Re: SueBW - Could Use Some Help Here

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Re: SueBW - Could Use Some Help Here

Posted By: SueBW
Date: Tuesday, 6 May 2008, at 5:47 p.m.

In Response To: Re: SueBW - Could Use Some Help Here (drmark)

Jerry,
First, the definition of a successful ACL reconstruction can be thought of in terms of the ability of the graft to provide stability to the knee joint...and/or the ability of the operation to enable a patient to return to their desired activity level. While one may think these 2 factors are always related, studies have shown they are not always so which leaves many patients unhappy with the end result. This is where preoperative patient counseling of the realistic expectations of the procedure are critical.
What concerns me in your situation is the fact that you have experienced multiple giving-way (instability, knee collapse) episodes. It is reasonable to expect that you have some joint damage (to the articular cartilage and menisci) and the ability of the reconstruction to return you to strenuous activities may be compromised because of this pre-existing problem. It is quite important that you understand the goals of the procedure - and that the prognosis for your knee and future activities will depend on what is found at surgery in regard to the status of the medial and lateral meniscus and the articular cartilage surfaces throughout the joint.
In terms of the ability of the operation to provide normal stability to your knee joint - this is dependent on your surgeon's skill in all of the technical aspects of the operation, choice of graft, choice of fixation, and the rehabilitation program. If the "gold standard" patellar autograft is used, and is placed in the proper position with solid internal fixation, then the stability issue should not be a problem. If, however, an allograft is used, then the results of some studies do show a decrease in the percentage of patients who obtain normal stability.
You should be certain your surgeon is very experienced with this operation and does several a month. In addition, your physical therapist will be paramount to the outcome of the procedure. We have a saying that a great surgeon's skill can be ruined by a poor therapist, and that the best therapist in the world can't help a patient regain normal knee motion and strength if the operation was done improperly.
Best of luck,
SueBW

Messages In This Thread

need suggestion(old injury of ACL) (views: 275) -- Jerry -- Monday, 5 May 2008, at 5:37 p.m.
- Re: need suggestion(old injury of ACL) (views: 256) -- Jerry -- Monday, 5 May 2008, at 6:28 p.m.
  - SueBW - Could Use Some Help Here (views: 241) -- OLarryR -- Tuesday, 6 May 2008, at 6:51 a.m.
    - Re: SueBW - Could Use Some Help Here (views: 246) -- drmark -- Tuesday, 6 May 2008, at 7:41 a.m.
      - Re: SueBW - Could Use Some Help Here (views: 258) -- SueBW -- Tuesday, 6 May 2008, at 5:47 p.m.
        
        Re: SueBW - Could Use Some Help Here (views: 165) -- Jerry -- Saturday, 14 June 2008, at 9:10 p.m.

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Message: > Jerry, > First, the definition of a successful ACL reconstruction > can be thought of in terms of the ability of the graft to > provide stability to the knee joint...and/or the ability of > the operation to enable a patient to return to their > desired activity level. While one may think these 2 factors > are always related, studies have shown they are not always > so which leaves many patients unhappy with the end result. > This is where preoperative patient counseling of the > realistic expectations of the procedure are critical. > What concerns me in your situation is the fact that you > have experienced multiple giving-way (instability, knee > collapse) episodes. It is reasonable to expect that you > have some joint damage (to the articular cartilage and > menisci) and the ability of the reconstruction to return > you to strenuous activities may be compromised because of > this pre-existing problem. It is quite important that you > understand the goals of the procedure - and that the > prognosis for your knee and future activities will depend > on what is found at surgery in regard to the status of the > medial and lateral meniscus and the articular cartilage > surfaces throughout the joint. > In terms of the ability of the operation to provide normal > stability to your knee joint - this is dependent on your > surgeon's skill in all of the technical aspects of the > operation, choice of graft, choice of fixation, and the > rehabilitation program. If the "gold standard" > patellar autograft is used, and is placed in the proper > position with solid internal fixation, then the stability > issue should not be a problem. If, however, an allograft is > used, then the results of some studies do show a decrease > in the percentage of patients who obtain normal stability. > You should be certain your surgeon is very experienced with > this operation and does several a month. In addition, your > physical therapist will be paramount to the outcome of the > procedure. We have a saying that a great surgeon's skill > can be ruined by a poor therapist, and that the best > therapist in the world can't help a patient regain normal > knee motion and strength if the operation was done > improperly. > Best of luck, > SueBW
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