Knee Reconstruction

[Guest]

I tore my anterior cruciate ligament about four years ago. Because i was only 16 at the time and my growth plates hadn't closed a reconstruction was not an option. After reinjuring it yesterday while doing explosive jumps :'((the type 100m sprinters do while waiting behind the blocks, i know stupid , but Ato Boldon looks so cool when he does em 8) )I am considering getting a reconstruction in the near future i.e within a year.
The technique used is to get two of the patient's hamstring tendons for a replacement graft(autograft). While talking to an orthapedic surgeon(who didn't specialise in knees) said that the removal of the hamstring tendons MAY POSSIBLY reduce the power output of the leg in question.
I am a track sprinter(200m match sprint, kieren etc) and wonder if it would reduce my power output after i get the reconstruction hence better to postpone the operation til after parrticipating in serious competition.
Any trackies who have experienced a knee recon who can compare before and after, your help would be appreciated. Or anyone who has had a knee reconstruction could help out with this or just tell of the experience like pain, rehab, time taken to fully recover etc.

thanks

 

[Guest]

Sorry, can't help much. But I'm interested in what you have decided to do.

 

[Jonny]

Anyways finally saw the orthopedic surgeon last week and the result was good news <br />Im getting a knee recontruction on the 25th of November using the hamstring tendons. The ortho tells me that there is no noticable differences in power output of athletes who have had reconstructions this way. <br />I'll be off the bike for 6 weeks after the op and only allowed to do small gears at first. 6 months until back to competitive cycling and physio basically everyday for 2 weeks after the surgery.<br /><br />catchya <br /><br />Jonny 8)

 

[2LAP]

Sounds like 'good' news (?)!

 

[qwas]

I have had 2 knee rconstructions in the past 2 1/2 years. Both were completly different. with the most recent one I am 7 weeks post op and have been walking since 4 weeks post op.

 

[J-MAT]

Jonny:

I know a guy who had a real bad motorcycle accident and severly damaged his cruciates. I'm not sure of what they did for him, but he had lots of staple scars on his leg, so they did something!!!

He became a very strong cat 1 road rider and was always a serious threat to other riders.

I would get more opinions before getting the surgery. Tendons have to transmit muscular force to the bones. Without tendons, we couldn't move our skeletons.

Will removing tendons reduce power output??? Who knows, but I would want to talk to a doctor that knows what competitive track cycling really is.

Your doctor might be lumping you in with a guy who does charity runs on the weekend for fun and has no competitive ambitions. The difference in power output between a competitive track rider and a recreational runner is massive.

If he is the guy doing the surgery, it's really not in his interest to tell you your power output might drop or you may be more prone to tendonitis or hamstring injuries. Anything that would scare you off means less money for him.

In my experience, most doctors care about money first and your problems last. Your doctor won't think twice or lose a minutes worth of sleep if your power drops off.

After something has been surgically removed, it's too late to change your mind if things don't go your way. If your hamstring remains as strong, the remaining tendons will have to take up the burden of transmitting the intense muscular forces of track riding.

Thick, powerful tendons are essential for transmitting maximum muscular force. Can you get by with 2 less tendons??? Who knows. The point is, once they are removed there is no getting them back if the surgery doesn't work out.

Whatever you do, I wish you the best of luck with your knee. Just make sure you have as much knowledge as possible before you decide to go under the knife.

Good luck!!!

 

[patch70]

Originally posted by J-MAT
If he is the guy doing the surgery, it's really not in his interest to tell you your power output might drop or you may be more prone to tendonitis or hamstring injuries. Anything that would scare you off means less money for him.

In my experience, most doctors care about money first and your problems last. Your doctor won't think twice or lose a minutes worth of sleep if your power drops off.

Gee, that's a very cynical view! Maybe it is true in California but I don't think the % of doctors that fit such a description around here is more than 5%.

Remember that these types of re-constructions are being done on plenty of elite athletes such as skiers or footballers (of most different codes). Certainly a large number of Aussie-rules footballers get it done. I would think (& this is only a guess) that they need their hamstrings more than a trackie yet they can still get to top level again.

 

[Babbar]

Originally posted by Jonny
Anyways finally saw the orthopedic surgeon last week and the result was good news <br />Im getting a knee recontruction on the 25th of November using the hamstring tendons. The ortho tells me that there is no noticable differences in power output of athletes who have had reconstructions this way. <br />I'll be off the bike for 6 weeks after the op and only allowed to do small gears at first. 6 months until back to competitive cycling and physio basically everyday for 2 weeks after the surgery.<br /><br />catchya <br /><br />Jonny 8)

Many pro atheletes have had this procedure and come back from it just as fast as before. I can't remember the guy's name, but a few years ago, a running back for the Washington Redskins had both knees reconstructed over the years and he was just as fast, just as elusive, and just as quick as ever.

