Allograft versus Autograft, and En Pointe

I was at physical therapy yesterday when Evan asked what I was going to opt for in my new ACL.  We had discussed this before, but I have had more time to think about it since our first conversation. There are three choices: the allograft and two autografts, one from the patella and one from the hamstring. The patella is considered the "gold standard" and is the most stable. The allograft has the fastest recovery time.

"I think I am going with the allograph," I said.

"Allograft?" he gently corrected.

"Yes," I said, "The kind from a cadaver."

"How did you decide on that?"

"My friend Michelle had one ACL done 18 years ago on her right knee, and had her left knee done last February. She had her hamstring on the first, and she feels like she isn't as strong as she used to be. She had an allograft this year, and her recovery time was much faster. She swears by it.

"Also Dr. Tex also suggested in not so subtle a way that an ACL from a cadaver would be younger than I am now."

The PT at the next table burst out laughing. I imagine he has worked with Dr. Tex and understands his direct manner. I told Jack and he said "Dr. Tex said the allograft would definitely be younger than you."

Allografts have proven not to be as strong or lasting for young athletes, but I am not a young athlete.  Theoretically, I don't need this ACL to last for 60 more years. Even if Tex's comment was true, middle age women do not like to be reminded of their age.

What is a little weird about the allograft is that the someone died and I get his or her leftover parts. Jack and I were driving down I-5 and we saw a motorcyclist weaving in and out of lanes with no helmet. Jack said, "There's your new ACL." Egads. I feel terrible that some family has to endure a tragedy for me to get a new ACL. The thought is a little creepy, especially if they are taking young body parts. There are 200,000 ACL surgeries a year. Surely there aren't that many deaths of people under the age of 30 in the US each year.

Nevertheless, if the ACL is there for the taking, and otherwise not needed, I can use it.

I decided not to comment on Dr. Tex's lack of bedside manner in the PT room. I wanted to keep karma on my side and accidentally piss of Dr. Tex before my surgery. I remember when I met him, I asked how long I would have to wear the brace after surgery.

"You've gotta earn your way out of the brace," he said.

What? I thought. I was almost in tears. I wanted a ballpark answer: two weeks, two months, six months? I am a middle aged woman who tore her ACL skiing. I am not trying out for the Navy Seals.

I thought about other things I've earned, and didn't feel so bad. Inspired by Lauren Kessler's Raising the Barre, I've taken to wearing my ballet slippers around the house and added modified barre work to my PT routine. (Shhhh.  Don't tell my PT team.) I thought about how I earned pointe shoes years ago. You can't sign up for a ballet class and go buy pointe shoes.  You need to be ready. You have to show you are strong enough to wear them so you don't hurt yourself. Rising in a toe shoe about having strong legs. If you do it right, it doesn't hurt at all. And it is glorious. I remember the magic I felt the first time I rose. I was at a ballet shop a while ago, and I saw a girl getting her first pair of pointe shoes. It is a big deal.

So, even if I am not trying out for the Navy Seals, I did earn my way into pointe shoes. Surely I can earn my way out of an ACL brace.