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  1. #1
    Join Date
    Mar 2015
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    10

    Has anyone older had an ACL repair with an allograft (donor) graft?

    I tore my ACL and have a slight tear in my medial meniscus.

    The surgeon thinks the meniscus will either heal on its own or be repairable. It's my first time tearing my ACL.

    I'm 33 years old, and my surgeon gave me the choice of either using my own hamstring tendons (autograft) or a cadaver tendon (allograft) to reconstruct my ACL.

    If I was under 20 years old, he would *definitely* have me use my own hamstrings. For people over 40 he almost always recommend people go with a cadaver tissue.

    I'm in kind of a weird age range so I don't know what to choose. I ski everywhere, paraglide, play tennis, dive, but no contact sports. I'll do drops and jumps but nothing too extreme.

    If he uses donor tissue, it'll be non-irradiated because radiation is known to weaken the tissue. He wants to get it from an Achilles tendon of someone under 40 years of age. I'm leaning towards the allograft because the thought of more incisions and possibly compromising my hamstring muscle group has me worried. I checked out some YouTube videos of the hamstring operation and they take out huge strands of tendon with muscle attached.

    Has anyone here used an allograft (donor tissue) for an ACL repair before? How old were you and how has it been? Which tissue did you use and do you know if the reconstruction was double bundle or single bundle?

  2. #2
    Join Date
    Jan 2008
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    truckee
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    8,880
    Quote Originally Posted by fuzzybabybunny View Post
    I tore my ACL and have a slight tear in my medial meniscus.

    The surgeon thinks the meniscus will either heal on its own or be repairable. It's my first time tearing my ACL.

    I'm 33 years old, and my surgeon gave me the choice of either using my own hamstring tendons (autograft) or a cadaver tendon (allograft) to reconstruct my ACL.

    If I was under 20 years old, he would *definitely* have me use my own hamstrings. For people over 40 he almost always recommend people go with a cadaver tissue.

    I'm in kind of a weird age range so I don't know what to choose. I ski everywhere, paraglide, play tennis, dive, but no contact sports. I'll do drops and jumps but nothing too extreme.

    If he uses donor tissue, it'll be non-irradiated because radiation is known to weaken the tissue. He wants to get it from an Achilles tendon of someone under 40 years of age. I'm leaning towards the allograft because the thought of more incisions and possibly compromising my hamstring muscle group has me worried. I checked out some YouTube videos of the hamstring operation and they take out huge strands of tendon with muscle attached.

    Has anyone here used an allograft (donor tissue) for an ACL repair before? How old were you and how has it been? Which tissue did you use and do you know if the reconstruction was double bundle or single bundle?
    Which option is your surgeon recommending for YOUR case? He or she owes you that. Once a decision has been made that surgery is indicated I think the technical details are best left to the surgeon unless every option has serious and different downsides.

  3. #3
    Join Date
    May 2012
    Location
    san diego
    Posts
    1,124
    I'm 39, just had my second ACL reconstruction of right knee. I was 25 when I had the first one. Both times I used hamstring. The first time the surgeon didn't even offer patellar tendon or cadaver as an option.

    This time both were mentioned. Cadaver was not recommended for me because it would take longer for the graft to grow together with my own tissue meaning longer recovery time. And I think those have a higher failure rate too. Given I am a mountain biker he also recommended against patellar tendon as using it could lead to more knee pain issues, which I already was having problems with. So his preference was hamstring. But since I already used the right one for my first surgery, we had to use the left hamstring this time. Each options has its pros and cons. For my circumstances this was the recommendation. He didn't seem to have age as a consideration.

    I had the surgery last week. There was some pain and swelling in the left leg from the graft removal, but it hasn't been bad. The first time around I didn't even notice it in the right knee given the pain/swelling from the ACL repair. I don't forsee any problems coming from the use of the hamstring. I didn't have any issues the first time. There will be much more rehab to the repaired knee. The only issue I had with surgery #1 was not doing enough rehab on it, so I never quite got the strength back in that knee. Ever since, it has always had a bit less strength and more pain than the left knee. I won't repeat that mistake this time.