 

[J-MAT]

patch70:

The only problem I have with the surgery, is that if it doesn't work out, it's too late to change your mind. My view on getting cut on depends on the situation. If I had some AK-47 rounds in my chest, I would opt for surgery immediately. If my knee was bothering me, I would wait a while and do a lot of research and thinking. In my opinion, way too many people jump into surgery as if it's the last time they will ever be able to have surgery done.

You might think I'm cynical, but for the most part doctors/dentists/etc. everywhere are the same, as long as they get their money from a free-market ecomomy. "How will you be paying" is always dealt with before you even see your doctor.

A surgeon makes money by performing surgeries, not by talking prospective patients out of them. In the legal world, they would be known as "biased parties."

Over the years, my experiences and the experiences of friends and family have always been the same. In 100% of the cases, all surgeons recommended surgery 100% of the time, of course performed by them. They have also been all to happy to get the cutting done as quickly as possible (before you could change your mind) as well. The results of many of these surgeries have been less than ideal to say the least.

If I were going to have the surgery, I would at least like to hear of some track riders who have had it done successfully, not from sports that are completely different and less intense.

 

[bkatelis]

Originally posted by Guest
I tore my anterior cruciate ligament about four years ago. Because i was only 16 at the time and my growth plates hadn't closed a reconstruction was not an option. After reinjuring it yesterday while doing explosive jumps :'((the type 100m sprinters do while waiting behind the blocks, i know stupid , but Ato Boldon looks so cool when he does em 8) )I am considering getting a reconstruction in the near future i.e within a year.
The technique used is to get two of the patient's hamstring tendons for a replacement graft(autograft). While talking to an orthapedic surgeon(who didn't specialise in knees) said that the removal of the hamstring tendons MAY POSSIBLY reduce the power output of the leg in question.

thanks

If you are concerned about the surgery ask the surgeon about patella tendon grafts - these are different to hamstring grafts.

I had a knee reco 7 months ago (ACL) and had the patella tendon operation - and although i'm only an amateur sportsman who loves playing any sport and now cycling - I have had no problems with my hamstrings.

bill

 

[Jonny]

Well it has been a while since I had my reconstruction. I had it back in November 2002, and had an awesome recovery/rehab. No crutches or brace the day after surgery. Back on the bike and gym only 3 weeks after surgery. I was back on the velodrome after 4 months.

Anyways tradgedy struck about 14 weeks ago when I crashed into riders falling down the velodrome and snapped the graft (the graft can take up to 2 years to fully strengthen). Ive had a second reconstruction already, this time getting the graft from my right hamstrings. This time recovery was alot faster. I walked out of the hospital without crutches or a brace that arvo and was back on the stationary trainer after one week.
Im already squatting and leg pressing within 5% of the weight that i was doing before the second operation.

At the time of the crash I was the fittest and stongest I had ever been. I had just started doing specific sprint work to get the leg speed I had before the op.
All the weights rehab provided me with a good base for explosive strength work for track.

Thats about it from me at the moment. I'll just keep plugging away at the gym continuing with rehab and hopefully beable to compete in the second half of the track season.

cheers

Jonny

 

[patch70]

Originally posted by J-MAT
You might think I'm cynical, but for the most part doctors/dentists/etc. everywhere are the same, as long as they get their money from a free-market ecomomy. "How will you be paying" is always dealt with before you even see your doctor.

I guess that is the fault with the overly privatised system of health in the US. It is not like that here in Aus as most healthcare is through the public system and surgeons get paid the same (in most public hospitals at least) whether they operate or not. Hence it can be hard at times to get them to operate and "how will you pay?" is not asked as the answer would be "I don't have to, taxes already did".

Sadly, our weiner of a Prime Minister wants us to adopt totally the US type of health system...

 

[shaneo]

Johnny

I had a patella tendon graft when I had my knee reconstruction in 1997. I come from a sprinting background (100m, 200m and 400m) as a junior and have crossed over to bike racing in later years. I'm not a trackie, but hold my own in field sprints in road races.

I have not had a single problem with power output from my legs...and my knee does not give me an ounce of trouble. The surgeon who did the operation is well regarded for his techniques and I shopped around before choosing him to do the job.

Is there a specific reason the graft has to come from your ham strings???

Anyway, just to let you know, my leg is absolutely spot on after having the recon......the key is to make sure you are vigilant when doing your rehab over the 1st year of recovery.....and be patient in this regard.

I completely blew my cruciate ligament to pieces and tried to let it heal before opting for surgery....I can tell you that I am glad that I had the procedure done.....

regards
Shaneo

 

[argonaut35]

Originally posted by patch70
I guess that is the fault with the overly privatised system of health in the US. It is not like that here in Aus as most healthcare is through the public system and surgeons get paid the same (in most public hospitals at least) whether they operate or not. Hence it can be hard at times to get them to operate and "how will you pay?" is not asked as the answer would be "I don't have to, taxes already did".

