 Poster: A snowHead
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@@ryancartiers, how are you doing after your procedure,?
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| Jonathan Bell wrote: |
@elpepe8989
There is agreement that only a very small number are suitable. ( roughly 10%) You are correct that the tear has to be right off the femur with minimal damage to the ligament otherwise.
Jonathan Bell |
This is incorrect - the tear does NOT have to be right off the bone.
Please look up mid-substance tear, you will find InternalBrace is used for this also.
I confirmed this prior to 2018 so the same publications should still be available online, and you will see the difference between where anchor screws are needed to re-attach to bone, and mid-substance tear procedure. Aside from the publications prior to 2018, according to MRI I had a "high-grade mid substance & likely functionally complete tear" which was repaired.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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| EastCoastUS wrote: |
The study was also conducted on an adolescent cohort (mean age 14.1 years), |
The way you present this is somewhat misleading without specifying the results are specific to adolescents, and their results are different from adults. Context is important.
How many people reading this are adolescents? Probably not the majority, but it they are these results need to stand out as it applies to adolescents.
Like myself, you may be asking why are results different for adolescents?
It is because they are still growing, and that introduces complications. You will also note some of the repair procedure criteria specify the patient be 18+ for this reason.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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| holidayloverxx wrote: |
| @@ryancartiers, how are you doing after your procedure,? |
Very well, thank you for asking. I'm overdue for offering an update, so I've answered several questions in the thread today.
I do not recall if I mentioned I went through testing in January 2020 - there are some minor things I still had to work on, such as some additional strengthening the hamstring for it to reach where it was previously/match the other side, but in general the outcome is very good. These results will be included in some research, as there is a significantly larger population to draw from now.
Prior to the testing I had returned to the gym training and was pushing up my 1RM squat.
I did a lot of mountain biking last summer as cycling increases blood flow to the knee and works the full range of motion - a great excuse to spend more riding. According to trailforks at least 700km.
We had a sick dump in December and I got some solid skiing in, everything felt great. Snow has been sparse this year but I did get a couple days at Revelstoke, and a day of spring skiing in last week.
Trying to upload a photo I took to this forum post, here's the blog post:
[url=]https://www.ryancartier.com/blog/2021/4/22/skiing-after-internalbrace-ligament-augmentation[/url]
here's my attempt to get link to the photo itself
[img]https://images.squarespace-cdn.com/content/v1/5a87c3d42aeba5f1586d7573/1619148708038-5BY7GIO1R6CRS7L72H51/ke17ZwdGBToddI8pDm48kDHPSfPanjkWqhH6pl6g5ph7gQa3H78H3Y0txjaiv_0fDoOvxcdMmMKkDsyUqMSsMWxHk725yiiHCCLfrh8O1z4YTzHvnKhyp6Da-NYroOW3ZGjoBKy3azqku80C789l0mwONMR1ELp49Lyc52iWr5dNb1QJw9casjKdtTg1_-y4jz4ptJBmI9gQmbjSQnNGng/20210416_141651.jpg?format=750w[/img] any how to feedback appreciated;
About a month left so I plan to squeeze in a few more spring skiing days.
I'm also still working on getting it into the Canadian public health system to stop unnecessary body part removal, starting with Alberta Health Services. It blows my mind Canada is a decade behind current orthopedic practices when the rest of the world is not. Despite introducing it in 2018 and providing a follow up MRI in 2019, they are still dark ages. Neither the Canadian sports med doc nor the orthopedic surgeons here have bothered to reach out or respond. Physicians have a minimum amount of ongoing professional development requirements, however seem to have missed 10 years of ACL regenerative medicine and have failed to submit the procedure for review.
That being said, I finally had a call this afternoon and may have found someone who will take a look at it and I may be able to get it submitted.
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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You'll need to Register first of course.
You'll need to Register first of course.
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| @ryancartiers wrote: |
| Jonathan Bell wrote: |
@elpepe8989
There is agreement that only a very small number are suitable. ( roughly 10%) You are correct that the tear has to be right off the femur with minimal damage to the ligament otherwise.
