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

[fuzzybabybunny]

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?

 

[Ken_R]

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?

My wife is getting ACL surgery on her left knee. She is 34 and they are doing allograft from either her hamstring or quad. The doc gave her the two options but ultimately decided on the allograft.

 

[Pequenita]

i know you asked for allograft opinions, but I wanted chime in with my experience with the hamstring tendon graft. The “compromise” with the hamstring tendon is that the range of motion for hamstring flexion is decreased. I haven’t had a need to kick my own butt the last decade, so it hasn’t been an issue.

 

[fatbob]

I must admit I've never understood the US obsession with allografts. I had an full ACL recon with a patellar autograft at 40. Been fine since although slight reduced flexion in that knee.

 

[Monique]

You would probably get more responses if you didn't ask specifically about "older" patients. I was 38 when I got my patellar autograft. I thought you meant, like, 50!

Pros and cons for everything. An autograft is recovery from two simultaneous surgeries.

 

[SkiSpeed]

I was 35 when I had an ACL surgery; they used a piece of my patella for the repair. I am way older than 35 now!

 

[Ken_R]

My wife is getting ACL surgery on her left knee. She is 34 and they are doing allograft from either her hamstring or quad. The doc gave her the two options but ultimately decided on the allograft.

My mistake should have written autograft

 

[Monster]

FWIW: I had ACL repair last April. My surgeon happened to be a guy who does ortho work for the US Ski team, so I figured I was in good hands. (Slight and athletic, joint issues had never come up for me until this flukey accident. I was 59 at the time.) He advised me in pretty clear terms not to choose cadaver tissue as, in his opinion, ok for non-athletes, but not as durable for people who put stress on the knees. Having listened to and quizzed my surgeon closely and gone with the hamstring choice myself, and since spoken with quite a few people who have chosen the other options, it seems like this to me:

Recovery, worst to best - patella, hamstring, cadaver

Durability, best to worst - patella/hamstring close, but patella the strongest by a bit, cadaver a pretty distant 3rd

After April 24th, 2017 surgery, I skied for the first time on November 17, skied about 60 days this season with steadily improving confidence and strength. When I stopped skiing for the season a couple of weeks ago :-( the knee actually rebelled for a while at the relative disuse. It's range of motion is still at about 95%; however, that is improving quickly now that I'm just walking, jogging, and doing normal home maintenance and lawn type labor.

Best of luck - at your age, it will come around quickly ;-)

 

[James]

For people over 40 he almost always recommend people go with a cadaver tissue

How many cadavers are under 40??

Fwiw, I had autografts from the patellar tendon at age 34 and 38. Fwiw2, meniscus damage causes more problems in the long run then acl repair. Yeah rehab from acl is worse, but post surgery for me after the meniscus "repair"- aka partially removed, was actually worse.
Ice, ice, baby.

 

[mdf]

I had a hamstring autograft on one knee last year at age 60 and the other about 5 years before that. I had meniscus trims, but I guess my surgeon didn't take too much out. I had an easy recovery and no long-term problems. I resumed skiing at 9 months after surgery this time (11 months the first time.)

I skied 8 full days in a row on two different trips this winter -- no swelling or pain.

The only time my knee bothers me is when work requires me to be inactive for more than 3 days in a row.

 

[newfydog]

I blew an ACL at 44. I never had it fixed, and am still skiing fine at 63. User experience may vary.

 

[James]

I blew an ACL at 44. I never had it fixed, and am still skiing fine at 63. User experience may vary.

Do you use a rigid brace?
That seems to be a more interesting question for acl repairs-or not, than how old the dead body for the graft is. Seems like in the last 20 yrs they still haven't settled the brace issue.

 

[Brad J]

I blew an ACL at 44. I never had it fixed, and am still skiing fine at 63. User experience may vary.

Exactly the same for me , I do still wear a brace , Its a mental crutch

 

[Ken_R]

My wife got out of surgery yesterday! Shes in pain but already got some mobility.

The brace she got and the water/ice system are nice!

 

[newfydog]

Do you use a rigid brace?
That seems to be a more interesting question for acl repairs-or not, than how old the dead body for the graft is. Seems like in the last 20 yrs they still haven't settled the brace issue.

I wear a brace with an extension stop, rather than an ACL specific brace. As long as the knee is not straight or hyper-extended, it is solid. So solid that one morning I put the brace on the wrong knee.

 

[Brad J]

My wife got out of surgery yesterday! Shes in pain but already got some mobility.

The brace she got and the water/ice system are nice!

View attachment 46300

I had a brace like that when I ruptured my Quad Tendon, If it has an adjustable hinge be careful not to hit the buttons that adjust it at night, I did that a few times with mine , IMO a real flaw, hope they fixed the problem.

 

[Snowfan]

Hamstring autograft at 47yo for me, 10 years ago. Total success. No "huge strands of tendon with muscle attached" were used. A thin strip was removed from hamstring, then sliced lengthwise and folded over. Sewn together to make a quad bundle about the same size as the acl. Skied on it 7 months later.

Recovery and rehab was a non-event. No big deal.

 

[AlpsSkidad]

Both ACLs have been repaired by different doctors. Right knee at age 27 with graft from my Patellar tendon- had 3 follow up arthroscopic surgeries to clear scar tissue over subsequent 3 years. Was done in Colorado. Initially took about 1 year to get back to feel full strength. Knee still doesn't have original Range of Motion.
Left knee ACL replaced at age 33 in Virginia with cadaver graft. Recovery was much faster- I was back playing ice hockey in 3 months. no follow up surgeries.
I'm 45 now, and the Cadaver side feels stronger and more flexible. I ski hard, still play ice hockey and have no overall issues in either one.

 

[OSD]

Left knee ACL replaced at age 33 in Virginia with cadaver graft. Recovery was much faster- I was back playing ice hockey in 3 months. no follow up surgeries.
I'm 45 now, and the Cadaver side feels stronger and more flexible. I ski hard, still play ice hockey and have no overall issues in either one.

I'm unfortunately going to have to make this decision soon. Anyone else have a post-allograft experience to share? I had a hamstring graft at 38 which has held up to everything I've thrown at it...bumps, steeps, wipeouts. I'm 54 now, curious if anyone here has actually had an allograft fail on them from skiing.

 

[surfsnowgirl]

My SO did. He had a full ACL year last April. Surgery 3 weeks later with an allograft. Doctor said Michael was a perfect candidate for this. If he were 16 it would have been a hard no as you have to take the tissue from somewhere else in the body. However, because he's an older adult taking his own tissue would add an extra 6 weeks of recovery time. Huge benefit of the allograft is they can beef up the ACL and make it nice and meaty.

Michael kicked butt in recovery and doc was very pleased with his knee. He was cleared to ski groomed greens and blues a month early.

We highly recommend the allograft based on our experience and others we've talked to who didn't do this.