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ACL repair VS ACL reconstruction

 Poster: A snowHead
Poster: A snowHead
Hi All,

I have ruptured my ACL last month while snowboarding. Totally gutted ... I have been looking into knee specialists and came a cross Hamphire Knee clinic. Yesterday saw a professor Wilson . He suggested that I should have an operation , however as the injury is fresh and there is a lot of good tissue left, he proposed to repair ligaments rather than standard ACL reconstruction. It is a totally new technique and I was wondering if anyone on this forum had their ACL repaired?

Thank you

Ksenia
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Personally I would be very wary of any new technique, until it had a proven track record. I had a "new" procedure 34 years ago, that was soon dropped due to complications that subsequently developed.
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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?
Frosty the Snowman wrote:
Personally I would be very wary of any new technique, until it had a proven track record. I had a "new" procedure 34 years ago, that was soon dropped due to complications that subsequently developed.


Thank you!

I have few friends who went with Standard ACL reconstruction,and all of them were not successful and required more operations. Therefore, i am thinking to take a risk. If it doesn't workout, I can always go for standard operation at the later day.
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@ksenia, depends what you mean by "standard". I had a hamstring graft and it worked perfectly; skiing again 8 months after opp and no real issues since (5 years). I also know a few others who have had the same success.

Knee operations are extremely invasive and take a lot of rehab and physio, I wouldn't be too blasé about having more operations than absolutely necessary.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
@Dr John, Thank you! I am glad you had a successful operation! I had a lot of time to read on ACL reconstruction using hamstring graft and actually until yesterday thought that it would be the way I go. Dr. Wilson has been highly recommended as a top knee specialist and has a very successful rate of total recovery. When I saw him yesterday, he talked to me about repair and how is it done. This technique has been pioneered by Professor Gordon MacKay ( other knee specialist) for last two years, and the data so far available is looking promising.
The main advantages of repair instead of reconstruction is that it is much less intrusive and rehabilitation time is quicker and less painful. But, as the data available is limited, I am considering my options. Dr. Wilson also suggested that the final decision on repair vs reconstruction will be done after arthroscopy on the day of operation .
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You'll need to Register first of course.
@ksenia, Adrian Wilson is one of the top knee surgeons in the UK and is recognised worldwide for his expertise. There was a "quick fix" used a few seasons back called "Healing Response" where they encouraged scar tissue to bridge the gap and so they only need to tidy up the frayed ends. Bode Miller had this procedure at the Steadman-Hawkin Clinic in Vail. He was back racing double-quick and the clinic had a big spread promoting the technique on their website for a while, now there is no mention of it anywhere, either on the website or in any of the journals. Same goes for the use of LARS (an artificial ligament that was heavily promoted for a few seasons as a way to speed up recovery).

Most problematic ACL repairs which result in further operations usually come down to either a non-specialist orthopod carrying out what they see as a "standard" procedure and basically getting aspects of it wrong, &/or the patient not following the rehab protocol accurately or diligently, particularly in the period between 6 to 12 weeks after the op, or a combination of both. Always see a specialist knee surgeon and make sure that they are well up-to-date with the techniques, the knee is an incredibly complex joint that we cannot really do without! My current surgeon estimates he carries out about 300 ACL reconstructions per year. He sorted the mess up a non-specialist had made of my knee and had me back on skis 5.5 months later. But when I went back to him with an ankle injury (broken ankle) and another time with a (what turned out to be a serious) shoulder injury, he referred me to the specialists in those joints he worked with rather than bodge along himself. "I only do knees" was his philosophy
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
@samer@Samerberg Sue, Thank you for advice and glad to know you now fully recovered! Very Happy .I am planning to follow full rehab protocol as I really want to be back to the mountains for next season.. I am still not clear how to get to physio, as my GP referred me to one, but since then I heard nothing back....
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
@ksenia, fill out the self referral form for physio. I did that fir my shoulder issues as it was such a wait to get to the Gp, thinking it would at least get me onto waiting list early. As expected the Gp said she was referring me for physio and said she would put an urgent request in. When I was called in for physio while talking to the physio I made mention of the gp referral and she said she hadn't seen one my appointment was purely in response to my self referral form!
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You'll get to see more forums and be part of the best ski club on the net.
@ksenia, is this what you are referring to http://www.basingstokegazette.co.uk/news/11107147.Top_knee_surgeon_helps_revolutionise_way_injuries_are_treated/ ?

I would have loved to have had an alternative to a reconstruction. What's the worst that can happen? I would love to know.
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@22 dropout, http://www.hampshireknee.co.uk/media/downloads/acl-repair-explained.pdf
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
@ksenia, interesting. Great pictures, especially where the tape looks like a piece of string! A couple of things spring to mind:

The presentation is on a five year old where ACL injuries are very rare. Is there any difference performing this on an adult?
My understanding was that the ligament does not repair as the fluid in the knee around the ACL prevents blood from coagulating and assisting with the repair
How is this different from carbon ligaments tried before with mixed success?

All things to ask. Keep us posted as maybe this is the future!
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
@22 dropout, thank you, all points are taken and will be discussed prior the operation. From my understanding, a case study on 5 year old was very interesting, as it gave an opportunity to examine the ligament after the surgery and it's recovery progress. Perhaps ligaments could heal after all if repaired early enough? There are several case studies I found also while researching Professor Gordon MacKay's work, who pioneers the repair technique, also interesting to read about. I will surely keep you posted with progress!
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 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
@ksenia, Sorry that you are injured and wish you well for your research of techniques and future repair.

I am a snowboarder too and always hope that snowboarding gives more protection against acl type injuries. Would you be able to share how your injury happened? Did you have both feet strapped in at the time?

Thanks and once again best wishes.
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 You know it makes sense.
You know it makes sense.
@cad99uk, Thank you for the kind wishes! I have been training in the park, did 4 jumps and went for a big 5th jump but lost the speed and probably concentration and landed on the knucle of the jump.... At that point I heard a pop and felt massive pain in my knee. After I tried to go down by myself, but on the first turn the knee gave in and that point I realised that things are not too good. If I ever go back to the park, I will always remember, that speed is our friend wink
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
@ksenia, Ouch, that sounds painful. Thanks for the info on how you did it.

I have had some wipe-outs this season in big moguls which has served to remind me that snowboarder knees are still at risk.

On a positive note a lady in our village did her acl skiing last year. She has made a great recovery (diligent in her prehab/rehab) so hope that you too will have a similar outcome.

All the best.
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 Poster: A snowHead
Poster: A snowHead
@ksenia,

Hi folks. My first post here.

Question to ksenia (or anyone else with relevant experience) if he or she is still around, did you have surgery with Dr. Wilson and if so how did it go?

My son damaged his ACL three weeks ago and the injury sounds similar to yours, partial tear (about 50%) although he also has damage to his patella ligament. He was seen by Dr. Wilson today who has proposed surgical repair, after a period of physio. Surgery planned for late Feb.

Having met with Dr Wilson we were highly impressed, but it never hurts to ask a question.

Thanks in advance
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Hi there

I had a surgery with Dr Wilson 10 months ago and back snowboarding now. Unfortunately, I had a full ACL rupture and could not have a repair so had a full reconstruction with hamstring draft.

Dr Wilson is great and I can not recommend him enough.

Good luck to your son and hope he recovers fully!
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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?
@ksenia, Many thanks. Much appreciated.
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