Noticias

http://at.blogos.us/post/the-ground-breaking-new-surgery-that-uses-donor-tissue-to-repair-torn-ligaments-mail-online-post-1295312763Walking with a dead man's knee: The ground-breaking new surgery that uses donor tissue to repair torn ligaments
It happened in a split second  -  one moment Ben Doltis was playing football with friends, the next he was prostrate, clutching his right knee in agony. The pitch was frozen and slippery, and his leg had twisted awkwardly while he ran. As he fell, he had heard a sickening  -  and familiar  -  crack. 'A year before, I tore a ligament in my left knee and had to take a month off work after surgery to repair it, so I knew it was serious,' says Ben, a managing director from London in his 30s. A trip to A&E confirmed his fears  -  he had torn another ligament.

The knee is the largest joint in the body, where three leg bones meet. The thigh bone and shin bone form a hinge joint and the patella, or knee cap, sits over them and slides as the leg moves. Crucial to this structure are the ligaments, the strong fibrous cables of tissue connecting the bones. The anterior cruciate ligament is one of the four main ligaments, which acts as a stabiliser to the leg. This is what Ben had damaged. It is one of the most frequent ligament injuries and is usually caused by a sudden stop and twisting movement or from a blow to the front of the knee. Damage often occurs while playing sports such as football and rugby, while running for the bus or simply stepping out of the bath. The reconstructive process has historically been lengthy and more painful than the injury itself. 'I couldn't believe I'd hurt my other knee in the same way as before,' says Ben. 'I was devastated. I run my own firm of headhunters for the IT and banking industry and I needed to be at work.'
Until recently, the only repair option was replacing the ligament with tissue from either the patient's patellar tendon, which runs from the knee cap to the shin bone, or the hamstring tendon. 'There are problems associated with both techniques,' says Simon Moyes, consultant orthopaedic surgeon who specialises in arthroscopic  -  or keyhole  -  surgery on the knee, shoulder, foot and ankle. 'Using the patellar tendon leaves a large scar running down the leg, and there is a high risk of pain and sensitivity post-operation. You may also have problems kneeling. 'The hamstring is an important stabiliser of the knee and there is a risk of nerve damage when using this technique. It's like robbing Peter to pay Paul  -  you may suffer a great deal of pain and are effectively undergoing two operations.'

Ben was reluctant to undergo the procedure again. He says: 'The patellar tendon graft left me with a huge scar down the front of my leg and across the knee. As well as being in an extraordinary amount of pain, I had to stay off work for four weeks.' But, as Ben's surgeon, Mr Moyes points out: 'Not only is this injury very painful, but if left untreated you risk further injury and early arthritis.' Luckily for Ben, Mr Moyes is championing a new technique called allograft reconstruction, in which ligaments are transplanted from a deceased tissue donor. While major organs must be taken at the time of death as they begin to decay immediately, making rejection far more likely, tissues such as skin, bone, tendons, heart valves and corneas can be safely donated up to 48 hours later. 'The public don't realise how many patients can be helped by tissue donation,' says Professor John Kearney, assistant director of NHS Blood and Transplant, the UK's major provider of human tissue for transplant. 'Age isn't a barrier to donation. Most people can be considered to be tissue donors. Disease and illness may preclude some people as there may be a risk of disease transmission. However, all potential donors are carefully screened.'