Jonathan Bell |
This is incorrect - the tear does NOT have to be right off the bone.
Please look up mid-substance tear, you will find InternalBrace is used for this also.
I confirmed this prior to 2018 so the same publications should still be available online, and you will see the difference between where anchor screws are needed to re-attach to bone, and mid-substance tear procedure. Aside from the publications prior to 2018, according to MRI I had a "high-grade mid substance & likely functionally complete tear" which was repaired. |
Don’t you just love it when Google experts and lovers of anecdote dismiss 25 yrs in the field ( eye roll)
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| Jonathan Bell wrote: |
| There is agreement that only a very small number are suitable. ( roughly 10%) |
Curious what ‘literature’ you referred to, and where the ‘agreement’ only a small # are suitable, I’m interested to read it.
When I estimated eligibility based on the DiFelice article stating in the US approximately 80,000 ACL tears a year are eligible, and divide this by the roughly 300,000 ACL tears a year in the US it shows roughly 26.7% are suitable, which leaves me curious if outside the 10% you mentioned which were clean bone tear, is the other 16.7% mid-substance? I’m curious what the actual break down would be. Perhaps the 1970’s data might also shed some light.
Here’s a 2021 article referencing the 80,000
https://paw.princeton.edu/article/gregory-difelice-89-bringing-back-acl-repair-new-technology
(the one I originally shared was in 2018)
| Jonathan Bell wrote: |
| Don’t you just love it when Google experts and lovers of anecdote dismiss 25 yrs in the field ( eye roll) |
Google wasn’t around when the data in the 70’s was reviewed and it was concluded repair & regrowth had poor statistical results, however the data was not separated based on ACL tear location, tissue condition, etc. It is my understanding that when that data was later reviewed and these specific conditions separated, the positive outcomes were outcomes which is part of the reason ACL regenerative practice has been growing around the world, particularly over the last 2-3 years.
You’re 25 years in the field wasn’t dismissed, I had no idea how long you had been practicing;
and I’m referencing 30 years in the field, so if it was based on years as you say then you’d have to put in 5 more to level the playing field, however is years really the measure to be using?
years do not measure an open mind,
nor to they guarantee one is up to speed on current research or practices.
While I disagree with your ‘years’ measure, I do respect one’s time & dedication in the field, and I also think it’s pretty awesome you ski with patients after.
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Update:
- did a fair bit of mountain biking over the summer, not quite as much as last year (due to wildfires & smoke) but season's not done yet;
- PhD research I mentioned on InternalBrace ACL repair & regrowth proceeding
- Canadian orthopedic practices are now a decade behind and counting, public system still not offering regrowth option, meanwhile it's increasingly being used around the world
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| Tiredoldskibum wrote: |
| Tiredoldskibum wrote: |
My son, who is 20, had ACL and ALL repair last Tuesday (6 days ago) using the internal brace technique.
Early days but he can currently extend the knee fully and bend it more than 90 degrees. He is using crutches but can put some weight on it without pain. Since yesterday he has not needed to take any painkillers.
Hospital physio told him that because he doesn't need to protect his hamstrings (since no graft required) his rehab should be easier. He starts rehab physio this week.
Surgeon was Prof. Adrian Wilson of Hampshire Knee. He will only use this technique where he deems it appropriate. The plan, in my sons case, was to use hamstring grafts, but having got into the knee, he decided that he was a perfect candidate for IB repair (this was previously explained and discussed).
I will update with his progress if there's interest here. |
3 year update for anyone interested.
My son, now 23, had internal brace repair for ACL & ALL as detailed above. 3 years on (just over) all is well. Skiing better than ever and learning to snowboard. He did have a couple of minor issues with the ALL (possibly overtight) but that seems to have resolved itself with no further intervention. |
Further update on sons internal brace ACL/ALL repair, for the sake of anyone who may be considering this procedure.
6 years now post surgery. He is now 26. All still good. Skis and boards regularly with no issues.
Not suggesting it's appropriate in every case but it has worked well for him.
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