Reconstructing knees?

Tony Bubb wrote: OK, Paul mentioned tendon sensitivity on the Patellar, and it sounds like you've had minimal problems... what about sensitivity afterwards? And comments on hamstring problems after using hamstring?

Vern Cooley repaired my left ACL with a hamstring graft in March of this year (no meniscus damage). He's a US ski/snowboard team surgeon, and says for a youngish athlete the hamstring is the way to go, esp. for a skier. Anyway, the first couple of months were hard and very painful. It took a while to gain any sort of motion back, and I lost about 30% of the muscle mass in my left leg (thanks to the fingerboard, my forearms were bigger than my left leg just above the knee for a while. it was awesome!)

I was bouldering V6 and leading .11's at about three months out, although pain was noticeable on steeper routes (heel hooks, toeing in, etc). My left foot felt "stupid" for a while, just sort of clumsy. Most of the pain's gone now, although the knee still swells after big days in the mountains, after riding centuries, or running more than 20 miles or so. I also refuse to drop knee, which makes certain routes much harder. I'm still missing a bunch of muscle in my left leg, but I'm climbing about as well as normal (6 month out).

Hey Tony,

I know you're looking for local suggestions, but... I just wanted to throw these guys out there:

rcmclinic.com/practice/

Where Tiger Woods chose to have his knee done.

Good luck!

Yeah, it's likely he had the same procedure I did (hamstring tendon folded twice "double bundle"), since I think Rosenberg did his, and he invented that technique.

So me and Tiger are both brown guys married to tall blondes who had Lasik done at TLC in 1999 and a left ACL repaired at the RMC clinic in 2008.

I am Tiger Woods!

I hear Dr. Trumper is the best knee guy in Fort Collins. He fixed my meniscus and I was bouldering 10 days later. Another friend had a torn ACL, MCL, and meniscus. Her recovery time was faster than another acquaintance who went with a different doctor, even though she only had a torn ACL.

Another pal just tore his meniscus (wow, coincidence) and hopes to fix it with PT and avoid surgery... any comments? He's watching the board here.

TB -- Here's another great resource:

knee1.com/forum/index.cfm?c…

I've had two ACL repairs, one on each knee (with a miniscus repair on the right knee). The left knee was a patella tendon graft and the right knee was a hamstring graft. I'm much happier and there's almost never any pain with the hamstring. Ten years after the patella tendon graft I still have problems kneeling along with a lot of crepidation in the knee - all that crunching noise when I bend my knee is from that! My dr. says that's a common problem with patella tendon grafts, which they didn't know until more recently. I can't hike more than 7 miles due to the amount of pain and swelling and I can't run anymore either, all because of the left knee. I'd recommend a hamstring or a cadaver graft just in case you're one of the "lucky" ones who has problems years down the road with the patella tendon. Also, I've always gone to Panorama Orthopaedics in Golden. I'd highly recommend getting a second opinion from there.

Best of luck to you!

I had the hamstring one done. You have 4 hamstrings; one big one on the outside and 3 smaller ones on the inside. They pull out 2 of the smaller ones, "braid" them together, and then use that as the new ACL.

Hamstrings DO regenerate, but they reconnect a little farther up on your calf than original.

My doctor said that if I was a runner, he would have done the patellar one because he wouldn't want to "shave off 1/100th of a second on your running time."

As far as the meniscus goes, there are two regions. If I recall correctly, the outer region has blood in it, and the inner region doesn't. If it's the outer region, you can sew it together and it'll heal (or maybe in your friend's case, heal itself assuming it's not too bad). Otherwise, if it's in the area with no blood, they cut off the flap because it will not heal and it'll get in the way.

As a side note, a couple of months ago I read a short blurb on some medical testing where they were using a special string to prompt the body to grow it's own ACL instead of using grafts. Anyone know any updates on that one?

i had surgery for a torn acl in may this year. dr. grauer did a great job fixing my knee and i've been working with the awesome people at boulder center for sports medicine to get my strength and range of motion back. i had a hamstring graft and that's been feeling fine so far. i'm taking my time coming back to climbing, it sucked missing most of the season, but it's important to me to get my knee healthy again.

sorry to hear about your knee.

Agent Chumley wrote: Best of luck . . . it's not the end of the world. You can easily come back stronger and more focused after an injury-induced hiatus.

Time to take my own advice of just 6 days ago . . . I tore the meniscus on my right knee 2 days ago after climbing through a roof, rocking onto my knee, and pressing it out. There was a very loud "pop" and I knew it was done. I did finish the pitch, though. Damn. Damn, damn, damn!

Weird.

Well, as it turns out:
The MRI's showed a complete detachment of the ACL from the Femur. It didn't snap in the middle- it pulled off the bone. It seems as likely as not that a prior injury. I had been hit by a car while walking 18 years ago- which took out my knee for months, but no MRI's back then -it was diagnosed as a sprain. I guess that may have played a part.

After talking with all y'all and a few doctors and the surgeon I selected, I will be going with a hamstring replecement. Because of my history of tendonitis, and particulerly in the lower extremities including the knee, the patella tendon option was eliminated.
Also, at a younger age, your own tissue is the better tissue- at an older age, recovery is more difficult and other tissue might be better than your own. Sub-40, I am told- use your own. This is not expected to cause me any hamstring trouble.

The surgery will be in a few weeks- when I can straighten the leg completely & have back the use of my left hand (currently broken and in a cast)- At present there is enough internal trauma to the knee (meniscus and bone bruising, etc) that presently I can not straighten it.

For a doc, I selected Dr. Cooney, at Foothills Orthopedics. This was based on my comfort level with him and his qualifications. He did his research/residency in this surgery, and also does almost all of them via hamstring replacements, which is my chosen method & according to my reading, likely the best.
Another comment made, for those who end up "here" later is that the position of the insertion of the replacement tissue is considered critical- but not always carefully watched. Be careful not to imbalance the knee.

The docs say I'll be back to participating in normal activities in about 6 months, and start strengthening up from there. I might be able to TR or follow EZ stuff sooner, but I am cautioned against even steep trail hiking for 3 months.

Thanks again for all of the info and encouragement.

Started riding my bike 5 weeks after surgery very carefully! Rode up Mt. Lemmon at 3 months.
I'm sure 'Tony' will be riding soon too! Wishing him a speedy recovery.

Nikolai Daiss-Fechner wrote:Stedman/ Hawkins clinic for sure. They did a bunch of my competative ski buddies. Always heard glowing reviews.

I'm jumping on the Steadman/Hawkins bandwagon. Note the change in spelling. Actually grew up with Steadman's grandson and know, first hand, that he is a top-notch fellow that has experience from professional football and tennis players, to the U.S. Ski team.

Edit. I should read first.