Doctor insights on:
Allograft Vs Autograft
In an alif, what factors go into your decision to use allograft vs autograft? Which would you recommend for a patient with autoimmune issues?
Multiple factors: Using an allograft when it is possible prevents the need to harvest a bone graft. However in patients who are expected to have problems with healing and incorporation of a bone graft an autograft is preferable. ...Read more
ACL: You should discuss this with your doctor since there are risks and benefits for each graft type. You might have less postop pain and a smaller scar with the allograft. ...Read more
For an acl ligament knee reconstruction if your hypermobile or have EDS is it best to have an allograft rather than autograft to reduce failure risk?
Best 2 have -: -allograft otherwise the surgeon is replacing torn tissue with diseased tissue. Auto grafts put Ur own tissue in as the graft, & it also is effected by EDS, & will stretch & lead 2 hyper mobility again & the knee will B unstable again & more prone 2 retreat. My trainor @ the gym has type 1 Marfan's, & had 2 failed ACL RECON, LAST WAS ALLO & holding up. ...Read more
What are the current trends in acdf? Is zero p one of the newest technology? What is its limitation? How good compared to autograft? What other inst?
Multiple: There are many new devices and materials for acdf. Zero-p or chesapeake are standalone devices. Some of the new spacers are made of titanium or bioceramic. Autograft remains the gold standard but has its own set of problems - persistent pain, second surgery site, etc. Limitations on some of the newer devices are lesser likelihood of successful fusion. ...Read more
To yourself: Tissue taken from one part of the body and grafted onto another, for example, a skin graft from a healthy part placed over a portion of injured skin. ...Read more
Just had alif on 6/19, with autograft. All went well, I was improving everyday. Fell asleep sitting upright. In major pain again. Could I have broken?
Pain after surgery: If in doubt, you should inform your surgeon about this issue. If the recurrent pain was similar to the pre-operative pain, then your pain should be investigated further with radiographic studies. A simple x-ray can be easily done to rule out any bone graft displacement. Mri is also considered. ...Read more
I had an ACL surgery (type autograft) 23 days ago! Swelling decreased a lot after 17 days, but past 5 days and so, swelling has increased!?
Tell your surgeon!: Acl surgery can cause swelling in the knee, especially in the early recovery. It is most important to work on regaining full extension over the next several days to weeks. The swelling should progressively improve as well. If you have calf swelling or pain, there is a small chance that you have developed a blood clot. Sometimes as you increase your rehab you will have a few days of swelling. ...Read more
ACL reconstructed with HS autograft 6 months ago. Last week it swelled up, I didn't feel any pain. Is it ACL failure or a meniscus tear?
Hard to say: Swelling in absence of pain or traumatic event could be any number of things but definitely less concerning than these same findings in assoc w/ pain or twisting re-injury to knee. If it persists for 10 days or more probably warrants re-evaluation by operating surgeon and if exam findings concerning probably repeat MRI to further evaluate. ...Read more
I'm having surgery for maltracking (lateral release medial pattellfemeroral reconstruction and autograft on hamstring) what should I expect?
Bracing & therapy: Bracing is usually warranted after patellar stabilizing surgery. Physical therapy is also important to help regain motion & strength. Your surgeon will have a specific rehabilitation regimen for you to follow for the 6-12 weeks following surgery. The layerl release decreases the tethering affect on the outside of your knee, and the mpfl reconstruction prevents patellar subluxation/dislocation. ...Read more
22m, I have exams for 15days continously. Is it okay if I skip the exercise. Don't do any of it for that time? 2months post ACL surgery hamstring autograft
Continue Exercise: In addition to prolonging and potentially harming your full recovery stopping your exercise may actually harm your exam scores. Taking time to walk and exercise during high stress times is an excellent way to reduce your stress, increase your focus, and improve your performance academically. ...Read more
I felt my leg slip a lil wen I was doin half squat. Left leg 2months post hamstring autograft surgery. Wat are the symptoms of graft failing? Pain?
Age22. 2months over with my ACL surgery hamstring autograft. I have my exams for continous 15days. Is it okay if I skip my leg exercises till dat time?
22 yr, badminton coach. 3months post ACL reconstruction, hamstring autograft. Can I split my daily daily exercises into parts? Or do it in one stroke.?
Can split: It's ok to split your daily exercises into parts. As long as you are consistently doing your exercises, I think you will be fine. Do see your surgeon if you notice that you are not progressing well with your exercises. ...Read more
Acl surgery (hamstring autograft) in 3days. Age22, m, badminton coach. When will I be able to atleast walk. Dat too without any external bulky aid?
Badminton coach, 22yrs.2months over with my ACL surgery, hamstring autograft. I only do standing core exercise, walk approx 4kms a day. Is it enough?
