Pre Surgery Diet

The surgeon has told me to follow a special low fiber diet leading up to the operation. Makes sense really, if you're going to have an epidural and lose feeling from the waist down you don't want any accidents during the operation!! 

Anyway, I have a whole list of eligible foods. Opt for spaghetti Bolognese without any cheese or onions. Should be fine for tomorrow.

Made up my mind on the graft (finally!). Going patellar autograft. It's gonna hurt more and tougher rehab but ultimately has the best long term prospects which is the most important thing I think.

Autograft Vs Allograft

So what is the difference between autograft and allograft reconstructions? Basically, the autograft is a tendon that is harvested from elsewhere in your own body and used as a replacement ACL. The ones that are typically used are part of the patellar tendon (it joins the kneecap to your shin) or a part of your hamstring. The allograft is a donor tendon from a cadaver, usually the achilles tendon is used.

I've been researching autografts and allografts for days now and there doesn't seem to be a clear favorite. The patellar autograft is often referred to as the "Gold Standard" for ACL repair, but research on other grafts is scant. Here is a summary of what I've found so far:

Allograft (Positives)

- Less pain in recovery as the surgery is just for reconstructing the ACL, there is no donor site.

- Rehab is much shorter as there is no donor site to rehabilitate.

- Surgery is quicker and less expensive.

Allograft (Negatives)

- Risk of disease transmission such as HIV, Hepatitis and more.

- Treatment of tendon for disease and preservation may weaken it.

- Takes longer for the tendon to vascularize (around 9 months).

- Higher failure rate than autografts.

- May not be sufficiently strong to endure frequent sporting 

Patellar Autograft (Positives)

- Considered the "Gold Standard" by which other grafts are measured.

- No doubts about tissue quality or disease transmission.

- Quicker vascularization (around 3-4 months).

- Higher success rate.

Patellar Autograft (Negatives)

- More pain and rehabilitation required.

- Possible numbness at donor site

Here are some of the articles I read to come up with the list. Click on the links below to see, plenty of details here:

Graft Choices for ACL surgery
Risk of Disease in Your Allograft
A Systematic Review of Anterior Cruciate Ligament Reconstruction Rehabilitation 
Graft Selection for ACL Reconstruction: A Level I Systematic Review Comparing Failure Rates and Functional Outcomes
Beliefs and Attitudes of Members of the American Academy of Orthopaedic Surgeons Regarding the Treatment of Anterior Cruciate Ligament Injury


There is plenty more if you google as well, either you will find all the info useful or it will drive you crazy :)