiate it to eliminate any germs/chance of infection.
Old     (texastbird)      Join Date: May 2003       09-02-2010, 6:00 AM Reply   
They take a cadaver ligament from the top of you foot?

I had hamstring autograft in November and my pain was moderate and recovery has been great so far.
Old     (samhanna)      Join Date: Sep 2009       09-02-2010, 6:59 AM Reply   
I had a hamstring graft the first time and if failed after surgery.

I have recently had a patellar graft and it feels amazing, stronger than before I tore it. You will have a lot of soreness in your patellar though and it will be the limiting factor on your recovery. But it will keep you from pushing to hard and will be sore for a 2-3 days after each wakeboard set you take.
Old     (adamsilcio)      Join Date: Oct 2007       09-02-2010, 7:54 AM Reply   
so many mixed opinions... but how many of y'all committed to your rehab? im 6 weeks out of ACL reconstruction and i had the hamstring tendon graft... ultimately it depends on how well and how hard you rehab, while staying within the boundaries as well. however, i do hear that there are more problems involved with the patella tendon graft--such as patella tendinitis. my hamstrings are strong so i trusted the doctor's decision. no to mention it was more comfortable to hear that the NFL and SEC don't allow their players to get cadavers. or they highly are against it at least.

see if you can opt for a hamstring. some athletes, like pro wakeboarders and basketball players, opt for a cadaver so that they can go back to the sport they play because it's their job. we aren't wakeboarding for a living so choose the best option that both you and your doctor feel comfortable with. if you have weak legs and your hamstrings aren't strong, then opt for a cadaver. its your body, you know it best.

also, prehabbing before surgery will help you out in the long run for sure. start getting on a bike, eliptical, and doing stretches and lightweight exercises/calisthenics in order to get the leg strong before surgery. i think that is what helped me get back on my feet quick. doc and physio said i am waaaay ahead of the game in recovery... just waiting on the graft to heal now. GOOD LUCK!
Old     (snowslider76)      Join Date: Mar 2002       09-02-2010, 8:21 AM Reply   
I had a petellar graft in Aug of 08, surfed a month later and snowboarded that winter. Was back on the water April of 09 after rehabing it above and beyond and continuing to do so. It felt fine after I got over the mental aspect of riding again. I wore and still do a Don Joy Defiance brace.

In Sept of 09 I blew out the same knee again landing flat off another two up. It actually bent and broke the brace, not an easy task. I shreded to pieces tons of my cartilage on both top and bottom bones and destroyed my miniscus. I had to have a mirco fracture done on both bones and 30% of my miniscus removed. Petellar tendon graft was still 100% intact and still larger and more strong then my orginal ACL in that knee. So I'm pretty happy with that graft, only downside is two years later it's still somewhat painful to kneel on that knee on a hard surface. And with my miniscus gone and the mircofracture still healing it hurts everytime I ride this year I'm a W2W'er now and still cant cut hard toeside without pain.

I did a bunch of research like you and just went with what made to most sense to me and I'm happy with the result.
Old     (eyedvride)      Join Date: Aug 2006       09-02-2010, 9:58 AM Reply   
I've done both knees, hamstring used for both. Would probably try for cadaver achilles tendon graft if I knew what I know now. Have used Breg, DonJoy and Cti braces. Cti's were the best. BTW I have two (right and left) Cti prosport ots knee braces for sale. pm if interested.
Old     (brianmiller)      Join Date: Aug 2003       09-02-2010, 11:51 AM Reply   
I have had the pateller and hamstring. Based on my experience the hamstring is way better. I have a hard time kneeling on the knee with the pateller. My recovery time was faster with the hamstring. I think all the options are fine and each Dr has there own preference. JUST DO YOUR REHAB.

As far as knee braces, CTI's for sure. Do a search on here and you will see they are the most recommended.
Old     (bcail)      Join Date: Aug 2007       09-02-2010, 2:50 PM Reply   
Let's start with how old are you. Younger (still growing) and older adults (40's +) tend to get the hamstring procedure vs mature but not too old tend to get the patella tendon.

My son just had surgery today and his doctor performs both procedures, all 3 if you count cadaver. His doc works with Andrews Sports Medicine, which is where a ton of pro athletes go. According to Dr. Cain, the patella is the strongest and most proven method. He refers to it as the gold standard.


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