Yes: You are very early out from your repair and should strongly avoid twisting or pivoting for another couple months. Soft tissue grafts can take 6-9 months to incorportate. We used to say 6 months but per dr. Fu the king of hamstring recon he typically advises 9 mo prior to return to competitive play. Closed chain exercises are strongly advised to avoid shear across the graft. ...Read more
4months post ACL surgery, hamstring autograft, 22yrs, badminton coach. Wat is good or bad pain cuz my top of knee sumtime pains doin exercises.
Patella femoral: If your pain is in front/under your knee cap, then most likely patella femoral pain syndrome/chondromalacia patella. Best managed with exercise to strengthen your quads to improve tracking, and avoiding deep knee bending activities. Also oral or topical nsaids can be of benefit, as well as a brace or injections. This is common after surgery as your muscles controlling the patella are out of shape. ...Read more
Periodontist explained she only does an autograft for any gum recession. I have 7 bottom front teeth to do. Best options to 2 surgical visits?
My daughter had ACL recon 18 months ago; hamstring autograft. Using endobutton in femur; bioabsorb screw in tibia NOT crossing growth plate retear?
How long after ACL reconstruction (patellar autograft) with medial meniscus repair and lateral meniscectomy can one start taking anti-inflammatories?
Hi, I had a ACL surgery Patellar tendon (Autograft) on Mar26 which is closely 4months by now. Now I am noticing some swelling on the right knee.
SL reconstruction using autograft yesterday, with an on-Q attached to shoulder. Shortness of breath, and lower back pain. Anxiety, or side effects?
Nerve damage to groin and hip area after illiac crest bone harvest. What's it called and is it reversable? Six months post op. Cervical fusion of c6-c7 with autograft from hip and hardware. Sensations range from numb, sharp quick pins and needles and sand
There are a few nerves around the pelvis that could be injured during graft harvest. The most common one is the lateral femoral cutaneous nerve which supplies the skin on the outside of the thigh. From your description, it is more likely the ilioinguinal or pedundal nerve that is affected. Since I don't know where the bone was harvested (anterior or posterior crest), I don't know how the nerve might have been injured.
Most of these nerve injuries are what are called neurapraxias. The nerves recover with time, but can be painful for several months to a year. A charring injury from the cautery used during surgery also recovers with time.
If the nerve is partially (axonotmesis) or completely (neurotmesis) severed, the recovery is less predictable. The nerve fibers have to regrow and find their way to the nerve endings. If they "get lost" they can cause a painful ball of nerve fibers called a neuroma. Nerves take a month to start growing and grow at 1mm/day or about an inch a month. Based on the location of the injury and the distance to the nerve endings, it can take a long time to regenerate.
Injured nerves can be very irritable and send any stimulus as a painful signal. To quiet the nerve, we use desensitization techniques. By constantly giving the nerve a low level stimulus, it "learns" what is normal and stops the painful signal. Then you increase the stimulation until that feels normal.
While Neurontin can be helpful, I have had better pain control (though not necessarily side effects) with lyrica (pregabalin). Insurers are often reluctant to cover it because it's more expensive. Amitriptyline or nortriptyline can enhance the effects, but also add to the sedation.
It is possible you may need surgery to explore the nerve and remove a possible neuroma, though that would likely leave an area of numbness. Only your surgeon knows what the likelihood of that is. Nerve conduction studies usually are not very helpful in this area and can be painful to get, particularly if the nerve is quite irritable.
To date we do not have any means of making nerves function. We can decompress them, repair them, remove neuromas, and even transfer them, but they have to work on their own. Maybe in the future we will have nerve growth factors or stem cells to help boost nerve function. For now, however, nerve pain remains a frustratingly difficult problem. ...Read more
A graft of tissue...: Allograft, when used medically, generally refers to transplants. One takes a tissue (heart, kidney, skin, liver, lung etc) from one person (same species) and transplants that tissue into another person that is genetically different (within that species). That is an allograft. ...Read more
Depends on the graft: There are many variables when it comes to acl grafts. Often has to do with a availability and demand of the particular type. (econ 101). Soft tissue grafts are often less than grafts with bone on the ends. There are many different sterilzation techniques that are important to consider which have different costs but also different affects on the quality of the graft. Can cost btw $1200 and $5000! ...Read more
Thousands: According to cole dw, et al from wake forest university in arthroscopy 2005, the average hospital charge for allograft acl reconstruction was $4622. Nagda, et al in corr 2010 reported a mean cost of $5465. These costs do not include preoperative office visits, MRI to confirm diagnosis of acl tear, postoperative physical therapy. Costs may vary by practice, hospital, asc, insurance, etc. ...Read more
Surgical procedure: Less painful than autograft. Still requires lengthy rehab. ...Read more
ALLOGRAFT: The surgical procedure for the acl reconstruction is similar to an autograft. However since the graft is a donor, extra time is not required to remove the graft and the pain can be less after the surgery. Check out www. Orthoillustrated. Com for some nice animatiions of the surgery. ...Read more