one ACL down - doc referrals?

[britney]

yes, i tore my left ACL at squaw on friday. (ask kellie)!

anyway, I need those top orthopedic surgeon referrals for San Francisco OR North Lake Tahoe - havent decided where to do the surgery yet.

I obviously want a knee specialist, and as among the 3 surgery options (cadeavor ligament, piece of hamstring, piece of patellar tendon), i am currently leaning towards cadeavor ligament procedure, but would welcome suggestions/experience.

But my first priority is the best possible doc...

Thanks.
-brit

[Dexter Rutecki]

Let the MD determine the graft type, I think. They'll discuss it with you, certain doctors seem to have different preferences. I'm sure someone out there can recommend a good doc.
Good luck, sorry to hear it. A bunch of us going through this right now, so if you need any advice or encouragement...

[iceman]

Bummer. Amazing how your avatar can jump like that on just one leg, though.

[Theodore]

I have the patellar tendon graft, but I think its the docs call. I still can't kneel comfortably(insert random bj joke here). I'd get the allograph(sp?) aka the cadaver lig. The hammy is also pretty popular. Have fun and keep at the therapy. Good luck!

Ted

[lph]

Really sorry to hear that, S.

Dex is right. I believe alot of surgeons have personal preferences re: the type of graft used. You should definitely discuss it with whatever docs you go to for opinions. However, i know from previous threads, (you could do a search), there a lot of people on this board with knowledge regarding the pros and cons of the different grafts.

Actually, I think a lot of the 'pros' from the north shore come to the south shore for their knee surgery. Most of them come to see Terry Orr. the guy i would go to on the south shore would be Steve Bannar. I believe they are both us ski/snowboard team docs.

Good luck! Let us know how things are going.

[Arty50]

Damn! Sorry to hear about the knee. Keep us updated and good luck!!!

[Kellie]

hey, glad you're home safely!

I have a list of the good ones in Truckee if you want it - check your email later today (not that you won't have it in front of you all day!)

let me know if there's any other way i can help!

[Telenater]

That really sucks. Too many have gone down to a knee injury this year.

Here's hoping for your quick recovery and rehabilitation.

[Vinman]

From experience, both personall and professionally my choice of grafts would be.

1. patellar tendon
2. hamstring
3. cadaver

Patellar tendon is considered the gold standard of ACL grafts with the hamstring a very close 2nd. Both of these grafts are good with the PT graft being a bit stronger. Both grafts will regain blood supply within the knee as compared tot he cadaver graft that does not ever regain blood supply as it is dead tissue. The chances of rejection with a PT or HS graft is 0 since it comes from your own body with the cadaver graft there is a slight risk of rejection. I'm not sure on stat for this, your doc could tell you

Personally I have had both and both come with different sets of complication and or risks. But you should consider a hamstring or patellar tendon first and the cadaver 2nd.

[altachic]

Ahhhhhh, bummer....Hope you find a good doc. Get that surgery done and PT hard and as much as you can. Your summer will be full of riding and riding some more. Good Luck!

[mntlion]

sorry about that, Greg emailed me about the skis and are working out the details

[altagirl]

That sucks. I also agree - find a good doc and get input from them on which graft is best for you. There are positives and negatives to each and it depends on the indivicual. I had a hamstring graft. No leftover aches and pains but the graft ended up a little stretched after a couple years, otherwise it's good.

[watersnowdirt]

NOOOOOOOOOOOOOOOO!!!!

I'm SO sorry, S! That completely sucks. i hope you find a good doc and get the care (and drugs) that you need. let me know if you need a ride to/from the hospital and all that stuff! I'm here to help if needed.

UGH!!!!!

[teledave]

Blown ACL's suck!

But 9 years afterwards my patellar graft is holding up, I know of some others that went the cadaver and have had to redo it (one 2x). A completely unscientific sample but take that info for what its worth.

My doc told me the only people that he would consider for a cadaver graft are pros that have to get back to their sport in 60'ish days, or people that don't participate in any kind of sports.

Here's to happy recovery! (You'll be back on it for the opening next season.)

[britney]

thanks SO much to all for the help and encouragement!

i just found out from insurance that i have to do it within 20 miles of work or home, SO

i need a doc with an office in san francisco!!!

keep the SF referrals coming... (anyone know who does the 49ers??)

thanks a million billion!!!
-brit

[L7]

Sorry to hear about that. I had the hamstring repair some years back (14years). It's been great and the joint is still super solid. Two 1" scars is what he did the work through so that made for less heeling that way. Like everyone says each Doc probably has their preference and reasons but I don't think there's a reason to shy from a good hamstring surgery.

I'd go hard on picking Vinman's brain because from what I've seen he's got a lot of knowledge on these things.

[iceman]

Originally posted by britney
(anyone know who does the 49ers??)

um, their cheerleaders?




