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Re: day 22 for 12 yo daughter

Posted By: AggieCatcher2
Date: Thursday, 1 May 2008, at 1:42 p.m.

In Response To: Re: day 22 for 12 yo daughter (drmark)

> I certainly wish you good luck with your meniscal
> allograft. Its good to know that its doing well at four
> months. I am certain that you have been told many times
> that the long term outlook is still guarded. Its good that
> some doctors are doing these operations so we can all learn
> from them. For me personally, at my clinic, the reported
> 30% failure rate at five years is still to high for me do
> perform such an operation on the patients entrusted to me.

> As far as the rational for taking a graft from the opposite
> side in concerned, the opposite sided graft patients have
> less pain, and a much easier time of their rehab. A bonus
> is a rapid return to sports. This is evident from the two
> folks who have posted on this thread. Having learned all
> this from Dr. Shelbourne, and copied his technique, my
> results have been identical.

> The long term result of the pristine knee which had a graft
> taken from it has been shown by Dr. Shelbourne to continue
> to be a pristine knee. My experience mirrors his. Naturally
> this knee needs to do some rehab before its pristine again,
> but the ACL knee is doing rehab anyway, and most machines
> at the gyms I am aware of are designed to work out both
> legs anyway.

> At the end of the day, while return to sports is always an
> option to most folks, everyone needs to walk like a human
> and have full straightening and bending of both knees. The
> opposite sided graft lets people meet these important and
> long strived for rehab goal from the day of the operation.

I went with Dr. Stone in San Francisco, and his failure rate is far less than 30%. However, if I get 3-5 years of pain free actvities, that would be worth it to me. Anything more than that is just a bonus. I had pain associated with all of my athletic endevors, so being pain free is major for me. My remaining meniscus (20%) was torn in half, so, I had no choice but to be without cartilege (a guarantee for arthiritis) or to have the procedure and continue my quality of life. It was no brainer.

As for the ACL's, I wonder why the Bengals didn't use an opposite ACL autograft for their $100M quarterback Carson Palmer? My thought is that some Drs are ahead of the curve on certain procedures, and the rest haven't caught up yet or are happy with the outcome of their methods (or like you on the meniscal allograft don't like the research numbers). I hear from sales reps who market the allograft cartilege (which is apparently a hot item right now by the way) that many of the Drs aren't willing to put in the time to learn the meniscal allograft procedure, and some are also shying away from it due to the fact it takes 3+ hours of OR time. They can churn out two ACL recons in that same time. Just a cynic here, but sounds believable. Dr. Stone also reports that if its done wrong, it will have devastating effects on the knee, so some docs don't want to have that exposure. My college teamate, a internist, had this done 6 years ago, and he swears by it today (done by a differnet doc).

I'll keep you updated, but so far (second knock on wood) so good.

P.S. I had an ACL "repair" in 1987 on my other knee and my doc did a "Tenodisis" during an open procedure. That's all I remember since I was 15 at the time. I was in a cast for a month afterwards (can't even fathom that now). However, I have never had a problem with that knee since...funny how we are always looking at the cutting edge, but sometimes great results come from old methods.

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