23 August 2009
Female athletes ACL injuries
Here is a video from youtube.com about female student-athletes and A.C.L. injuries
ACL injuries in female soccer players
My knee problems started back in high school when I first tore the A.C.L. of my right knee playing soccer, at age 16. Since then I have read and heard about many more injuries to young female athletes. Especially knee injuries. I was given this article by a friend last year and was both fascinated and saddened by the findings.
The story of Janelle is similar to my own. I started playing soccer at age 4 and was playing on a traveling competitive team by age 8. I played on a competitive club team as well as started on the varsity soccer team in high school all four years. You could say I follow the idea that I am a girl "who believes they are as capable and as tough as any boy."
The part of the article I find to be most intriguing is that "the nature of both [Janelle's] A.C.L. injuries — occurring, as they did, without contact and seemingly in the absence of any extraordinary circumstances — is the very thing that perplexes A.C.L. researchers. It takes 2,000 Newtons (a measure of force) to rip an A.C.L. apart. The mystery is why a knee works properly for many years — through game after game, practice after practice, long season after long season, for tens of thousands of repetitions — and then, without warning, a tiny but crucial component suddenly malfunctions." Prior to my first A.C.L. tear I was in the best shape of my life. It was the summer before my senior year in high school which is THE crucial recruiting time for any player interested in playing soccer in college. I was in outstanding shape and ready to be seen by college recruiters who I had already been in contact with. In July I was at a tournament in Colorado, chasing after a ball where I planted wrong and heard that infamous "snap". Every female soccer player fears the letters A-C-L and they all know (without their own experience) that the "snap" means trouble. This article spoke to me, and made me realize that I am not alone and that there are many other young women out there who have experienced, or will experience, the same injury I did.
I often get asked the question "If you knew then what you know now, would you have changed anything? Would you have quit playing soccer?" My answer is always the same "there is no way you could have stopped me from playing soccer". I do not regret my decision and feel that although I have been through quite a long road of knee injuries and surgeries over the past 12 years, I am a stronger person now and the path since my first A.C.L. injury has lead me to where I am today, and I am happy.
The story of Janelle is similar to my own. I started playing soccer at age 4 and was playing on a traveling competitive team by age 8. I played on a competitive club team as well as started on the varsity soccer team in high school all four years. You could say I follow the idea that I am a girl "who believes they are as capable and as tough as any boy."
The part of the article I find to be most intriguing is that "the nature of both [Janelle's] A.C.L. injuries — occurring, as they did, without contact and seemingly in the absence of any extraordinary circumstances — is the very thing that perplexes A.C.L. researchers. It takes 2,000 Newtons (a measure of force) to rip an A.C.L. apart. The mystery is why a knee works properly for many years — through game after game, practice after practice, long season after long season, for tens of thousands of repetitions — and then, without warning, a tiny but crucial component suddenly malfunctions." Prior to my first A.C.L. tear I was in the best shape of my life. It was the summer before my senior year in high school which is THE crucial recruiting time for any player interested in playing soccer in college. I was in outstanding shape and ready to be seen by college recruiters who I had already been in contact with. In July I was at a tournament in Colorado, chasing after a ball where I planted wrong and heard that infamous "snap". Every female soccer player fears the letters A-C-L and they all know (without their own experience) that the "snap" means trouble. This article spoke to me, and made me realize that I am not alone and that there are many other young women out there who have experienced, or will experience, the same injury I did.
I often get asked the question "If you knew then what you know now, would you have changed anything? Would you have quit playing soccer?" My answer is always the same "there is no way you could have stopped me from playing soccer". I do not regret my decision and feel that although I have been through quite a long road of knee injuries and surgeries over the past 12 years, I am a stronger person now and the path since my first A.C.L. injury has lead me to where I am today, and I am happy.
10 August 2009
Carticel Surgery - one man's diary
I stumbled upon this blog (Jim's bionic knee) a few months ago and felt as if I was reading from my own post-surgery diary (if I had kept one). He uses phrases that I have uttered word-for-word during my rehab. If anyone is thinking about having the ACI surgery here is a great overview of everything about this surgery, from the patent's perspective. In hindsight I wish I had followed through with keeping a journal of my rehab. It's hard to believe it's been 9 months since my surgery. I will say again that I have no regrets about my decision to go through with this surgery. My life had gotten to a point where simple daily activities were made harder because of the chronic pain I had. While I am not 100% back to "normal" yet I feel much better than I had before the surgery and know that I will continue to feel better. I did not have a goal of going back to soccer, rugby or triathlons but am looking forward to the next 50 years of my life and instead of saying "I had a total knee replacement at 35-40" I can say...I had this über cool surgery where they grew my own cells to make new cartilage and fixed my knee." (yes I do plan on using the word "über" when I'm 80.)