(sorry for the jokes in your bad news thread)

[divegirl]

So sorry to hear about this, Brit.
This sucks!!!
Here's to hoping you have a full and speedy recovery!

[britney]

one SF doc whose name has come up a few times:

Marc Safran

anyone heard anything about him (good or bad)? thx!!
-b

[phUnk]

Bummer . Please re-post hottie brit pictures to cheer everyone up. It'll help, I promise.

[basom]

just going through this now too brit so i know how tough the doc selection can be. i lucked out and got one of the team orthos for the patriots, bruins, celtics, and revs. he is also Tyler Hamilton's ortho. basicly this guy does a lot of pro athletes, and he said pateller all the way when i told him my list of priorities.

1- skiing is the most important activity in my life
2- i want to be able to ski at a high level for my entire life and not have horrible pain when i'm 75 or 80


he said if my job was the most imortant (i'm a carpenter and thus have to kneel often) he would go hammy, but he said it is not as strong or stable and would only treat me so well for so long. if i was older (i'm 26 now) he would consider it, but he recomends pateller for any one my age who considers themsef an athlete, or very active. he never considers cadaver unless the patient is over 40 and not planning on skiing or playing bball more than on a low ipact level (no hucking, no high speed sillyness)

honestly i would have gone with whatever he recomended, he was very confident of the graft that would suit me the best.

best of luck to you!

[Dexter Rutecki]

Originally posted by britney
i just found out from insurance that i have to do it within 20 miles of work or home, SO

Since you're in SF I'm sure there's an excellent ortho in town who can cut you. But that's the type of rule that I would definitely try to find a way around (appeal to the co.) if my doctor weren't within 20 miles.

And as Vin stated, although your doc will help you decide which graft is used, my doc (and the first guy I had knee surgery with) both see the patellar graft as most reliable (I think that's because it is). Although hamstring gives easier recovery and doesn't cause problems with kneeling later on, the idea of it potentially stretching is enough to keep me away. I'm two for two with patellar, and although the second one can't really be tested yet (<5 weeks post-op) the first one from 4 years ago has done everything it should (and didn't break unlike my right 'real' ACL).

Good luck, again. It sucks, but there's definitely light at the end of this particular tunnel.

[KevinDineen]

My advice, Britany, avoid the Patellar graft. I've had both the hamstring (right knee) and the Patellar (left knee) and the hammy is much, much better. Left leg is still skinnier that the right, and it was reconstructed five years before I had the right one done. The doc. who did the second told me It'll never get back to full size. Plus the knee was too sensitive to kneel on for about 2 years. The Patellar graft was big news about 15 years ago, but it's obsolete now. If your MD recomends it, find a new MD.

[Agent 00X]

NNOOOOOOOoooooooooo!!!! So sorry about your blown ACL. Hopefully all your other knee tissues are in good shape.

I have not blown this ligament yet but this might help.
I did have a small tear in a discoid lateral meniscus trimmed out at Kaiser and had a grade 1 MCL sprain in February. Before I did the menisectomy I got 3 bay area assesments each with an examination of the knee, X-rays and MRI. The meniscus assesments were from 1)Kaiser(2X), 2) Dr. Cannon (with resident), UCSF and 3)SF private practice knee pro. Things change, but next time I need serious help with my knees I would probably keep the choices in the priority as listed. I'd not been thru this deep a medical experience previously and had to figure out a couple of things. Other folks would do things differently and have conclusions that suit them best.

I got an assesment from Cannon because from the info I had, he looked like the knee guy at UCSF, with max experience. I also pretty much got a referal to Kaiser from him as well. So, from my experience, considering things and things that I think are important, I like Kaiser. Yeah, Kaiser has it's haters but I'm not one of 'em.

I'd like to comment a little more on docs but I'd rather do it on the PM level.

Finding an orthopod is important now but (not having personal ACL experience) I guess you have been instructed to do anti-inflamitories (ibuprofin, naproxen etc) and ice on some schedule. I just want to say I found ice to do a whole lot more than I thought it would and want to say don't underestimate it now, more useful than meds maybe. Do 2-4 trays of cubes at a time. Get a roll of small trash can bags for the ice, ~ 6 ice trays and an ace bandage or two to hold the ice in place.

Good recovery!

[britney]

so here is a list of SF doctors i can get referred to for insurance purposes (feel free to forward to anyone who might have insight).

if you or a friend recommend another SF doc, let me know (the list may be broader than the below, but it is definitely not narrower. also there may be misspellings below):

Francois Antounian
Lesley Anderson
Robert Branick
Gordon Lundy
Frederick Bost
Christopher Cox
Keith Donatto
Jon Dickinson
Robert Gilbert
Taylor Smith
Kevin Louie
Michael Ries
W.D. Cannon
Marc Safran

thanks again for all your advice and insights! it looks like the most important thing right now is picking a surgeon...
-brit