Knee surgery worth it, a guide to the ACL

BY SAM BAUMAN

Appeal Outdoor Columnist

I'm sure that many are as bored with the story of my right knee replacement as I am, but I figure for those facing a similar complete knee job, this might be the right moment to bring readers up to date.

Next week marks two months since the operation, and with the exception of a short bout of gout triggered by the surgery, progress has been just about as predicted. I now walk freely, although I slipped going down the aisle at the Shakespeare Festival last Saturday and landed on my bum. Just this week I started walking up stairways, two flights to the office. Tough, but doable.

The physical therapy has been relentless and the knee now goes to 0 degrees flat and 123 degrees at angle, about where it should be. Daily exercises are a must and I've been slowly integrating some of my old workout routine in with the special knee moves.

In sum, it's been painful at times and hard work at others, but if there is one thing I'd like to pass along, it's that all of the effort and pain are a lot better than the alternative " giving up hiking and skiing.

THE TOLL OF ACL INJURIES

Here's news of the other major surgery among skiers. With an estimated 80,000 anterior cruciate ligament tears happening each year in the United States " including recently to golfer Tiger Woods " choosing the best replacement ligament for surgery is one key to success. A study released in Orlando, Fla., at the 2008 American Orthopaedic Society for Sports Medicine's Annual Meeting, found that with a failure rate of almost 24 percent, the use of cadaver replacement ligaments may not be the best choice for young, athletic patients.

"Choosing a replacement ligament, whether it comes from a cadaver or the patient's own tissue, is a decision that must be made by the surgeon and patient," said co-author Kurre Luber, orthopedic surgery fellow at Mississippi Sports Medicine and Orthopaedic Center. "This study found a very high failure rate in patients 40 years and younger with high activity levels in ACL-dependent sports like tennis, basketball, soccer and downhill skiing.

"Certainly, it would be naïve to think that only the graft selection led to these failures, we also need to look at surgical technique. Better outcome measures also need to be developed. However, this study definitely raises questions about the validity of using cadaver tissue in this patient subgroup."

The ACL is one of the major stabilizing ligaments of the knee. Located in the center of the knee joint, it runs from the thigh bone to the shin bone through the center of the knee. Typically, tearing the ACL occurs with a sudden direction change. To repair a torn ACL, a surgeon replaces the damaged ligament with a new one, either from a cadaver or the patient's own body. Typically, either the patellar-tendon bone or the hamstring tendons are used.

In the study, 64 patients, 40 years old or younger with high activity levels who had ACL reconstruction with a cadaver replacement ligament, were followed for a minimum of two years. ACL reconstruction failure was defined as requiring a second reconstruction due to injury or graft failure or poor scores on a combination of orthopaedic outcome measure tests. The study found that 15 (23.4 percent) of the 64 patients' ACL reconstructions failed as defined by the study.

"This failure rate in this young, active population is exceedingly high when compared to a previous study that looked at failure rates of cadaver replacement ligament in patients older than 40," said corresponding author Dr. Gene Barrett. "The older group's failure rate was 2.4 percent. So while there are obvious benefits of using the cadaver ligament, like avoiding a second surgical site on the patient, a quicker return to work and less postoperative pain, for a young patient who is very active, it may not be the right choice."

SKY SHOW AT SQUAW

ON Aug. 11, there will be a Perseid Meteor Shower Family Campout. Families can camp under the stars and watch the night sky light up at the best viewing location in Lake Tahoe " Squaw Valley USA's High Camp, elevation 8,200 feet.

The Perseids come every year beginning in late July and stretching into August. Among the many nights of the shower, there is always the one night that the viewing of the shower is at its best. This year, that evening falls on Aug. 11. Sky watchers can witness colorful fireballs, occasional outbursts and almost always, long hours of gracefully streaking meteors.

Perseid Meteor Shower campers can upload the Cable Car from 5-6:30 p.m. At High Camp, guests have the option of starting off the evening with a sunset hike around Squaw Valley's upper mountain peaks or eating a special dinner at the mountain-top cafe. Following, there will be an informational briefing on telescopes as well as campfire activities and at 10 p.m., the meteor shower viewing will begin. In the morning, from 7-8 a.m., campers can enjoy a continental breakfast before downloading the Cable Car.

Reservations for the Perseid Meteor Shower Campout are required. Registrants will receive a detailed information packet along with confirmation. Call (530) 452-7110.

Adults (16 and over) are $60, youngsters (15 and younger) are $40. Price Includes

professional stargazers on site to assist guests with questions about meteor shower. Viewing telescopes provided; campsite, continental breakfast, reservations required.

If you can't make the Perseid Meteor Shower, you can explore the wonders of the night sky during one of Squaw Valley's summer Stargazing Sessions on Friday and Saturday evenings in July and August. Professional stargazers Paul and Gigi Giles bring a variety of high-powered telescopes to High Camp, offering guests the chance to explore the majesty and wonders of the night sky.

HEAVENLY SCHOLARSHIPS

Heavenly Mountain Resort announced this year's recipients of the Community Scholarship Program. For the sixth consecutive year, Heavenly will award $4,000 scholarships to five recent high school graduates, bringing the resort's overall commitment to the Scholarship Program to $120,000.  

This year's recipients include Bridgett Maestretti of Douglas High School and Nora Esders of Whittell High School; Ryan Bugg of Douglas High School; Karli Vath and Cierra Rawlings of South Tahoe High School.

To date Heavenly has awarded 30 scholarships. Call 586-4461.

NORTHSTAR PLAYS HOST 

AST, the umbrella brand and organization of action sports events, has announced that Northstar-at-Tahoe will host the third and final stop for the inaugural season of the Winter Dew Tour Feb. 19-22,.

The Winter Dew Tour, which will feature freeskiing and snowboarding disciplines for both men and women, kicks off at Breckenridge, Colo., Dec. 18-21 and continues at Mount Snow Resort in West Dover, Vt., Jan. 8-11. All three stops of the Winter Dew Tour will be televised on NBC.

The disciplines for the men will include slopestyle and superpipe snowboarding as well as slopestyle and superpipe skiing. The disciplines for the women will include slopestyle and superpipe snowboarding and slopestyle and superpipe skiing exhibitions.