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I just had my MACI surgery a few days ago. Prior to that I had my knee scoped to see how bad the cartilage damage was back in Dec ‘17.

Back in 2009 I had a nasty fall that started causing me pain. I tried to ignore the pain as much as I could but it started getting to the point where I could barely walk without being in a tremendous amount of pain. I saw several doctors ove the past 8 years and they all kept telling me that the pain was all in my head. I had 12 steroid shots in the last 3 years to help manage the pain. I recently got a new doctor back in Nov and she listened to me about my pain and immediately referred me to a specialist a few hours away from home. The specialist ended up finding a stage 4 chondral defect (cartilage was gone all the way down to the bone) under my right knee cap-I had zero cartilage to help fusion any type if impacts my knees would take.

The MACI surgery I had was a little bit more involved though. The had to cut my Tibia and move it so the groove at the top of the bone allowed the kneecap to glide over it properly. They also had to put a new tendon in that went from the top of my knee cap to just inside my leg to keep the knee cap from constantly falling off track.

I’m not going to lie, the post surgery pain is intense and the pain meds they give you only take the edge off but they do make you sleepy. 

For me the surgery was worth it even though I have a long road to recovery ahead of me.
If you have any questions, feel free to reach out to me.
6 days post op now! Been to the physio this morning to review and look at my strength.

Happy with the quad strength and getting the leg straight, but need to work on the bend and waking normally. The walking isn't going to be easy as I probably haven't walked quite right for the 4 years I haven't had an ACL!!

The pain is probably a tad worse as the bruising is coming out,but nothing unbearable! Mainly feeling pain from hamstring twinges.

Just got to crack on now with the excersies - now getting bored of being layed up, but have more of the same to come so need to just get on with it!! :)

Indeed - a pillow or cushion between your knees is the best solution - relieves the pain from the injured knee

JohnK/ Manchester UK
You need to be thinking more in terms of months with ACLr. Seems most people are over the worst post op pain in the first month. Try getting naps in the day, sleep crucial for recovery. The first week you’ll also be suffering the after effects of the anaesthetic. You will be in pain, your knee has been cut and traumatised big style in major surgery!

Try taking your pain meds regularly. Talk to your doctor but assuming you can tolerate, take your ibuprofen every 6 hours and paracetamol / codeine / tramadol every six hours but alternating.

Sleep on your good side with a pillow between your knees. When sitting or lying, elevate above your heart, supporting below calf and ankle, not below the knee / with bent knee

Good luck
So I am two days short of my one month post op anniversary. [Yay] Ever since my ACL construction with my quad graft I've struggled getting good sleep. I wake up at least 5 times every night. I am only getting 6 hours of sleep as it is so this is a huge burden. I've tried taking ibuprofen before going to bed and when I wake up I take it again if it is time. I've tried using the ice machine while I sleep. Every time I wake up I am in a little bit of pain and very uncomfortable. Looking for any suggestions, advice, and I need to hear that it won't be like this forever.

Thank you for taking the time to reply.
Hi Celina,

Sometimes they find things during an arthroscopy that didn't show up on MRI. You can find several stories about that on this forum. I think it is really important that you give the knee some rest and don't overdo things (including PT).
Up to you but I’d persevere with Physio. Kneecap pain can come on suddenly. PFS isn’t only duebti dislocstions, more commonly overuse and / or muscle imbalance.

They might find some minor cartilage damage or a meniscus tear although you’re young for degeneration. Has the position of your kneecaps been checked on CT? (Not MRI)

Good luck whatever you decide
thanks for your reply Vickster. I googled for it in the first month of my kneepain but quickly thought It is not, especially cause it says it gradualy starts. For me this suddenly started.
I now did some more research in it first by searching this forum. The pain some unfortunate ppl go to here kind of equals mine. I have flat feet for which i have special soles (correcting a slight x leg with that as well). Ive been to pt 8y ago (with the loose body) as well as now. Both didnt mention PFS or anything related. Also my OS didnt. No dislocating of my kneecap and not the idea it moves different then my good knee. Also cycling with low resistance works fine for me, which is named on the internet as one of the provocing factors of the pain.

Since my injection worked of the pain is so bad i cant do my normal job. In fact i cant even do a short walk. If i go out of the house i need my crutches. I really miss walking my dog. I walked a lot before this started but besides that I was not very sportive.

Im just hoping arthroscopy can fix something and i finally can start to recover. But with not knowing what it is and no diagnostic tool finding anything im nervous they wont.
I was just taking a look to see if there is anything new in the literature about the Hoffa fat pad:

but it seems as if the profession remains unresolved, except that doctors have shifted from thinking that it is unimportant to realising that it plays a role in the joint and should not be randomly removed unless there is a tumour or unless it is very enlarged and causing severe problems ('Hoffa's disease').

Perhaps you could try the physio options first as described in the first paper, maybe pay careful attention to wearing supportive footware and then if no improvement see if the local anaesthesia/steroid injections might help?
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