Sadly, our weiner of a Prime Minister wants us to adopt totally the US type of health system...

Overly privatized or not...if I were sick I would much rather be in the US than in Australia. I do have medical insurance through my company and I pay very little.

 

[patch70]

Have you had intimate experience with the Australian system? The problems that are developing in it at the moment are that it is becoming Americanised. At many hospitals, I have listened to lectures form American doctors imploring us not to follow the path of the American overly-privatised system.

What do you say to the 30-odd million Americans with essentially no access to medical care despite the fact that you spend ~double what we do as a % of GDP?

Why is your infant mortality rate so high compared even to Cuba?

 

[argonaut35]

Originally posted by patch70
Have you had intimate experience with the Australian system? The problems that are developing in it at the moment are that it is becoming Americanised. At many hospitals, I have listened to lectures form American doctors imploring us not to follow the path of the American overly-privatised system.

What do you say to the 30-odd million Americans with essentially no access to medical care despite the fact that you spend ~double what we do as a % of GDP?

Why is your infant mortality rate so high compared even to Cuba?

I personally haven't had any experience with the Australian system. I think that it is interesting though that many foreigners fly to this country and have procedures done instead of in their own countries...that should tell you something right there.

Regarding American doctors going to Australia to convince you not to follow our system...everybody has their opinion...I'm sure you could find just as many if not more that would have the opposite opinion, they just choose not to fly to Australia to give their opinions.

30 million Americans without access to medical care?? It must be because of all the illegals taking up so much room at our hospitals without having to pay a dime...US citizens pay in this case. I agree that in this case our system stinks. Anyway, half way kidding on the last one. Those 30 million must not have insurance...which probably means that they are jobless. If they would get off their lazy butts then they can have a piece of the American pie as well. People that are 65 years of age and older and some who are disabled under age 65 are covered by the government under the medicare program.

Our system has problems and it tends to favor those who are responsible and successful citizens. I did well in school and I work hard at work. All of my friends have insurance and are well covered under their insurance plans. Our system definitely doesn't favor irresponsible people who are burdens to our society. I can't say that I agree with this...but it works for me and my friends. The innovation and technology components of our system are phenomenal but expensive. The real question is....how do we make it cheaper without doing away with the innovation and technology? Maybe we should pay our doctors and scientists less money. Let's see what those doctors that visited Australia have to say to that. Anyway, what would your suggestions be? Higher taxes perhaps? More government regulation? Most Americans don't like government intervention.

Finally, if adopting our system is so bad, then I know that Australians are smart enough to vote not to adopt it. I've been to Australia to visit my cousin a couple of times in Sydney and if there is anything that I have learned is that Australians are smart. So don't worry...if it doesn't work, I'm sure it will be gone promptly!

Thanks

 

[Jonny]

Shaneo,

The surgeon that did my first and second reconstruction is probably one of the best in australia. He does recons on professional rugby league/union, AFL players and Olympic skiers.

He said the use of the patella tendon caused too many problems. eg unable to fully bend the knee to original flexion, tendonitis in shins etc. Cycling is one of the only sport she can do that doesnt cause her problems.

I also talked to a downhill skier who had both knees reconstructed using the patella tendons. She had the exact complications that the surgeon suggested could happen. It basically ended her career and she finds it too painfull to even ski normally.

I posted an update a couple of posts up as my original post was last year. I know the importance of rehab and patience is the major battle im dealing with at the moment

Jonny

 

[Boomer-61]

I work in orthopedics but do not specialize in ACL reconstrustion. I spoke with one who does and here is the scoop. Go with the hamstring graft, it has the lowest complication rate. Your hamstring, donor side, will be considerably weak early on. Do not try to train these early. Let them heal completely. There is a 90% probability you will suffer a hamstring tear if you attempt to train them too early. Studies show your hamstrings will completely recover to pre-donor strength if trained correctly. Have your surgery done by a fellowship trained sports medicine doc, not a general orthopedist who does two of these a year. You want a guy who does five or six of these a week. There are several new minimally invassive techinques, study up on them (on the internet) and find a guy who does them and well. If you need a name of a guy in your area PM me and I'll find one for you.

 

[shaneo]

Jonny

Now that I think back, it did take ages for me to be able to lock my leg out.....probably a good year....but after that the leg has been spot on....I dont get any pain in my knee and ride heaps of kms....

I did read your updated post after posting my original message....bad luck on snapping the graft

your recovery time was alot quicker than mine.....so the hamstring graft sounds the way to go

handy to know......good luck on getting back in the hunt

shaneo

 

[bkatelis]

Like I said in an earlier post - 7 months since my patella tendon ACL reco and no problems.

I could lock the knee fully after a week.

I too - had mine done by a guy who does a lot of the AFL players and for my height (6ft5) and weight (110kg) he recommended the patella graft.

So far so good.