Orthopedic Surgeon (knee) Recommendations

[ericb]

I'm looking for a good orthopedic surgeon....specifically someone adept at ACL reconstruction. According to an MD buddy of mine hamstring graft is becoming the preferred method, and from what I can tell, you are pretty much picking a method when you choose your surgeon. If anyone has any personal experience (pos or neg) with any local Docs, I'd love to hear about them.

[ryland_moore]

I had my ACL and meniscus replaced recently(ACL in December 05)and meniscus in March '05. I tore the meniscus while heading into Mowich side of Rainier. Had to hop out all the way from the saddle above the glacier to the TH. It tore because I was missing my ACL, which I tore on Denali in '03 but nevIer knew about it (I heard the pop skiing down from 11k to 9,800 to pick up a cache but kept climbing). the meniscus tore due to lack of support from no ACL. Anyway, when I got the meniscus fixed, I took many recs. from friends who were skiers, climbers, and snowboarders, plus runners and bikers. Overwhelmingly they recommended the Portland Knee Clinic. These guys were awesome! With the meniscus surgery, I was actually dancing for St. Patrick's day one week after the surgery. The ACl surgerer was more intense and painful, but my doc wanted me moving around on crutches within 5 days post surgery and in the gym 10 days after the surgery. he really pushed me. I had the patella ACL surgery. This was recommended to me by my doc becasue of how active I was. He said that if I wanted a quick recovery that this was the best way to go. Hamstring version takes a lot longer to recover. Cadaver you do have a chance of rejection (not sure how this works becasue no blood flow but that is what they said)

 

My first night in the gym I met a guy who had ACL surgery over a yeaw ago who had the hamstring hsurgery and he said he was on cruthes for three months and never got into the gym until after 5 months. He could not walk normally for 4 monts and was only able to run after 6 months.

 

I on the other hand was already training for a half ironman by January, and running up to 10 miles by end of February.

 

The only down fall with a patella tendon surgery is that the knee can be sore and it will be difficult to ever remain on your knees for a long period of time. I didn't care about this and it has not affected me since. It is sore from time to time, but doesn't affect my climbing or training for triathlon.

 

A good doctor is key. I would go to whomever the Seattle Sonics use. The Portland Knee Clinic is who the Trailblazers use as well.

 

Good luck!

 

[rbwen]

I had mine done by Dr. Lawrence Holland at Swedish and I highly recommend him.

 

http://www.swedish.org/11762.cfm

 

I went the patellar tendon route because I asked him what he would do for a pro athlete or a family member. It took a few months longer in rehab but I think it's stronger (no chance of denial as in an allograft (cadaver) and not made of hamstring strips). Plus the patellar tendon will grow back, the hamstring won't.

 

PM me if you want further details.

 

Also, lots of discussion on the subject here:

 

http://factotem.org/cgi-bin/kneebbs.pl

 

rbwen

[Doug]

Dr. Steven Ratcliffe. He has an office on Gilman Blvd. and on 116th in Bellevue. He was originally recommended to me by a guy who had his ACL rebuilt by him. He has scoped me twice and did a great job. My brother in law is an Orthotics & Prosthetics guy and knows most of the Orthopedics guys in the region; he rates Ratcliffe as the best. He also has a great bedside manner. If you see him, ask him about his hobby - Aerobatic flying!

[ericb]

Thanks for the input all....a friend of mine recommended Dr. Zorn, same practice as Holland, and the ortho for the Sonics. Looks like March 23rd for me unless they get a cancellation. He's a hamstring guy.

 

Ryland - I think your fast recovery was as much due to personal factors as the fact that you used the PAT method. Generally there's not much difference in recovery times, although the PAT tends to be faster right out of the gate due to bone-to-bone bonding, the recovery curves converge at ~ the 4 month mark. I've had some mild patellar tendonitis in the past thanks to soccer in my youth, so given the risk of patella complications in the graft area, I've decided to go the hamstring route.

