I also spoke with Dr. Michael Pearl, who originally started doing the ACR arthroscopically in 1999, and he said their long-term followup paper is due out next March. According to their results, they still recommend the ACR as the only procedure for young children. They are reporting a 20% rate of kids going on to need further tendon transfers.
I can't wait to see the details in the paper.
Kate
ACR good/bad
Re: ACR good/bad
to the guest with the MRI/CT scans,
Did you "specialist" actually look at the MRI scan him/herself? You can never trust a general technician, even a general MD, to read any scans in BPI. They don't often know what they are looking for. That's why we go to all the trouble to see specialists.
Rather than subject my child to more tests, I got two second opinions on our son's MRI. I got the scans on disk and emailed pictures from them. If anyone wants some hints on doing this, email me.
Kate
Did you "specialist" actually look at the MRI scan him/herself? You can never trust a general technician, even a general MD, to read any scans in BPI. They don't often know what they are looking for. That's why we go to all the trouble to see specialists.
Rather than subject my child to more tests, I got two second opinions on our son's MRI. I got the scans on disk and emailed pictures from them. If anyone wants some hints on doing this, email me.
Kate
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chrystalhurst
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Re: ACR good/bad
I can't WAIT to see the paper too....
All of these opinions are so confusing. Facts would help a lot!
Chrystal
All of these opinions are so confusing. Facts would help a lot!
Chrystal
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admin
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Re: ACR good/bad
Am I correct in saying that a 20% chance for further surgery means that 1 out of 5 kids will need to have an additional surgery? I am asking because with the last surgery we were considering, the doctor told me that there was a 20% recurrance rate, which he was highly concerned about. If it isn't as big of a deal as it sounds, I would be more willing to have the surgery, but 1 out of 5 doesn't seem very promising, as the doctor stated. Am I understanding this correctly, or can someone explain it better? For the record, we did NOT see Dr. Nath, Kozin, or Waters for that statistical information. I would appreciate clarification so I can feel better informed. Thank you.
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Matt's Dad
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Re: ACR good/bad
Krista,
I have heard the explanation of the ACR from Dr. Kozin at the Shriner's BPI seminar and assusimg it is the same as Dr. Waters.
Other than the fact that Nath does tendon transfers at the same time, how is it MUCH different?
The procedure seems the same, except it is open cut. The only difference seems to be on why the dislocation/internal rotation is present. Nath does additional work in the TT to correct that, the other docs don't?
I have heard the explanation of the ACR from Dr. Kozin at the Shriner's BPI seminar and assusimg it is the same as Dr. Waters.
Other than the fact that Nath does tendon transfers at the same time, how is it MUCH different?
The procedure seems the same, except it is open cut. The only difference seems to be on why the dislocation/internal rotation is present. Nath does additional work in the TT to correct that, the other docs don't?
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needmorshoes
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Re: ACR good/bad
As you know, none of the other docs perform the triangle tilt surgery. They have not been convinced of it's success rate as yet. I can't wait to see research and see how much things change after the procedure to see if it really is as great as it has been spoken of! Could be a great thing, we just don't know yet, only time will tell!
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Matt's Dad
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Re: ACR good/bad
Just to correct my post above...
There should be a period not question mark at the end of this sentence: Nath does additional work in the TT to correct that, the other docs don't?
I am not questioning why the other docs don't. I understood why prior, it was just an error in punctuation.
There should be a period not question mark at the end of this sentence: Nath does additional work in the TT to correct that, the other docs don't?
I am not questioning why the other docs don't. I understood why prior, it was just an error in punctuation.
