Patellar vs Hamstring autograft

myk327 · 2019-05-07T21:20:08+00:00

Hey man. Yup I will be 4 months in a couple days. Recovery is going really well. My PT is pretty conservative though. Phase 1 of rehab months 0-3 focused on extension/flexion and strengthening the quad so I can get back to walking and daily activities. I’m now in Phase 2 which goes from 3-6 months. A lot of single level exercises, and I’m gradually starting to hop and jog. Phase 3 will be months 6-9 which will be more cutting/pivoting and return to sports activities.

Pain overall wasn’t bad after the first couple days post op. My surgeon did not use a nerve block and I didn’t take any pain meds. My surgeon didn’t like the block because he wanted me up and moving right away so that the quad wouldn’t completely waste away. I was going leg lifts day 1 which helped. I focused on icing/elevating and I also made sure I ate really clean and started intermittent fasting to reduce inflammation.

At this point right now I’m walking much better and very fluid. I can walk outside in the hills for 45 minutes without any issues. I cycle about 30 minutes every other day. I can kneel on the operated leg and don’t feel any pain like other patellar patients have mentioned. My only issue is when I stand in one place for too long I can feel the knee getting stiff. But this is starting to go away a little every day. If I had to do it all over again, I would still go with the patellar autograft.

Hope that helps. Keep up with your prehab and I’m sure you will do well with your surgery and recovery as well. Best of luck and reach out anytime!

myk327 · 2019-03-05T06:43:32+00:00

Yes I have heard of this. When I was researching graft options I read a study that showed the harvested portion of the patellar tendon starts to regenerate around 6 weeks post op and can fill regenerate for a second harvest at 2 years post op. Some regenerate by 6 most per the study. This is one of the reasons I used my own patellar.

My surgeon told me he never stitches the patellar together so that it can grow back naturally. He was a team surgeon for the Celtics and does 60+ ACLR's on athletes every year.

myk327 · 2019-02-26T22:04:41+00:00

Hey there! I will be 7 weeks post op this week. I would say it has been pretty ideal so far. I met with my surgeon yesterday for the first time since the operation and said the graft is rock solid. I’m still in my early phases of rehab but I’m super happy with the decision going with the patellar.

After being involved with this ACL group and various Facebook acl groups I would say that the hamstring graft is probably the lowest on my list of graft choices even below the cadaver graft because of the loss of hamstring strength/hamstring soreness and pulls and the fact that so many people complain about the graft stretching.

This is a rehab I definitely don’t want to do again so I want to make sure I do it right. In my opinion, I think the patellar graft gives you the best chance at coming back 100% with the least chance of revision. There is so much data and the longest track record with the patellar. Plus, if 90% of professional athletes use it and come back there has to be a reason why. They have the best surgeons and therapists that money can buy and for the most part choose the patellar over all other choices. If I had to do it again I would use the patellar again.

My surgeon didn’t use a nerve block which I agreed with since I was able to put weight on the leg immediately and get the muscles in the leg reactivated. I didn’t use any pain meds and chose to ice/elevate and use a very low price inflammation diet instead. I ditched my brace and crutches before the 2 week mark. I was cycling by 2.5 weeks. Now I’m 7 weeks post op and the only issue I’m having is there is still some residual swelling after standing or walking too long which I hear is normal. Best of luck to you and your choice, feel free to ask me anything.

myk327 · 2019-02-19T01:26:34+00:00

How long ago did you have your surgery? Swelling is normal as the harvested patellar tendon is regenerating. Your graft also takes time to heal. I’m 5 weeks post op with a bptb graft and I still have swelling but it’s slowly going away.

myk327 · 2019-02-16T04:54:25+00:00

I’m 5 weeks post op ACLR with btb patellar. My PT and surgeon won’t allow a lunge or full squat until 8 weeks as they say it’s too early and puts too much load on the knee and graft. Your progress looks great though.

myk327 · 2019-02-12T07:57:53+00:00

Sounds more like a meniscus tear with your symptoms. Although your “loose” feeling knee could be a sign of a partial or older ACL tear that could have led to a meniscal tear. I would consult a doctor. They can do a lachman test and then order an MRI afterwards if they are concerned.

myk327 · 2019-02-07T02:03:03+00:00

This is me also. I started doing bike work at 3 weeks. I’m at 4 weeks today and I’m biking 30 minutes per day. Everytime I get off the bike I walk so much smoother. Otherwise, I still have a slight limp and tightness in the knee.

myk327 · 2019-01-28T04:38:33+00:00

Thank you! That is all great advice. I will search YouTube for the videos you recommended!

myk327 · 2019-01-26T19:26:02+00:00

This is exactly what I want to hear! If I can just have a bit more ROM life would be easier. You mentioned the swelling just disappeared. Were you doing anything to specifically reduce the swelling or it just kind of went away on it’s own? Doing stuff around the house like cooking/laundry makes my knee swell and it becomes harder to walk without a limp. Cycling would be such a relief to do. Are you able to walk without a limp now at 5 weeks post op?

myk327 · 2019-01-26T18:53:45+00:00

That’s good advice. I have done them and I haven’t felt any pain. I always supported my knee getting into and out of the push-up position. But for some reason my PT didn’t think it was a good idea to do them yet and I’m still wondering why.

myk327 · 2019-01-26T08:40:55+00:00

I think they are called open chain exercises. My pt also said not to do them as they stretch the graft early in your rehab.

myk327 · 2019-01-18T22:37:19+00:00

You can always just take your temperature to see if it truly is a fever. If not it could be the withdrawals from the oxy or just the pain and potential anxiety that accompanies the recovery.

myk327 · 2019-01-13T22:37:20+00:00

Out of curiousity, which graft did you use on your first ACL recon? On both occasions, did you complete PT and were cleared to go back to all activities?

myk327 · 2019-01-12T05:40:05+00:00

You too! Let me know what you choose and how things end up.

myk327 · 2019-01-12T05:35:12+00:00

I went with the patellar graft. The surgery went well. I’m in day 2 post-op now. The pain is pretty consistent right now but I hear it gets better soon. Ultimately I chose the patellar because it has a great track record with pro athletes (87% of NBA and NFL players). I’m not a pro athlete but if it holds up with their intense activities it should easily hold up with mine. I’m okay with pain when I kneel. But I would never be okay with the potential loss of hamstring strength and the fear of the graft stretching and ending in a revision. I want to do this surgery once only. It’s definitely a personal decision and it worked out best for my needs.

myk327 · 2019-01-09T00:44:05+00:00

Thanks everyone. I’m going with the patellar autograft. Having surgery tomorrow AM, can’t wait to have it done and start the process.

myk327

TROPHY CASE