ACL Reconstruction with Quad Tendon

[SkiGal]

Hello,

I am having my right ACL reconstructed (revision) using my ipsilateral quadriceps tendon. I have already had 3 ACL recons (2 on left knee and 1 on right knee) so I know a little about physiotherapy already. However, I cannot afford physio this time so I plan on doing it on my own with the knowledge I have gained over my last 3 rehabs.

None of my previous recons have been with a quad tendon. For my left knee I used my hammies first and then an allograft (which is holding up great) and for my right knee I had another allograft which has failed.

My question is are there a few specific exercises that would be more helpful than another for rehabbing the quad graft donor site. I do not know anyone who had had an ACL recon with a quad tendon and the physiotherapists I have spoken to have never had a quad tendon patient.

I am just looking for a few suggestions from some people who may have experience with this graft.

I am assuming that straight leg raises and mini squats are very good as well as riding the stationary bike. Physio is just not in the budget this time. Last summer I spent over $1500 on physio (used an allograft) so I am hoping that I can use a similar program for this rehab. From what I understand there really is no restrictions from the quad harvest.

Thanks,

Denise

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[BlakeyCFC]

Hi Denise

Im 4 weeks post op of an ACL reconstruction using my hamstring. The only exercises i've had from the physio so far is:

squats

leg lunges

an exercise where you lay on your back with a plastic bag under your heel and you raise your knee up with the bag sliding up and down the floor.

also lay on your stomach legs straight and raise your heel up as far as possible and hold, that will help your hamstring.

my physio says your buttock muscles will be weak so if you lay on your side with legs together slightly bending your knees. then raise you knee which is on the top keeping you feet together.

I know your is different to mine but hopefully this can help. Im seeing the physio Wednesday so if you want me to ask I can do, you never know she might have some advice.

How did your hamstring ACL go again? You've got me worried lol!

Thanks

Blakey

[SkiGal]

Thanks for your reply Blakey,

My hammy did not work out so well unfortunately but I am sure yours will. I am a hard skier and I blew it out 2 years after I had it done. Now I have an allograft patellar tendon in my knee and it's holding up quite well. My knee feels much better now than it did when I had the hammy reconstruction.

My left knee had an allograft but I blew that one out as well skiing so I am having it done again with my quad tendon. So this will be my 4th reconstruction between the 2 knees.

Please don't get worried. I am a rare case most people don't blow their ACL's as often as I have. My problem is that I am a crazy skier but I am also overweight. I don't look like I am that heavy but I am built like a brick.

After this reconstruction I will definitely be skiing slower. I am not going to give up skiing but I will stay off the moguls and avoid jumping.

For what it's worth all my recoveries were as smooth as a babies bottom. I have never had a problem with pain, ROM or flexion. I guess I am lucky. But such is life right? No one will die without an ACL. If I blow one of my ACL's again I doubt I will get it fixed. I skied for a while without an ACL in either knee so it can be done.

Just keep doing your exercises to get ROM and flexion. After that it is smooth sailing.

[Yarok]

HI
As far as i know, rehab is the same but You'll have a problem with bending knee, much tender knee around for few months, painfull kneeling. etc, etc
Jarek
all the best
Fizjomanual I Fizjosport - Start

[roycar]

rehab isnt hugely different following quads tendon graft.

anterior knee pain can be more of an issue but that can be addressed if you encounter it i suppose.

its very interesting to hear your history. 4 acl recons and you'l be getting back on the ski's again. fair dues.

humour me with a few answers! would you consider yourself hypermobile? double jointed? do you hyperextend at the knees? elbows? any other joint problems other than your knees?

i assume you've spent a lot of time (and money!) on balance and proprioceptive re-education when you've been rehabbing? were you wearing any sort of brace when skiing?

[SkiGal]

Thanks for your replies. Sorry I didn't check back sooner. I am 5 weeks post op from my acl recon with my quadriceps tendon. I will admit that this recon has been the most painful which I did expect. I still have some swelling but the knee feels pretty good. I ride my stationary bike for about 1 hour every day and do lots of quad sets. My quad is still weak but it's getting stronger. My doc wants me on crutches for 6 weeks because I also had an osteochondral allograft. So my exercises are limited right now because I can't bear much weight for another week.

For roycar,

I am nothing but a fearless idiot on skis. I do things I know I shouldn't do like ski through trees and jump over giant logs. By no means am I hypermobile or so-called double jointed. My ortho gets mad at me all the time telling me that I can only be put back together so many times before my joints fall apart. I am his only 4-time acl recon patient. He also tells me that I should seriously consider giving up skiing but in my opinion that's just dumb. Skiing is what I love and if I have stop and get a knee replacement in 10 years so be it. I will not have my acl's done again if something happens to them. I do wear custom knee braces when I ski which do help with limiting the hyperextension but I tore one my acl's while wearing them. There were a couple of times when I was feeling over-confident and decided not to wear the knee braces and sure enough I tore my acl on the moguls (the one I just had done). The good news is that with me around my ortho will never suffer from lack of business.

BTW, I also have a labrum tear in my shoulder from when I misjudged a landing but I can live with that right now.