Torn ACL cadaver ligament reconstruction

Hi!

I tore my acl three weeks ago and have had a reconstruction surgery where they used a cadaver ligament (I'm too small to have enough ligament to use for it from my own body).

I was just wondering what recovery time is like in terms of top roping and leading outside/inside for anyone who has gone thru this. I'm worried because I know the cadaver ligament is not as good as using your own ligaments so I just don't want to risk tearing anything. I DNT do anything crazy, I'm still a beginner so I do 5.9s and 5.10s, I want to keep improving and doing harder climbs but I'm just really worried and I don't even know when I can start climbing again.

What do you guys think? Thank you so much!

Hey Claudia! Bummer about the injury..

I just passed one year post-op and am feeling great! I had an ACL reconstruction with a hamstring autograft and a median meniscus repair. I had surgery 2/7 of last year. I top roped outside for the first time 11 weeks post-op. First lead was about 14 weeks post-op.

Hang in there! It can be brutal but keep your head up and keep pushing! You'll get there. Feel free to reach out if you have any questions. Good luck! 

Hey,

I feel your pain. I had cadaver done twice (it didn't work out for me) the first time I returned to activities at 6 months and re-tore it snowboarding. I had surgery 8months apart. It's not worth the risk returning to soon. You need to tell your physical therapist and doctor what you would like to do and listen to them. My guess is between 6-9mo before they let you do easy climbs but that's just a guess. They will see how you are recovering and strengthening to best suggest what is a good or bad idea. The ligament doesn't fully recover for about a year. It actually gets weak again after surgery before you get strong again. This happens about 6-12weeks after surgery. By month 6 you'll be feeling great and like you want to do everything again. Its a really long road of recovery and it sucks.  I would get into biking if you aren't already. That'll help get you really strong. They may not let you bike outside for a bit though so a stationary will be better for a while, again the physical therapist will be your best place for advice on this as every body recovers differently and there's lots of factors. My second surgery I listened to all suggestions and came out of it stronger than ever. Unfortunately my body doesn't like cadavers and 3 years later it tore again. I wound up having surgery a 3rd time using my quad tendon. Try to stay positive I know its easier said than done. My guess is you'll be able to get back on ropes faster than you'd be allowed to boulder. I'd stay away from cracks, chimneys, and anything that would require twisting of the knee. Im 4 - 5 years past my last surgery and I cannot chimney. My knee swells and it hurts. I hope you dont experience that and think mine comes from the multiple surgeries. Good luck. Im here if you need moral support.

I have a cadaver one.  One year out.

Tons of PT in months 0-6.
Maintenance PT after.
Top rope m 6 months out, for sure I would guess.
Everyone is different.  Listen to your body.
I was scrambling in flatirons 4 months out.I was leading and developing a crag at 6-9 month.
I am skiing from 9-12 months out.
I always wear my brace.  It prevents re injury.
Might wear the brace for 2 years as a ligament takes 18-20 months to be done doing what it does.  Might wear it forever skiing.  I will decide when the two year mark comes.​I always surprised my PT and personal trainer.
Bottom line.  Experiment but listen to your body.

I had a bad accident, and long story short my entire left arm is a cadaver. I can still climb ok after 3 years, but it keeps wanting to strangle people 

I am a PT.  Cadaver grafts take longer to incorporate and remodel.   Toproping by 4-5 months should be fine.  Just gradually progress the stress you are putting on your knee.  I'd strongly recommend waiting a year before leading.  Falls produce stronger eccentric loading of the knee when you come in to the rock (worse with a hard catch) which is the worst case scenario for a healing ACL graft.  If you can, find steep stuff that will reduce your impact forces and find a lighter than you belayer.

Also, research does not support the use of braces in the prevention of ACL injuries or re-injury.  There is too much soft tissue to be able to adequately stabilize the knee during the injury event.  Braces can help prevent injuries to the collateral ligaments (ligaments on the sides of the knee)

Not sure if it has been mentioned yet, but I reccomend avoiding dihedreals until you're very confident in the knee. The loaded twisting and pivoting motion that I think most employ will put a lot of stress on it. I had a scare at the gym several months after I was cleared to climb while twisting into a corner. 

Claudia Ki wrote: Hi!

I tore my acl three weeks ago and have had a reconstruction surgery where they used a cadaver ligament (I'm too small to have enough ligament to use for it from my own body).

I was just wondering what recovery time is like in terms of top roping and leading outside/inside for anyone who has gone thru this. I'm worried because I know the cadaver ligament is not as good as using your own ligaments so I just don't want to risk tearing anything. I DNT do anything crazy, I'm still a beginner so I do 5.9s and 5.10s, I want to keep improving and doing harder climbs but I'm just really worried and I don't even know when I can start climbing again.

What do you guys think? Thank you so much!

Claudia-- sorry to hear about the surgery.
 For me, by about 4 months was TRing in the gym, being very careful about shocking the knee or twisting. Now, nearly 3 years post-op, my knee can do everything it could before, but does not feel exactly the same. Sometimes, it suddenly weakens and I have to respond quickly.
 
