Riding the Metro
12-07-2005, 04:49 PM
From:
Mark S. Sanders, MD
Sanders Clinic for Orthopaedic Surgery and Sports Medicine
Question: I had an unsuccessful ACL surgery years ago and live with chronic pain, an unsteady footing and a noticeable limp. Because of this, I have not been able to participate in some of my favorite sports. Is there anything that can be done to improve my condition?
Dr. Mark Sanders: Unfortunately, this is something we see regularly because over half of the ACL reconstructions performed in the United States each year include tissue from cadavers (allograft), or the patient?s hamstring tendon. Nearly all of the allografts put into serious athletes fail and the hamstring tendon adheres poorly to the bone and often heals in a lengthened position causing recurrent instability. This is why we regularly see athletes who are suffering from permanent stiffness of the knee, with loss of normal motion, called Arthrofibrosis, or recurrent knee instability and giving way. While there are other reasons an ACL surgery may fail, an inadequate graft source and failure of rehabilitation with resultant stiffness are the most common causes.
At the Sanders Clinic, we approach the salvage of a previously failed ACL surgery by first examining the patients lifestyle and overall mental and physical condition. This is important in developing the best type of treatment and rehabilitation program. Some minor rehabilitation modifications may be all that is necessary for those experiencing a small lack of extension, though a large extension or flexion loss may require arthroscopic surgery ? in order to remove scar tissue.
When recurrent instability is present, usually because of a failed allograft or hamstring operation, I have found phenomenal success using the patella tendon from the patient?s opposite leg, because not only is the body more willing to accept its own tissue, this tissue adheres well to the bone ? necessary in creating a strong ACL. When this type of graft is combined with a rigorous accelerated rehabilitation program, our patients are back to their sport ? even ones they may have long since given up - in less than three months. At the Sanders Clinic, we can arrange for an athlete to regain his or her motion, as well as make a knee strong and stable. Unfortunately, we are unable to give an athlete back the lost years of competition resulting from a poorly planned and executed surgery.
Mark S. Sanders, MD
Sanders Clinic for Orthopaedic Surgery and Sports Medicine
Question: I had an unsuccessful ACL surgery years ago and live with chronic pain, an unsteady footing and a noticeable limp. Because of this, I have not been able to participate in some of my favorite sports. Is there anything that can be done to improve my condition?
Dr. Mark Sanders: Unfortunately, this is something we see regularly because over half of the ACL reconstructions performed in the United States each year include tissue from cadavers (allograft), or the patient?s hamstring tendon. Nearly all of the allografts put into serious athletes fail and the hamstring tendon adheres poorly to the bone and often heals in a lengthened position causing recurrent instability. This is why we regularly see athletes who are suffering from permanent stiffness of the knee, with loss of normal motion, called Arthrofibrosis, or recurrent knee instability and giving way. While there are other reasons an ACL surgery may fail, an inadequate graft source and failure of rehabilitation with resultant stiffness are the most common causes.
At the Sanders Clinic, we approach the salvage of a previously failed ACL surgery by first examining the patients lifestyle and overall mental and physical condition. This is important in developing the best type of treatment and rehabilitation program. Some minor rehabilitation modifications may be all that is necessary for those experiencing a small lack of extension, though a large extension or flexion loss may require arthroscopic surgery ? in order to remove scar tissue.
When recurrent instability is present, usually because of a failed allograft or hamstring operation, I have found phenomenal success using the patella tendon from the patient?s opposite leg, because not only is the body more willing to accept its own tissue, this tissue adheres well to the bone ? necessary in creating a strong ACL. When this type of graft is combined with a rigorous accelerated rehabilitation program, our patients are back to their sport ? even ones they may have long since given up - in less than three months. At the Sanders Clinic, we can arrange for an athlete to regain his or her motion, as well as make a knee strong and stable. Unfortunately, we are unable to give an athlete back the lost years of competition resulting from a poorly planned and executed surgery.