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admin
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Re: ACR good/bad
Bernie
If you have spoken to Waters or Kozin personally about this surgery and the way THEY perform the surgery and the success they see behind it, you will understand the reason of my sentence when I say "much" different. The reason I bring the word "much" into the post is mainly b/c of the differences Nath and Waters/Kozin would have when they describe why they think it works compared to Nath's reasons of what he sees different when it comes to the success of the surgery. This was actually the very first time I ever read about Dr Nath's view of the surgery. And after reading that, the difference in their views were very obvious to me since I have personally spoken to Dr Waters about this surgery before Ella had it 2 years ago. The reason why you are questioning my post is b/c you feel that I am offending Dr Nath and his statements. That is not the case. I am simply stating that there are differences when it comes to how each doctor describes the surgery. I wanted to bring this to the attention of other parents so they do not assume that Dr Nath's opinion is the ONLY explanation of this particular surgery. Hope this clarifies my previous post.
Also, before I forget to add this, I am not sure that Kozin would describe it the same as Waters b/c Dr Waters usually will do the ACR along with transfers and Dr Kozin will do just the ACR. So there is a difference there.
~Krista~
If you have spoken to Waters or Kozin personally about this surgery and the way THEY perform the surgery and the success they see behind it, you will understand the reason of my sentence when I say "much" different. The reason I bring the word "much" into the post is mainly b/c of the differences Nath and Waters/Kozin would have when they describe why they think it works compared to Nath's reasons of what he sees different when it comes to the success of the surgery. This was actually the very first time I ever read about Dr Nath's view of the surgery. And after reading that, the difference in their views were very obvious to me since I have personally spoken to Dr Waters about this surgery before Ella had it 2 years ago. The reason why you are questioning my post is b/c you feel that I am offending Dr Nath and his statements. That is not the case. I am simply stating that there are differences when it comes to how each doctor describes the surgery. I wanted to bring this to the attention of other parents so they do not assume that Dr Nath's opinion is the ONLY explanation of this particular surgery. Hope this clarifies my previous post.
Also, before I forget to add this, I am not sure that Kozin would describe it the same as Waters b/c Dr Waters usually will do the ACR along with transfers and Dr Kozin will do just the ACR. So there is a difference there.
~Krista~
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admin
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Re: ACR good/bad
And let me clarify something again...
As you may know, Ella had the ACR along with transfers (like Nath would usually do)...that should show you that I am not speaking directly about his way of performing the surgery, but I am speaking about how they view the ACR surgery as one subject. As far as the TT surgery...I don't know much about it so I won't go into any kind of conversation about that. It just seems like there is a big difference after I read Nath's explanation from when I talked to Waters personally. Is that okay with you or an I wrong for thinking this?
~Krista~
As you may know, Ella had the ACR along with transfers (like Nath would usually do)...that should show you that I am not speaking directly about his way of performing the surgery, but I am speaking about how they view the ACR surgery as one subject. As far as the TT surgery...I don't know much about it so I won't go into any kind of conversation about that. It just seems like there is a big difference after I read Nath's explanation from when I talked to Waters personally. Is that okay with you or an I wrong for thinking this?
~Krista~
Re: ACR good/bad
Krista,
I'm in agreement with you on the subject.
Matthew would have been a candidate for transfers with the capsule release but they were already done with mod quad so Dr. Kozin did not do any type of transfer. When Matthew had mod quad at TCH they did nothing with his anterior capsule. He was 18 months at the time so maybe things changed since then. I can tell you that he had the capsule release over two years ago and is doing fantastic, there have been no other issues with his shoulder and his winging has reduced significantly.
Surgery decisions are so hard to make, we always spoke to a lot of doctors and made comparison spreadsheets to compare everyone's opinion and procedure. It made deciding what to do easier for us.
Cindy
I'm in agreement with you on the subject.
Matthew would have been a candidate for transfers with the capsule release but they were already done with mod quad so Dr. Kozin did not do any type of transfer. When Matthew had mod quad at TCH they did nothing with his anterior capsule. He was 18 months at the time so maybe things changed since then. I can tell you that he had the capsule release over two years ago and is doing fantastic, there have been no other issues with his shoulder and his winging has reduced significantly.
Surgery decisions are so hard to make, we always spoke to a lot of doctors and made comparison spreadsheets to compare everyone's opinion and procedure. It made deciding what to do easier for us.
Cindy