Edited February 24, 2007 by ericb

[high_on_rock]

 

Found him. Joel Shapiro http://www.swedish.org/body.cfm?id=6&action=detail&ref=927&HC1=Orthopedic%20Surgery&HC2=%2D%20blank%20%2D&HC3=%2D%20blank%20%2D

 

He went in, cleaned up the meniscus and discovered that I had about 10% of my ACL left, but did not fix it while in there. I then had to fully recoup my knee before I could have it opened again to fix the ACL. In total, it added about 6-7 months to my down time.

The reason? Golf tee time, or an actual appointment that was more important than 6 months of my life. I don't know. I do know that I would never go back to him.

 

I loved the Swede hospital though.

Edited February 25, 2007 by high_on_rock

[gruntpltleader]

If you head into portland try Dr. Crawford at OHSU. I didn't tear the ACL, but completely tore the PCL, Meniscus, and a bone fragment when the PCL detatched. Portland Knee Clinic referred me to him. Great guy, and one of the best surgeons on the west coast.

 

A big plus is to do as much physical therapy prior to the surgury as possible. It really speeds up the healing process, as your muscles will atrophy very quickly.

 

I don't know how you feel about cadaver parts or allografts, but from what I read and what the doc's told me that they heal faster and stronger. You are not taking pieces of tendon from other parts of your leg/knee.

 

 

It totalled my climbing time last spring, summer, but I am looking forward to this year.

 

good luck!

 

 

Edited February 25, 2007 by gruntpltleader

[brukb]

You can't really go wrong with Holland or Zorn. I would also recommend Dr Peterson at the Sports Medicine Clinic, excellent at not only surgery but also getting you back to your activity.

After working with a lot of post-op ACLs I would also opt for the hamstring option. The only conundrum is that even after the ACL is reconstructed (no matter what the surgeon says), it never provides stability to the knee as reliable as the original ligament. Functionally the hamstrings provides dynamic support to the ACL, so its a bit of a catch 22 after surgery; you need excellent hamstring function to support the reconstructed ACL, yet it becomes very weak, possibly permanently, due to the harvest of tendon tissue for the ACL graft.

Get good rehab!

[davidio]

I'll second gruntpltleader's suggestion to beef up your legs before surgery - it really helps. At 27, i've had both of my ACL's replaced (former ski racer and pro patroller) so i feel your pain (well, probably more frustration than pain at this point).

 

I would also say to get a road bike after surgery (if you don't already have one) and ride it as much as possible when you're ok to ride. the constant motion loosens up your knee and it's great low-impact strength conditioning for your legs. If at all possible, try and get your doc to write a prescription for one I had a friend have one covered with his insurance (i wasn't so lucky).

 

Best of luck to you, just take it easy afterward and don't go dancing the week after you get cut.

[BirdDog]

Had my ACL (patella method) in fall of '95 by a Doc @ Seattle Ortho & Fracture Clinic in Seattle. Doc retired now, but a great clinic in general. Took about a year to fully recover, re: mobility. Knee is about 95% as good as it ever was. Some pain on long downhills now, but I think that's more due to age - 49.

 

Get in as great a shape as possible before surgery. Ask your Doc about wieghts etc... Get a road bike, and get out a ride on the flats. I was riding 6 weeks after surgery and still ride a couple thousand miles a year.

 

Best of Luck - you will be just fine.

[ericb]

Thanks for all the input...very helpful. So I´m about 2 weeks since my injury, and have surgery scheduled 3 weeks from Friday. I left for a scheduled vacation in Costa Rica (currenlty in CR)last Saturday and will not return until next Monday. I was just able to get my consultation with Zorn before I left thanks to a cancellation, and asked in parting what I could be doing pre-surgery to prepare. His PA mentioned stationary biking to recover range of motion, and straight leg quad raises to maintain quad strength....nothing about the hamstring. Perhaps they are assuming that I´m in pretty good shape already, and will not lose much in the 5-1/2 weeks between injury in surgery....who can say.

 

I´m just now able to walk w/o brace comfortably, and am using the recumbant bike here at the resort. What else did you guys do pre-surgery to prepare? I´ve got five more days down here, and with limited facilities, and then basically 2.5 weeks in Seattle to do whatever I can.

 

Appreciate any advice you can offer....Thanks!