After surgery - scar treatment
I personally subscribe to the idea that scars give you something to talk about and are a sign of your past. I take pride in my scars (mainly because they tell a story). Some great do's & dont's from a fitnessmagazine.com article are listed here: DON'T expose new scars to the sun. Ultraviolet rays can slow the healing process and, since they stimulate melanocytes (the cells that produce pigment), can cause dark discoloration. When you're outdoors, always slather on a broad-spectrum sunscreen with an SPF of 15 or higher. to try: Neutrogena Healthy Defense Oil-Free Sunblock SPF 30 and L'Oréal Ombrelle Sunscreen Lotion SPF 30. DO gently massage the mark once the surface is completely healed. "Massage helps break down the dense bands of collagen that attach to underlying tissue—a common reaction to cesarean sections, appendectomies or hand wounds," notes Robert Bernard, M.D., a plastic surgeon based in White Plains, New York, and president-elect of the American Society for Aesthetic Plastic Surgery. Once skin has grown over the site, gently massage the area with lotion in a circular manner for 15 to 30 seconds a few times a day. Another preemptive strike: Apply Mederma*, a nonprescription ointment that contains onion extract, which has been shown to inhibit the formation of collagen.
*For my first ACL surgery in 1997, I used Vitamin E capsules. I would pierce a whole into the tiny capsule and use the pure Vitamin E oil on my scar. The above information suggests NOT to do this, but I had no negative reaction to this treatment. I don't recall putting anything on my scar from my 2nd ACL surgery besides lotion, and that scar has healed just fine. It is a relatively thick scar (maybe a 1/4 inch wide) but it is not discolored at all. For my most recent ACI surgery, since my scar is 6+ inches in length I decided to be more proactive in my scar reduction efforts. I have been using Mederma (not as often as is suggested) since my doctor gave me the OK. I have been happy with it, but agree with several online reviews that it is a bit pricey for a small amount. I will also agree that a small amount goes a long way. I have two tubes, one at home and one at work. I do try to apply it with some regularity and I am now almost 9 months post op and I still have a decent amount in both tubes. I think the most important feature of Mederma is that you are applying a nourishing substance and massaging the scar multiple times a day, which helps breakdown the scar tissue underneath the scar, which is crucial.
DON'T treat with vitamin E. Despite what your grandmother may have told you, vitamin E has been shown in a University of Miami study to impair wound healing. (In addition, one-third of the patients tested also developed an allergic reaction.)
DO ask your physician to remove external stitches before they leave "track" marks. To prevent those little bumps that form on either side of the incision and become permanent reminders, Dr. Bernard routinely removes stitches after a week. (full article online at fitnessmagazine.com)
*For my first ACL surgery in 1997, I used Vitamin E capsules. I would pierce a whole into the tiny capsule and use the pure Vitamin E oil on my scar. The above information suggests NOT to do this, but I had no negative reaction to this treatment. I don't recall putting anything on my scar from my 2nd ACL surgery besides lotion, and that scar has healed just fine. It is a relatively thick scar (maybe a 1/4 inch wide) but it is not discolored at all. For my most recent ACI surgery, since my scar is 6+ inches in length I decided to be more proactive in my scar reduction efforts. I have been using Mederma (not as often as is suggested) since my doctor gave me the OK. I have been happy with it, but agree with several online reviews that it is a bit pricey for a small amount. I will also agree that a small amount goes a long way. I have two tubes, one at home and one at work. I do try to apply it with some regularity and I am now almost 9 months post op and I still have a decent amount in both tubes. I think the most important feature of Mederma is that you are applying a nourishing substance and massaging the scar multiple times a day, which helps breakdown the scar tissue underneath the scar, which is crucial.
28 July 2009
The Carticel procedure
The best resource for information on the Carticel procedure is at the Carticel Website. For a great video describing the process of implantation click on the image below to be taken to the full video.
27 July 2009
Is Carticel right for you?
The answer to the above question for some people is, no. Click the image below to take the Carticel.com quiz:
24 July 2009
Carticel research results
There continues to be greater research done to support the long term effects of cartilage replacement. There are always two sides to every story and I have come across some positive and some not-so-positive articles to support this claim. At the end of the day though I am still hands down happy that I did decide to go through with the Carticel procedure. I am only 8 months into my recovery but I can say that my quality of life has been vastly improved from before the surgery. I cannot run, but that is not a goal of mine. I want to make sure I can walk (as simple as it sounds, it hasn't been easy as of late), chase my kids around, bike, hike, do yoga, be comfortable working out, I have no plans of running a marathon. This surgery, for me at least, wasn't an action to return to the athletic life I had before, it was to continue to lead the life that is ahead of me, and to NOT have a knee replacement at age 40. I will touch on whether or not Carticel is the right procedure for you in another post. I have pasted a few snippets of articles I found, the appropriate links are also included to take you to the full article.
An article earlier this year from Hays Pharmaceutical states: "The findings show that nearly 90 per cent of patients using the drug saw an improvement in their knee function and that this continued for almost ten years...These data suggest that the ACI technique not only works, but when it works, the results will last for a long time."