Keeping fit: An increase in active lifestyles has also led to an increase in cases of knee surgery
And unlike organ transplants, tissues such as ligaments do not need to be matched and patients do not require drugs to prevent rejection. The donor remains anonymous  -  although a letter from the recipient can be forwarded to the family. Ben says he did not want to know more. 'I was very grateful, and just thrilled to be offered the operation,' he says. The need for knee operations is increasing as more of us take up more active lifestyles - up to 25,000 people in Britain need reconstructive knee surgery each year. ' First we remove the damaged ligament via a keyhole incision,' says Mr Moyes. 'Two small tunnels are drilled into both the shin and thigh bone. Then the allograft or replacement ligament is pulled through, tightened, and fixed into place with pins or screws. Recovery time is reduced, there is less pain and bruising and the scar is much smaller. It can be done as a day case, if you're lucky. 'When performing the old procedure you may be compromised by the size of the patient's ligament, but if you are ordering from a stock, you know that the graft will be the right size. Time in surgery is reduced by about 25 minutes.' The only potential complication is being infected by a virus from donor tissue, although the chances of this are extremely remote. The allograft tends to be available only privately, but Moyes thinks it has so many benefits that it should be used more widely. It costs more than the standard operation because the replacement tendon has to be prepared, but savings in length of time in hospital and recovery period make it an economical option, too. Ben is convinced that the allograft is the superior method but says it is still a very painful procedure. 'I was off work for only a week and a half, but I won't risk it again. I have given up football  -  just in case.' organdonation.nhs.uk; www.simonmoyes.com
i was offered an allograft to repair my cruciate ligament in WALES on the NHS but i refused and opted for hamsting tendon to reconstructIon instead.
This is not new. The use of donor tissue has been around in the USA - one example - for at least 10 years. I had a cruciate ligament reconstruction in 2002 and I was interested in the medicine behind it so I did a lot of research on the topic.
This is old hat. As a county standard footballer, I had my left knee cruciate ligament replaced in 1986. My new ones were synthetic, but at that time many of my old district team mates had already gone on to play professionally and ligaments harvested from cadavers was common even then.
I have the exact same thing in my knee. I ripped my ACL to shreds at the young age of 25. While it's not a major organ that saved my life, I am very grateful to the man or woman who donated their organs and tissue. Before the graft, I suffered from severe pain. Since the graft, I am mostly back to my old self, but with arthritis now.
Like the above, the DM has so often criticised the top surgeons for their salary scales but when consultants like Simon Moyes are championing such innovative techniques, we should only be thankful and give praise to the time and effort people like him have put in to save the victim from added pain and hassle. Simon Moyes for PM! :)
Allografts have been around in small numbers for a little while, and I have rehabilitated patients with them. They tend to work well.
The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.
We welcome your opinions. This is a public forum. Libellous and abusive comments are not allowed. Please read our House Rules.
Remember me - this will save you having to type out your name and location when you next leave a comment.
It's a girl! Nicole Kidman and Keith Urban welcome a surprise second child via surrogate
Ricky Gervais insists he was NOT banned from Golden Globes... as awards boss brands jibes 'unacceptable'
No frills spared! Kate Beckinsale shows off her curves and lighter locks in pretty ruffled bikini
Spider-Man's Andrew Garfield does whatever a spider can... but not after a very long night at Golden Globes
'There's no loving after dark': Sandra Bullock laughs off rumours of romance with Ryan Reynolds
Sarah Jessica Parker plays a working mother on film set... something she knows ALL about
Jesse James and Kat Von D fuel engagement speculation as the tattooed star flashes sparkling ring at Los Angeles gala
As Good As It Gets: California girl Helen Hunt shows off amazing bikini body to go surfing
Thin thighs in 30 days: Think nothing can be done about cellulite and stubborn saddlebags? Think again...
Walking with a dead man's knee: The ground-breaking new surgery that uses donor tissue to repair torn ligaments
If I rewrote my life story, I'd make myself a fitness freak! Why Maeve Binchy regrets ignoring 'the concept of moderation'
High IQ ... but what about your ZQ? Introducing Zeo, the new machine that tracks your every sleeping (and waking) moment
Patient without a heartbeat brought back to life by machine after THREE hours with 20,000 chest presses
Give your love life a lift - and live longer! An active sex life is good for your heart, memory and immune system
High IQ ... but what about your ZQ? Introducing Zeo, the new machine that tracks your every sleeping (and waking) moment
If I rewrote my life story, I'd make myself a fitness freak! Why Maeve Binchy regrets ignoring 'the concept of moderation'
Bye bye Botox? These celebrities claim to have given up their frozen faces - but have they really?
New dad Orlando Bloom puts his Hollywood bachelor pad up for rent for $18,000-a-month
Single ladies Eva Longoria, Christina Aguilera and Scarlett Johannson lead the fashion pack at the Golden Globes
Rock hard! Davina McCall is abs-olutely taut as she shows off an enviable flat stomach
The last straw: Katie Price sees red after Alex Reid 'uses' her son Junior for photo opportunity
What's in a kiss: From Don Juan to 'rolling a shovel', the bizarre history of locking lips
The icing on the cake! Billionaire's daughter Tamara Ecclestone serves up a birthday treat for her boyfriend...herself!
Oscar glory beckons for Colin Firth and Natalie Portman as they scoop top honours at the Golden Globes
Give your love life a lift - and live longer! An active sex life is good for your heart, memory and immune system
Don't worry Alex, there is life after Katie Price! Peter Andre and Elen Rivas all smiles on romantic dinner date
'I love my new body': New mother Chanelle Hayes regains her size 6 figure after undergoing liposuction and a boob job
From South Fork to Wisteria Lane: Larry Hagman plays 'grumpy racist pensioner' in Desperate Housewives
http://at.blogos.us/post/the-ground-breaking-new-surgery-that-uses-donor-tissue-to-repair-torn-ligaments-mail-online-post-1295312763