Wednesday, December 12, 2007

Calm before the storm

OK, here's the latest scoop.

Saw my PT over lunch today, she confirmed that my ROM is pretty damned good right now (130 degrees flexion, I think minus 2 extension? Not certain about the latter..) Monday I could tell the swelling was on the downside, and this confirms it. If not for the weird characteristic instability of the ACL-absent knee, I could almost imagine myself having only a sprain. Almost.

Speaking with my OD's assistant, I got recommendations on surgeons. Looked at their bios and went with my second choice, since the first choice isn't even doing consultations until mid-January; I'm NOT waiting that long to book a date for surgery!

I'm hoping for surgery early in January. I'd do it sooner, but have to hold off until 2008 for financial reasons.

I consult with the surgeon this Friday around lunchtime and with a bit of luck we'll come to an agreement about surgical options and scheduling.

In considering an Allograph (ligament harvested from a donor) I do have concerns due to the recent story of 4 organ donor recipients in the Chicago area contracting HIV and Hepatitis C. That, and in many studies it's been shown that an autograph using part of the patella ligament from the patient's own body tend to result in stronger knees, and shorter time spent on crutches compared to allographs.

So...when it comes down to it, I'll sacrifice a little extra discomfort from the harvest to reap the benefits sown by providing my own hardware for the fix.

On another front, my daughter has decided that she'll take on sparring. She really didn't want to do it right away, but I think she's more comfortable since she'd be starting with a fairly good sized group of her classmates at the karate school. Good for her.

Now if I can just scrape up $400 for the gear amidst Christmas shopping...


Blackbeltmama said...

Make sure you do your research and also listen to what the surgeon says. My surgeon used to only do patellar but now doesn't do them at all because the recovery is harder and many have issues with kneeling and phantom pains (my boss for one). A karate instructor of mine had hamstring with good results recently. My surgeon does mostly allografts because he says they are safe, they've never had a problem with infection or other issues and it's an easier recovery. Keep in mind that organs are a bit different. They can't sit around for weeks at a time. Allografts for ACL recon's are tested, washed and retested, and kept frozen until used. My boss blew both of his acl's. He had patellar and allograft. He said his allograft knee is much better than the other. Wouldn't it be nice if you could just grow a new one??? That's what I keep thinking. ;-)

BobSpar said...

Hi, Hack,

My surgeon did say that there is evidence that patellar technique is stronger. I know that the chances of an infection from an allograft are very slim, but that chance seems spooky to me.

Since we're not doctors ourselves, it's hard to know whether they're just talking up their own business, or they have legitimate disagreements.

I can feel the patellar incision when I kneel, but I can do it without pain now (it took a while to be brave enough to try). There are some people who continue to have pain.

A friend at my martial arts school had an allograft. His recovery took longer than mine, BUT his injury was much worse, he had lots of damage to the soft tissue around the knee. His lower leg would kind of slowly twist when he held his knee up. So you can't judge by that experience.

Good luck making your decision.

BobSpar said...

PS: More important that which technique is that the surgeon has done LOTS of these surgeries beforehand. You don't want someone inexperienced!

Doug said...

Make sure that you talk to your surgeon about your concerns. Mine said that its almost impossible to contract a disease because there is so little genetic material in the donor material that they use and the fact that it is cleansed throughly before it is used. There is however a much greater chance of you body rejecting it - althought that is still also very small. I opted for the allograft due to the fact that this was my second ACL surgery and did not want to weaken other areas of the leg/knee to fix the ACL. My first surgery was almost 20 years ago so to compare the two is somewhat misleading but the recovery has been much quicker with the second. Rehab is critical. I actually started doing exercises the right after the surgery. Granted it was minor stuff but dedicating yourself to rehab is important for a full recovery. Good luck.