ACL Revision - Advice Sought

Dr. Mark,
I had patellar tendon autograft (graft taken from injured knee) & 4x menisectomy(sp?) in my left knee Nov '99. Today, my ortho is saying my left knee is 3X looser than my right knee w/torn lateral menesicus but the ACL is intact. I haven't worn my CTI2 knee brace in a long time because the knee felt pretty good up until ~4 months ago.

Ortho is recommending a patellar allograft and given that I can't kneel on my left knee I'm leaning towards that route. Can a patellar tendon autograft be done w/o the side effect of not being able to kneel w/o pain?

I'm a little concerned with the rehab protocol but I'm not sure if I'm misinformed or not. What excercises are you having patients do the day after surgery? The medical assistant said the rehab protocol is PT 2X/week for six weeks AFTER sutures are removed. At this time I don't know if there is CPM regime prior to PT or not.

Obviously I need to find out more info but I'm hoping you can shed some light on this.

Brian

I use the lateral third of the patella tendon and associated bone with a skin incision quite a bit off the midline laterally. Kneeling pain is not on my radar screen. I have never had a case.

With an autograft, from whatever knee or a Quadricepts tendon graft from what ever knee, there will be no problem with rapid return to MX, as oppossed to allograft which will keep you off your bike easily until the 2009 models are almost delivered.

We have all our patients doing full range of motion exercises, and walking like men without crutches, braces, or other encumbrences the day of thier surgery. Our patients don't need the CPM because they have little trouble getting the heel to a few inches of the butt by the first day. The exercises become more aggressive over the next weeks.
It takes serious work to get back to riding by 90 days.

ACL Revision - Advice Sought

Brian_in_Long_Beach

DrMark