Knee Surgery And A Road Worth Taking

It’s the risk we all take as riders, whether freeriding on a powder day or competing on a hardpack day. As snowboarding progresses, so does the incidence of injury-arguably, the most common is the knee injury, be it a minor meniscus tear (cartilage tear) or a severely torn ACL (Anterior Cruciate Ligament). Either way it’s very time-consuming and expensive.

When an athlete is injured, many questions arise. If a doctor says you may have damaged your ACL, the first step in answering important questions is to get an MRI (Magnetic Resonance Imaging). If the MRI shows that you indeed need surgery, then begin your research. Here’s a start on what’s out there to best repair a knee:

With current technology in the medical field, there’re many new procedures in knee reconstruction. Doctor Howard Marans, an orthopedic surgeon who specializes in sports medicine, has had great success with knee reconstruction. He replaces the ACL by using an autograft (your own tissue) or allograft (someone else’s tissue). The allograft seems to have better results-especially for athletes-because the procedure is less painful, has a shorter recovery time, causes less trauma to the knee, and is not a complicated surgery.

Case Number One: The Autograft

Having surgery is an experience, but going through more than one is not something you want to endure. Rossignol rider Dave Basterrechea had to deal with two knee reconstructive surgeries. In the first surgery, Doctor Steve Wasilewski of Sun Valley Sports Medicine reconstructed Dave’s knee by using tissue from his hamstring (an autograft). Dave then started snowboarding three months later, which proved not to be enough time for the autograft to heal and resulted in another tear. So, for the second surgery Doctor Wasilewski had to use tissue from Dave’s patellar tendon (the tendon that runs vertically across the kneecap). Nine months later, the autograft adapted and Dave could perform his normal activities. When the doctor used tissue from Dave’s hamstring to replace his ACL, Dave says his knee felt very strong and he had a better recovery-he just didn’t give the graft enough time to heal. But because tissue from his patellar tendon was used on the second surgery, he now experiences some tendinitis. This is why he recommends using the hamstring when considering an autograft procedure.

Case Number Two: The Allograft

Last season I blew out my knee in a Swatch Boardercross at Bear Mountain. I did not know my knee was completely blown out until the results of the MRI came back. I then researched all the different ways to reconstruct a knee and found Doctor Howard Marans, who informed me of the difference between the autograft and the allograft. I asked him what kind of reconstructive surgery he would choose for his own knee, and without hesitation, he said he would use an allograft. That’s when I decided my research was over and I wanted the allograft.

Doctor Marans called me three weeks later to tell me that he had found a tendon donor and that he was going to use a hamstring from a dead person (hereafter known as a cadaver). The deciding factor of using a dead person’s hamstring or patella tendon is based on the availability.

Using a cadaver part to reconstruct a knee has many benefits-instead of taking away from your own tissue (e.g., a hamstring or patellar tendon) you can use someone else’s who doesn’t need it. Unlike an autograft, the allograft is less traumatizing to the leg because you’re not using your own tissue to reconstruct your knee (which creates another injury because you are taking a piece away from a “perfect” part. This is why there is a lot less pain for the patient who opts to use cadaver tissue. And of course, with less trauma to the leg there is less rehabilitation time.

Rehabilitation or physical therapy can cost up to 150 dollars a day. That can really add up quickly. By using cadaver tissue you can save money in physical therapy, because rehab time is lless-and if you’re wondering, the price of using cadaver tissue is about the same as using your own.

Not only is an allograft less painful in the immediate post op, it can save you from aches and pains down the road. Also, Doctor Marans says, “By using a cadaver you have less chance of getting tendinitis.” Tendinitis of the patellar tendon occurs often in people who have had their ACL reconstructed from a piece of their own patellar tendon.

After I underwent surgery, I was up and walking without crutches in only two days. I had close to no pain and did not lose any flexation. I was amazed how well everything went. All those horror stories were not true for me. A week later the staples were taken out and my scar was hardly noticeable. I have seen knee-surgery scars as long as four inches down the knee. I was lucky to get through my surgery with only a half-inch scar. I definitely recommend looking into an allograft if you ever have to experience knee reconstruction. And of course this goes without saying-flat landings and knees don’t mix!