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Physical Therapy Continuing Education – ACL Reconstruction Surgery – Use of the Hamstring Graft

Physical Therapy Continuing Education – ACL Reconstruction Surgery – Use of the Hamstring Graft

Physical Therapists spend much time in Physical Therapy continuing education courses learning how to rehab patients after ACL surgeries, but rarely due we get taught about the surgery itself. We recently interviewed an orthopedic surgeon to ask him some questions about the use of the hamstring graft in ACL reconstruction surgery. Here are some of his answers.

PhysicalTherapyContinuingEducation: So to summarize on the use of hamstring graft in ACL surgery, the biggest advantage of the hamstring graft would you say, I think you alluded to earlier, that it is an easier rehab period with less pain. Are they the two major points, or are there other?

ACL Surgeon: I think the advantages are that it’s a very strong graft that has actually, bio-mechanically, when you double up the two strands of the hamstring and basically have a four strand graft it’s actually a stronger graft initially than the patella tendon. It actually now has stronger fixation. It is not quite as painful as taking the patella tendon and the rehab I think is initially a bit easier. I think with time that evens out. And the results now clinically are as good as patella tendon.

So, I think there are a lot of advantages. It is a smaller incision as well, so that may come into effect, particularly with those that are conscious of cosmesis. But, as we know, that’s not the most important factor, but to some that may be.

PhysicalTherapyContinuingEducation: Fantastic. Let’s talk a little bit more about the graft and the fixation. When we say we use the hamstring, what specifically do you use? And then on the fixation, you mentioned that there was some advancement in fixation. Could you just expand on that a little bit too?

ACL Surgeon: The grafts that we typically use for hamstring are the gracillis and the semitendinosus, and these are two long tendons that are attached to some of the hamstring muscles. If you really think about it, there are numerous hamstring muscles in the back part of the leg, so you still have many hamstring tendon muscles left, even after you take two.

So, these long tendons basically are such length that you can double them over and still have adequate length to reconstruct the ACL. So, we double them over and then the size of that can fit through a round tube anywhere from six-and-a-half millimeters all the way to eight millimeters in diameter, and really it actually provides more surface area and bulk a graft than say a typical ACL graft, which is a different type of graft. Actually, I’m sorry, I should say an ACL patella tendon graft, which is more of a – it doesn’t quite fill up the diameter of a tube. It’s more of a flatter graft, although it’s quite strong. So, the tendons that we use are those.

The fixation, there’s a lot of ways of fixating a hamstring graft. There’s basically a point fixation that you can use with screws. You can use pins that go across the bone, and these will go through these or wrapped around these. There are also what we call suspension type fixation, where the graft is looped around a very heavy duty type rope suture and then there’s an implant that goes around the end of the bone, and these are implanted around this and are terrifically strong fixation, and then fixed on the other end with either a combination of a screw, a washer, or some type of implant into the tibia. So, the fixation has really developed along the years and now is very strong. In fact, is stronger than that of the patella tendon.…

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Invest in Yourself With Continuing Education

Invest in Yourself With Continuing Education

In today’s ever changing economic times it is more important than ever to you to continue on the path of continuing education. It is only by bettering oneself do you truly protect yourself from being the next casualty of this ever growing recession.

You need to start looking at continuing education as an investment into your self. It is interesting that people completely understand the importance of changing oil in the car in order to keep the car running at peak performance. These same individuals also realize the importance of maintaining their household so it will appreciate in value. Yet, most of these same individuals have not invested a single dime into furthering their own education.

Imagine you graduated from either high school or college 10 years ago and have taken no courses since then. This would be the same as not changing oil in your car for the last 10 years. No one in their right mind would find it acceptable to go 10 years without an oil change and expect their vehicle to perform at peak levels. Why would you expect your place of employment to be any different? When they are forced to make difficult cuts in difficult times, they are going to keep those individuals who have invested in themselves.

With so many choices available today there is no real excuse for you not to continue your education in some way. Continuing education does not have to be a complete curriculum like obtaining your law or nursing degree. Continuing education can be as simple as one class online or a local community college.

To determine the best path for you, you first need to determine in what area you want to continue your education. You need to start with the question – do I enjoy my field of work and do I want to continue in this field? If the answer is yes then look around at those who are either higher in pay or higher on the organization chart. Determine what skills they have that you do not. Do they have management experience and you do not? Management courses are very easy to find online. Do they understand the department budget better than you do? If so, all junior colleges offer many options for non-accountants to better understand accounting.

If you have determined that you do not want to spend the rest of your career in your chosen field then determine what truly inspires you that you would enjoy doing for the rest of your working life. Then take one class in that field. Do not make the mistake many do and dive in over your head and take a complete course load in that field. By taking one class online or at a local junior college you will keep your investment low and be able to determine of this new field of endeavor is as satisfying as you had envisioned.

The next time your place of employment has to make cuts this continuing education path will be noticed and they should recognize what a key asset you are. If not and they make the mistake of letting you go, you should have no problem finding a quality organization to work for that will recognize the investment you have made in yourself.…