ACL - 20 months later

[johannus]

sounds like you're getting it all figured out, but to add my 2 cents..

i'm a believer in pt, go if you can, as often as you can. although my situation was different (partial tear of acl & mcl), pt helped more in muscle recovery than i thought. after a knee injury your surrounding muscles compensate for the weakness. as such, the simple firing of the quadricep muscle during simple movements was lacking compared to my healthy knee. i wouldn't have noticed it had i not had an electrical device that measured the firing of specific muscles. pt helped condition the target muscle to fully contract which ultimately helped stabalize the knee.

unknowingly favoring the good knee and continued atrophy (lack of muscle development) of the bad knee could be indications of some important leg muscles not adequately supporting and motioning the knee which would lead to alignment issues, pain, yada, yada.

hopefully all goes well, and you'll get your knee dialed in...

[splat]

Not trying to throw a bum trip in the report here, but since this was the top thread on acl injuries, I thught I'd paste this up for anyone scheduled for
an operation using cadaver tissue:



Hospitals asked to return cadaver tissue after patient is infected
POSTED: 2:23 p.m. EST, November 22, 2006
Adjust font size:
(AP) -- A Minnesota patient apparently was infected with an unusual germ from cadaver tissue used during routine knee surgery -- a discovery that has led the nation's largest tissue bank to ask 750 hospitals around the country to return 2,400 tendons and other body parts as a precaution.

A hospital reported the bacterial infection in September to the Centers for Disease Control and Prevention, which launched an intense, nationwide effort to search for more cases.

None have been found, but the incident shows the dangers that patients face when receiving such tissue and how dependent they are on the companies supplying it to ensure its safety.

A three-month investigation by The Associated Press, published in June, detailed problems that can arise from cadaver tissue used in more than a million medical procedures each year in the United States, especially knee and back surgeries.

Two scandals involving tissue suppliers have occurred in the last year, and the federal Food and Drug Administration has formed a task force to look for regulatory gaps that threaten safety.

The new case involves a company that many health officials and tissue company executives regard as an industry leader and standard-bearer: Musculoskeletal Transplant Foundation, or MTF, of Edison, New Jersey. In more than 20 years of supplying 2.7 million pieces of bone, skin and other tissues, this is the company's first reported infection, said a spokeswoman, Cindy Gordon.

In April, MTF noticed an increase in the number of tissues rejected for not passing sterility tests at its Jessup, Pennsylvania, processing plant -- one of two such facilities it operates. Tissues were quarantined and about 150 that failed tests were destroyed, Gordon said.

In September, the CDC notified the company that an unusual infection had been reported in a Minnesota patient who received MTF-supplied tissue during surgery to fix a torn ligament a week earlier. Fluid from the patient's knee joint grew Chryseobacterium meningosepticum -- a germ never previously linked to tissue or organ transplants, said Dr. Arjun Srinivasan of the CDC.

"It's a very rare cause of infections in the health care setting," so the agency asked more than 1,000 public health officials, infectious-disease doctors, microbiologists and orthopedic surgeons around the country to search for additional cases, he said.

Five other people had received tissue from the same donor and none developed infections. MTF retrieved a sixth sample, and tests at CDC revealed it had the same bacteria as the Minnesota patient.

As a precaution, MTF decided to go back six months before the Minnesota case -- to February -- and try to retrieve as many of the 4,700 tissues supplied by the Jessup facility as possible, Gordon said. About 2,300 had already been implanted, and no other infections have been reported, she said. Hospitals have been asked to send back the remaining 2,400.

"This was not something that the FDA or the CDC asked us to do," but a voluntary action to ensure patient safety, Gordon said.

The Minnesota patient made a full recovery after antibiotic treatment and still has the cadaver tendon, said Joel Osborne, MTF vice president of quality assurance and regulatory affairs. MTF would not identify the hospital or give details about the patient.

Srinivasan praised the company's handling of the case.

"They've been very aggressive working with us" to try to locate the source of the germ, which may have been introduced during processing rather than originating with the donor, he said.

FDA spokeswoman Julie Zawisza emphasized that this case is not like the two earlier scandals in the human tissue industry, "where the suitability of the human donors was called into question." She said MTF is cooperating with the FDA on the case.

Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

[lph]

Although infected allografts are exceedingly rare, they can't absolutely assure a sterile specimen. The supplier can do absolutely everything right and it can still happen.

That being said, if my ACL goes, I am getting a cadaver graft.

[Huckwheat]

How about a current report for all your fans Kellie?

Hope it is doing better!! In Tahoe right now, we dont even know if skiing hurts our knees.......so, dont feel bad about skipping a few days.

[Kellie]

Good days and bad days - I have had some pain free days and am realizing that I need more strengthening to be sure. I also realize how important stretching the rectus femoris is and that it really does play into my pain. I have been working on hero pose in yoga, which is challenging from a flexion standpoint, but great for releasing the rectus femoris. I am actually pretty amazed at how much it helps. I haven't skied on it again since going to PT - Wednesday should be the big day - gotta admit I'm a bit nervous, but hopeful I can at least keep the swelling down so my muscles will fire enough to protect the darn thing.