(view full article)
An article on rxlist.com goes into detail about the most common adverse effects of the surgery:
"The most common serious adverse events (> 5% of patients), derived from the STAR(Study of the Treatment of Articular Repair) study include arthrofibrosis/joint adhesion, graft overgrowth, chondromalacia or chondrosis, cartilage injury, graft complication, meniscal lesion and graft delamination. Only serious adverse events were collected in this study." (see list below for greater detail)
An article earlier this year from Hays Pharmaceutical states: "The findings show that nearly 90 per cent of patients using the drug saw an improvement in their knee function and that this continued for almost ten years...These data suggest that the ACI technique not only works, but when it works, the results will last for a long time."
(view full article)
An article on rxlist.com goes into detail about the most common adverse effects of the surgery:
"The most common serious adverse events (> 5% of patients), derived from the STAR(Study of the Treatment of Articular Repair) study include arthrofibrosis/joint adhesion, graft overgrowth, chondromalacia or chondrosis, cartilage injury, graft complication, meniscal lesion and graft delamination. Only serious adverse events were collected in this study." (see list below for greater detail)
20 July 2009
Cartilage damage - roadmap
Here is a brief overview of the knee with particular attention to injured articular cartilage. Notice in the image above the pink/red area. This is a simple snapshot of what damaged cartilage looks like and a simple easy to understand look at the inside of the knee.
What is cartilage?
Cartilage is a type of connective tissue in the body. It is made of cells called chondrocytes embedded in a matrix, strengthened with fibers of collagen and sometimes elastin, depending on the type of cartilage. There are three different types: hyaline cartilage, elastic cartilage, and fibrocartilage. Cartilage serves to provide structure and support to the body's other tissues without being as hard or rigid as bone. It can also provide a cushioning effect in joints.
Cartilage is avascular, meaning that it is not supplied by blood vessels. Instead, nutrients diffuse through the matrix. Cartilage is usually flexible, again depending on the type. Some of the bodily structures that include cartilage are the ears, nose, ribcage, and intervertebral discs.
(view the full article)
Torn Meniscus
The meniscus is a C-shaped piece of fibrocartilage which is located at the peripheral aspect of the joint. The majority of the meniscus has no blood supply. For that reason, when damaged, the meniscus is unable to undergo the normal healing process that occurs in most of the rest of the body. In addition, with age, the meniscus begins to deteriorate, often developing degenerative tears. Typically, when the meniscus is damaged, the torn piece begins to move in an abnormal fashion inside the joint.
(view the full article)
Benefits of cartilage repair
Each year, hundreds of million of people injure the cartilage in their knees, shoulders and other joints. Whatever the cause, the result is the same: pain that makes it difficult or impossible for you to lead the active lifestyle you wish to enjoy. Unfortunately, these injuries happen to people considered too young to undergo artificial joint replacement surgery. Many patients have been living with joint pain for years. Some cannot remember a time when their knee didn't throb or swell with every step, flight of stairs or short jog. Fortunately, there are For more information visit: cartilage.org a website dedicated to cartilage repair. )
14 July 2009
My Knee Story
Who am I? Why am I writing a blog about knees? Good questions!
Me: I am a 28 year old female, and I have had four knee surgeries. Two Anterior Cruciate Ligament (ACL) Reconstructions (one left, one right), one arthroscopic (right knee), one Autologous Chondrocyte Implantation (ACI) /Carticel (right knee)...in 12 years.
I now consider myself an ex-athlete, I grew up playing soccer competitively for 15 years, played women's rugby for two years in college (yes that is a real sport), and ran triathlons for two and a half years. Now I bike, swim, hike, do yoga and pilates and look towards the future. My knees need to last me a long while, it's time I start being nice to them.
Why?: After my diagnosis' I was looking for some sort of resource or group where I could talk to others who had these surgeries, and find out just what was about to happen. For my first ACL surgery in 1996 the Internet (and dial-up connection) was not a good outlet. Now after my ACI surgery the wealth of information available online was helpful, but overwhelming, and I found very little personal connection.
This blog will be a resource for helpful, concise information and a way for others who have undergone these knee surgeries (or are about to) or have other such knee injuries to connect to each other, share tips, advice, or lend a friendly ear. Please feel free to comment with questions, or advice, links, or references.
Me: I am a 28 year old female, and I have had four knee surgeries. Two Anterior Cruciate Ligament (ACL) Reconstructions (one left, one right), one arthroscopic (right knee), one Autologous Chondrocyte Implantation (ACI) /Carticel (right knee)...in 12 years.
I now consider myself an ex-athlete, I grew up playing soccer competitively for 15 years, played women's rugby for two years in college (yes that is a real sport), and ran triathlons for two and a half years. Now I bike, swim, hike, do yoga and pilates and look towards the future. My knees need to last me a long while, it's time I start being nice to them.
Why?: After my diagnosis' I was looking for some sort of resource or group where I could talk to others who had these surgeries, and find out just what was about to happen. For my first ACL surgery in 1996 the Internet (and dial-up connection) was not a good outlet. Now after my ACI surgery the wealth of information available online was helpful, but overwhelming, and I found very little personal connection.
This blog will be a resource for helpful, concise information and a way for others who have undergone these knee surgeries (or are about to) or have other such knee injuries to connect to each other, share tips, advice, or lend a friendly ear. Please feel free to comment with questions, or advice, links, or references.
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