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Enhanced Biologic ACL Reconstruction

Enhanced Biologic ACL Reconstruction 2016-10-17T11:36:43+00:00

Project Description

ACL (anterior cruciate ligament) reconstruction is critical to restore stability and function to the knee when injured. The ACL provides support during pivoting and stop-start activities and is required for participation in most sporting activities and exercise. Once ruptured the ACL has limited or no capacity to “heal itself”. In active, healthy people reconstruction is recommended immediately, or soon following injury, to protect the remaining knee structures. An ACL deficient knee is prone to develop progressive damage to the menisci and cartilage (soft tissue structures of the knee) as the joint “shifts” inappropriately. Arthritis is the end result of this downward spiral.

What is enhanced biologic ACL reconstruction?
A series of patient specific ACL reconstruction options, customized for the individual. The best option is selected individually for each patient.

  • Allograft: (cadaver tissue from a donor)
    • The allograft provides immediate strength, far exceeding the native ACL.
    • This choice speeds the early recovery process as the harvest of graft can often be the most difficult part of the surgery to recover from. Adult patients often choose this type of graft to maximally speed their return to work, driving, taking care of children and other daily demands.
    • By using allograft the risks and pain associated with harvesting graft (autograft) from one’s own leg is avoided.
    • The allograft is sterile and will not transmit disease.
    • The allograft is not subject to rejection and does not require anti-rejection drugs.
    • These high quality, specially processed and young allografts are readily available in Dr. Davidson’s practice.
  • Combination Allograft – Autograft
    • This ACL procedure uses allograft tissue to provide immediate strength and limit the amount of autograft (tissue harvested from one’s own body) needed to form a new ACL.
    • A small piece of hamstring (Gracilis tendon, about 3mm wide) is harvested to augment the allograft, forming a combination 4 strand graft. This small hamstring tendon is typically not “missed” by the patient. The donor site heals in the weeks following surgery.
    • By using one’s own tissue (autograft) the healing of the allograft is enhanced and the time of biologic incorporation is promoted.
    • This graft option is commonly recommended for most adults to offer a combination of rapid early recovery, immediate stability, and excellent long term healing.
  • Autograft (tissue from one’s own body)
    • This option is typically selected for youth athletes anxious to return as soon as possible to sport.
    • The healing time for autograft is somewhat faster than allograft, but the time of initial recovery is longer, as the body needs to heal from the graft harvest.
    • The gracilis and semitendinosis (hamstrings) are harvested to yield a strong graft making a new ACL.

 

What is allograft (cadaver donor) tissue?

  • Allograft (cadaver) tissue is donated tissue from younger donors used to make a new ligament (ACL).
  • It is processed and shipped from a specifically selected tissue bank after the graft is individually reviewed and approved by Dr. Davidson on the patient’s behalf.
  • This tissue is specifically selected in each case to be from a younger donor and very carefully screened and rendered sterile.
  • There are no living organisms, cells or “germs” on these grafts.
  • There is no rejection reaction associated with this type of allograft tissue.
  • The tissue comes from tendons around the ankle of donors.
  • The tissue provides excellent immediate strength, being many times stronger than a native ACL.

 

PRP (platelet rich plasma) enhanced ACL surgery

  • PRP can be prepared from the patients own blood, concentrating Growth Factors, potentially enhancing healing of the ligament during recovery.
  • In this procedure, using a centrifuge and special separation tubes, the platelets containing growth factors are concentrated into a sutureable matrix and then fastened to the graft prior to insertion into the bone tunnels.
  • Early evidence suggests that the PRP may enhance and speed healing of the ACL reconstruction.
  • Please note, this procedure is unfortunately not currently covered by insurances and is available only on a special request basis.

What Some of Our ACL Reconstruction Surgery Patients Say.

Hello Dr. Davidson,

I don’t know if you remember me, but I was a patient of yours back in St. Pete. You performed a meniscal allograft and an ACL replacement on me back around 2003. It’s been awhile, but I wanted to thank you and your assistant Dennis for your help in getting me back up and active. I didn’t know you moved to Utah until I Googled you a few minutes ago. Anyway, I thought I would pass along the results from my latest effort in the Gasparilla 15k. It’s not spectacular, but 8:12 miles for a 46 year old guy with four knee operations isn’t too shabby either. I couldn’t have done it without your help.

Best of luck out in Park City. It’s a beautiful place.

Warmest Regards,
John C.
(Meniscal Allograft and an ACL Replacement)

John C., Meniscal Allograft and an ACL Replacement
Dr. Davidson
My wife was recently in need of your services and we looked to find you at TBO, only to find you have moved to Utah. You may recall that I received a full knee repair from you in 1999, including reconstruction of my ACL and meniscus. I am happy to tell you that these many years later I am going strong and have had no problems with it. I made a full recovery and complete return to sports and police work. I thank you for your good work and excellent care. Best wishes to you and your family in Utah. Thanks for the opportunity to have a pain free and normal knee.

Andy H.
(ACL Reconstruction)

Andy H., ACL Reconstruction
Hello Dr. Phil Davidson.

You may or may not remember me, but I am Cynthia S, a former work comp patient of yours whom you treated at T.B.O.S. center in St. Pete. Over the years I got to know you, Dennis and your staff very well. You literally took my knee apart and put it back together. You did a tremendous amount of work on my right knee, and an arthroscopic surgery on my left (other) knee, as well. While I faced some difficulties due to the severity of my injury, you and your staff were with me all the way and I am very grateful. Needless to say, when I called Tampa Bay Orthopedics to schedule my annual appointment, I was speechless to learn that you had relocated to Utah.

The last time that I saw you, you had a USF student intern who was present when you examined me, and I wanted to tell her that no matter how much interning she completed, I hope that she will be the kind of doctor who is empathetic to ALL patients, as you have been with me. Your ability to do that was unlike any other doctor who had treated me in the past.

I have been in the work comp system since 1998, so you know that I have seen my share of snobby, cold, and unsympathetic doctors, just because the patient is work comp. Dr. Davidson, thank you very much for caring for me as if I were Michael Jordan or Scottie Pippen, even though I was just plain old “Cynthia”! I thank you, and my entire family does too. I couldn’t figure out who was more upset with your relocation, my mom or me!

Like I said, over the years, since 2002 or 2003, I think, we got to know your staff very well, and I spent some time at the Palms of Pasadena Hospital. I could go on longer, but I won’t, I know that your time is quite valuable. Although we did not reach all of the goals that we set, I am truly grateful for the fact that you tried and I was able to reach many of my goals. You probably thought that in some way you had failed to helped me, but the fact that your effort was ABOVE and BEYOND, we were both WINNERS! The citizens of Utah have been blessed with a true public servant!

Thank you, Dr. Phil Davidson, and may God bless you and your family,
Cynthia S.
(Revision ACL Surgery, Osteochondral Allograft and Meniscal Transplant)

Cynthia S., Revision ACL Surgery, Osteochondral Allograft and Meniscal Transplant