Though I am just a single case, I may have learned two other things from my experience. 1) I did all the range of motion exercises suggested by the surgeon's team, and my ROM stayed the same from before. 2) This might be a coincidence, but my hip osteoarthritis became noticable right after my ACL surgery, and I figured that what happened was that I let the surgery greatly reduce my activities and exercises. If I were to have the surgery again, I would do a lot more exercises to make sure my other joints don't deteriorate.

There's some good info on this thread.  There's also a number of other really informative threads out there: mountainproject.com/search?…

Claudia, feeling your pain. I had ACL reconstruction surgery 2 weeks ago using a cadaver. My recovery is going incredibly well, low pain and range of motion is returning quickly. I’ve asked the PT and he’s warned me about trying to push back too soon (with in the first 3 months.) Going to keep working the exercises from the PT and following his advice to make sure I don’t re-injure, which research says is mostly likely in the 5-6 months range.
Keep positive and follow your PT and OS advice and you’ll be crushing again soon. Hopefully I will too!!

DrewH wrote: Claudia, feeling your pain. I had ACL reconstruction surgery 2 weeks ago using a cadaver. My recovery is going incredibly well, low pain and range of motion is returning quickly. I’ve asked the PT and he’s warned me about trying to push back too soon (with in the first 3 months.) Going to keep working the exercises from the PT and following his advice to make sure I don’t re-injure, which research says is mostly likely in the 5-6 months range.
Keep positive and follow your PT and OS advice and you’ll be crushing again soon. Hopefully I will too!!

I retore mine in that 5-6mo range my first time. Wound up with surgeries 8 months apart. Dont be like Stephani. Take your time and heal right. Believe me, I have now had 3 replacements and the 3rd ended up being a 2 part surgery with a blood clot...wishing you all speedy recoveries

Steph Hukk wrote:

I retore mine in that 5-6mo range my first time. Wound up with surgeries 8 months apart. Dont be like Stephani. Take your time and heal right. Believe me, I have now had 3 replacements and the 3rd ended up being a 2 part surgery with a blood clot...wishing you all speedy recoveries

Hi Steph,

So sorry to hear about all those surgeries but that's good advice. I'm 6 weeks out from surgery and feeling really good and itching to climb, hike, etc. But the ligament is definitely not ready for that even tho I feel good. I'll start some easy top roping at 4 months out and won't push anything till pass 6-7 months. Having to restart this process would suck too much haha

I've had both done, Cadaver on one knee, autograft on the other.  I recovered from the latter more quickly, and it is also the better knee at this point.  Perhaps because I was able to rehad it better because I recovered more quickly.

Ask your physician about their opinion on why the cadaver knee is supposedly inferior.  Some will tell you that it is only inferior for relatively young people.  Some will tell you that the taking of one's own tissue slows recovery, or at least perceived recovery down to the point where the patient takes less risks and is less likely to hurt themselves.  Perhaps why older patients do just as well with donor tissue, and why once a certain distance in time from the surgery, the statistics merge.

Regardless of which you choose, the injury will start to feel better around the time that the tissue is at its weakest, in 2-4 months.  Don't push it then.  the tissue was dead with no blood flow when it was grafted, and weakens over time then strengthens as the body replaces the dead tissue with it's own healthy living tissue.  That graft is just a lattice, a conduit for that growth.  And it is not strong enough to do much until 6 months out.

For my own part, having done both, I'd do the cadaver tissue if I had to do it again, as I did for my second knee.
Best of luck with yours (applies to all reading this).

Tony B wrote: I've had both done, Cadaver on one knee, autograft on the other.  I recovered from the latter more quickly, and it is also the better knee at this point.  Perhaps because I was able to rehad it better because I recovered more quickly.

Ask your physician about their opinion on why the cadaver knee is supposedly inferior.  Some will tell you that it is only inferior for relatively young people.  Some will tell you that the taking of one's own tissue slows recovery, or at least perceived recovery down to the point where the patient takes less risks and is less likely to hurt themselves.  Perhaps why older patients do just as well with donor tissue, and why once a certain distance in time from the surgery, the statistics merge.

Regardless of which you choose, the injury will start to feel better around the time that the tissue is at its weakest, in 2-4 months.  Don't push it then.  the tissue was dead with no blood flow when it was grafted, and weakens over time then strengthens as the body replaces the dead tissue with it's own healthy living tissue.  That graft is just a lattice, a conduit for that growth.  And it is not strong enough to do much until 6 months out.

For my own part, having done both, I'd do the cadaver tissue if I had to do it again, as I did for my second knee.
Best of luck with yours (applies to all reading this).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445196/ 

Claudia Ki wrote:

Hi Steph,

So sorry to hear about all those surgeries but that's good advice. I'm 6 weeks out from surgery and feeling really good and itching to climb, hike, etc. But the ligament is definitely not ready for that even tho I feel good. I'll start some easy top roping at 4 months out and won't push anything till pass 6-7 months. Having to restart this process would suck too much haha

I wasn't climbing then, mine were snowboard related but seems logical  to me. Good luck in your recovery.