    If you're not comfortable with the surgeon's recommendation or lack thereof you could always get a second opinion.

  4. #4
    Join Date
    Jul 2005
    Location
    Moose, Iowa
    Posts
    5,542
    My surgeon recommended cadaver but we went with patellar. He literally told me to do my own research and let him know so it was my call. It is working so far. Surely took me longer to recover as I waited for the patella to recover but now feels solid.

    In the end it is your decision. Every surgeon seems to have different opinions and the strength of allografts vs autografts seems to be a matter of opinion. Anecdotally the autografts seem to be stronger but that might be because old allografts were irradiated. I'd just make sure that you make sure the surgeon is practiced in the technique whichever way you go.

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  5. #5
    Join Date
    Mar 2009
    Location
    On your tic list
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    314

    Has anyone older had an ACL repair with an allograft (donor) graft?

    The Mrs. did cadaver at U of Iowa sports med in her early 30s. That's what they recommended. Same surgeon as the FB team, big important hospital, so she just rolled with their advice. Lots of PT, did surgery in March, was hiking in LCC by July, skiing without issue in December.
    (For UglyMoney and the other Hawk fans here, her PT buddy/partner was Eddie Podolak, this was the summer he drunk jaywalked in Scottsdale and got schmucked by a Caddy)
    Loves the knee today, still wears that classic Iowa lineman knee exoskeleton while skiing.

  6. #6
    Join Date
    Jan 2009
    Location
    Squaw valley
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    2,148
    My wife had two acl tears, same leg first time was from her hamstring, second time cadaver. Apparently the cadaver are considered stronger. She is very active and the surgeon ( different one this time) said that cadaver is the only way to go for someone active.

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  7. #7
    Join Date
    Jul 2005
    Location
    Moose, Iowa
    Posts
    5,542
    I know a few people with cadavers that are pretty sure they got grandma's loosey goosey tendon. I know some that are happy with the cadaver including people who had my same surgeon that did my autograft. Also a lot of people swear by the patella...supposedly the strongest but with the side effect of anterior knee pain in some people especially for the first year. 14er girl (?maggot name?) had allografts and now swears by autografts because she feels they hold up better.

    Ymmv. If you are a skier you know people that have had the surgery. I called an old school maggot that lives in town here who had my surgeon years ago and a bunch of other friends I know that had surgery and just talked to them about their experiences. I learned a ton. Some of it depends on what kind of a person you are mentally, it isn't just a physical decision.

    My doctor told me he would never do a surgery on someone if they weren't comfortable with it and that was me with the cadaver. As soon as he could see I was going patella after we talked over the ups and downs he was stoked to go that direction and we went for the knives.


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  8. #8
    Join Date
    Jul 2005
    Location
    Moose, Iowa
    Posts
    5,542
    Quote Originally Posted by Notchtop View Post
    The Mrs. did cadaver at U of Iowa sports med in her early 30s. That's what they recommended. Same surgeon as the FB team, big important hospital, so she just rolled with their advice. Lots of PT, did surgery in March, was hiking in LCC by July, skiing without issue in December.
    (For UglyMoney and the other Hawk fans here, her PT buddy/partner was Eddie Podolak, this was the summer he drunk jaywalked in Scottsdale and got schmucked by a Caddy)
    Loves the knee today, still wears that classic Iowa lineman knee exoskeleton while skiing.
    Nice. My wife works with a moto cross guy that did the U of I thing. Exceptional pt. IIRC he did hamstring this last time after bad luck with cadaver the first time.

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  9. #9
    Join Date
    Nov 2016
    Posts
    178

    Has anyone older had an ACL repair with an allograft (donor) graft?

    I'm 31 and just had a reconstruction with a patellar autograft (2 months out from the surgery, 3 months out from the injury). I found this to be interesting reading when I was making the decision: http://uhealthsportsmedicine.com/doc...on_%287%29.pdf

    My surgeon has been doing patellar autografts for years and urged me to consider another factor when making the decision -- his experience. He is a well-known ACL surgeon who's been working with NBA and NFL teams for years, and the vast majority of the reconstructions he has done were patellar tendon autografts. He gave me the option of a hamstring or quad autograft (no option of an allograft; he said that would be a terrible choice given my age), but I went with the patellar graft given that he was much more experienced with those. Apparently some of the younger surgeons have grown up on quad and hamstring grafts (which I’m told only recently became relatively common), so they may have more practice with those. I trust my surgeons advice completely, so would really question the wisdom of an allograft (even if it's a little less shitty following the surgery). I'd ask your surgeon and go with whatever s/he has the most practice and experience with. I'll say the graft site (patellar tendon and knee cap) were slow to heal, and the pain I feel now is in the patellar tendon. But I sleep better at night thinking that the extra pain reduced the chances I'll have to go through this horrible ordeal again in the future. Either way, good luck!
    Last edited by mrkbrnblm; 05-14-2018 at 08:30 PM.

  10. #10
    Join Date
    Jan 2008
    Location
    truckee
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    8,880
    My wife went with cadaver--she didn't want a scar from graft harvest. Now she has big scars from her total knee replacement. You win some you lose some. The cadaver graft did work fine for quite a while, but too much other accumulated damage.

  11. #11
    Join Date
    Apr 2006
    Location
    Spokane/Schweitzer
    Posts
    4,864
    My wife had a cadaver allograft 21 years ago. She is active; skiing, hiking and has no issues at all. Hers was a patellar donor that was irradiated so she may have been one of the lucky ones. In her favor, she is very light weight so doesn't load up her joints like a larger person would.

  12. #12
    Join Date
    Jan 2007
    Location
    The Pacific Northwet
    Posts
    539
    One month past my 44th birthday (Feb. '09), I had allograft ACL reconstruction, performed my Dr. Michael Thorpe in Bellingham, WA.
    As stated by others, I didn't want an additional healing/scar-tissue site beyond age 40, so autograft was out. Would probably have gone auto- if I was 30 or younger.
    Had a freak near-zero speed tumble on 7th day of ski season. I'd been very diligent in pre-season ski conditioning that year, I was in excellent shape.
    This played a hugely-positive role in my rehab program; kept swelling at bay and restored ROM quickly.
    My PT told me "You picked the PERFECT time to tear your ACL!" Lol, funny guy.

    Me: Moderately active, no fast-paced sports, i.e. tennis or hoops. Still ski pretty aggressively (others have described my style as "powerful"), hiking, rec/exercise bike rides, etc.
    Coming up on 10 years now. Zero problems with the refurbished ACL.

    However, in the ACL-wrecking crash, I also suffered a 'bucket-handle' tear of the lateral meniscus. Pre-op plan was to clip it out.
    But when i woke up, Doc said it was near a blood supply, so he stapled it up and attached it there. It worked fine for 4-5 years, but I had a 'tugging' sensation on the outside of the knee after that. Not painful, just a bit annoying.

    One cold, windy day I took an unplanned 2'-3' hop, landing skis flat on a boiler-plate cat-track. I literally felt the repaired meniscus go 'pop'. Hurt like hell, I knew exactly what happened. And the 'tugging' sensation abated. I've been just soldiering along with it for a while now, but it's getting progressively worse, knee is pretty clunky these days.
    Calling Dr. Thorpe is on my short-list of things to-do.


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  13. #13
    Join Date
    Nov 2003
    Location
    Joisey
    Posts
    1,562
    How much “older” are you talking about? I had a patellar autograft at 43 years old. ACL repair is great. Donor site issues/numbness still persist 4 years later.
    Because rich has nothing to do with money.

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