5-month follow up

[blackbeltgirl]

I figured I'd give an update, since I don't have to go back to my OS unless the pain gets really bad again.

The good news: despite the size of my lesions (3x6CM and 1x3CM), he thinks the knee is actually forming fibrocartilage.  There is no swelling.  And I am allowed to start adding activities - I am now allowed on a bike and the elliptical trainer.  Low/non-impact activities.  I am even allowed to do open-chain weight training exercises.

The bad news: The lesions are already kissing.  Any activity must limit the repeated bend of the knee to 70 degrees.  This means I am still modifying a lot of the moves in water fitness classes, and have to be VERY conscious of how I set the bike seat.

The worse news: Because of the size and placement of my lesions, if the 2 lesions blend together over time the only treatment option (apart from tkr) is a large mosaicplasty from a cadaver.  My OS specifically said that if the 2 blend together, my knee becomes a salvage case.  (nothing I wanted to hear)

So I will start adding in the elliptical for 15 minutes twice a week, and hope to build that up.  I'm happy to have some more options, since water classes at my gym start at 5:30, and I can't always get there.  And I am glad I'll be allowed to ride my bike, as spring has finally arrived.  And I will be SUPER CAUTIOUS to try to prevent turning my bad knee into a salvage case.

Good luck to everyone else.  Hope you get better news.

Jess

[Nettan]

Hey Jess !!

Sorry for the bad news. Hang in there and be carefull.Hope things start to improve soon.
Wish you good luck !!

Hugs Nettan 

[kathleenj]

Hi Jess,

Sorry you didnt get the greatest news today.  On a good note...the fibrocartilage may give you  pretty good short term relief.  Some people start to develop that on there own for some reason and are able to put off surgery for a while.  Hopefull you will get some relief with it. 

Anyway, I just wanted to say be careful with the elliptical.  I have kissing lesion also and although it may have nothing to do with it...I cant do the elliptical if my life depended on it...well thats a bit of an overstatement.   I had been doing it for years since I have one and since the 1st surgery something just doesnt seem right.  I have heard a lot of people have a hard time with it after knee sugery, something about the motion...I'm not really sure.  I have pushed myself to stick with it for about 10 minutes a couple of times and then really paid for it the next couple of days.  The recumbent bike has been great though.  Be careful with the elliptical...especially since you need to watch every step, just as I do with the last few degrees of extension.

Hang in there, and enjoy the extra activities!!!
Kathy

[Beauzer]

I got about 5 years of good pain control after my microfracture in 1999 so don't give up hope yet.  I actually enjoyed the elliptical, once I got used to it.  However, I'm not sure how much it contributed to my two large MFC cartilage defects which got much, much worse in the past year (the reason I just got OATS'd, or whatever the past tense would be).  Be careful.

good luck,
Danielle

[blackbeltgirl]

Thanks everyone.  My OS actually was much more positive about the elliptical than the bike.  I used to use one for an hour, 5 times a week, so I'm actually really excited to be able to add that back in.  Of course I forgot to ask him if I should wear my brace when I do these things.  Stupid me 

Now I'll go call his nurse, get that question resolved, and give it all a chance.  Danielle - Thanks for the good news on microfracture.  I'm not all that positive on it, since it still hurts if I walk quickly.  Plus the whole, not wanting to become a salvage case thing.

Oh well.  Focus on the positive, keep the muscles strong, and hope the pain level stays low.

Jess

[casey2291]

Hi Jess,

I'm glad to hear that you are able to add some activities back into your life.  I saw where you posted that you did the elliptical for ten mintues pain free.  That is awesome!

 I was curious if you had a new MRI done before you saw your OS for your 5 month post-op visit?  How did your OS know that the fibrocartilage was forming? 

Casey 

[blackbeltgirl]

Casey -

MRIs generally do a VERY POOR job of showing articular cartilage (or it's lack).  That's why so many of us go for a partial meniscectomy, and wake up with microfracture.  He won't order an MRI since it's not terribly definitive.  He saaid the only way to be 100% sure is to go in with a scope to check it out, something we don't do in the US.  Past that, it seems I have healed from the microfracture.  All of the pains and twinges that scared the heck out of me for months, thinking I was worse after after surgery than before have mostly gone away.  The other realy test is the new activities.  If I can handle them with low pain/pain free, it's an indicator that there's something there.  If I couldn't, it's bad news.

And I did 20 minutes my 2nd session on the elliptical.  It hurt the next morning, but 600mg of ibuprofen was all I needed.  TOmorrow night I'm going to try the stationary bike.  (If nothing else, all this will help me get the weight off, so I can proceed to ACI as planned.)

Jess

[casey2291]

Hey Jess, 

I was not aware that MRI's did a poor job of showing articular cartilage.  I know that my first MRI did not give a very good indication of what was happening in my knee, but my second one did a better job.  However, it still missed the piece of cartilage that was flapping around in there.  I just figured that it was missed because MRI's in general can be inconclusive.  My PA mentioned a new MRI at 6-8 months post op and said they wouldn't even consider a new one before that. 

I'm glad to hear that all your pains and twinges have mostly subsided.  I have been having some sharp pains on the outside of my knee that are not close to the microfracture area.  I am hoping that maybe mine are just some weird pains that are going to resolve themselves with time. 

Congrats on being able to increase the elliptical.  I hope that as you do more, your knee will adjust and you will be able to exercise pain free!  Sorry to hear that ACI is in your future!

Casey

[blackbeltgirl]

OK - so I'm a fool.  I've been playing phone tag with my OS, trying to find out if the joint pain I feel on the elliptical (not all the time, and it's starting to come later and later in my time on the machine) means I should stop.

Since I missed his call last night, I decided to try 45 minutes on the elliptical.  Forward and backward, at a low tension level, no incline.  This is the first time that the 600-800mg of ibuprofen the next morning didn't get rid of the pain.  Stupid, stupid me.

Oh - and I never did get to try the bike.  No way to reach the bottom pedal and have the top knee at less than 70 degrees.  So I'm back to the pool, and hopefully still the elliptical.

[casey2291]

Hey,

I'm sorry to hear that the elliptical did not turn out well for you.  I hope that you are able to get ahold of your OS soon so that you can find out if you can continue with it.  45 min. is a long time.  It seems as if you have doubled the amount of time that you are on the elliptical in just a little over a week.  Maybe you are adding too much to soon.  Maybe you could just go until you start to feel the pain and then stop.  I know that I am several months behind you but I know that if I am feeling pain with any exercise my PT has me stop doing it.  I hope your knee feels better soon!

Casey   

[blackbeltgirl]

Thanks Casey -

It's actually been about 3 weeks that I've built up my time on the elliptical.  At first it hurt around the 10-minute mark, then 15, 20, etc.  I'd been doing 30 a couple of times with only minor pain, nothing 1 dose of ibuprofen didn't handle.  So I tried for more - sue me.  I'll be swimming laps tonight, definitely not up to doing the elliptical 2 days in a row (I actually haven't tried that yet).  Oh well, it's just 1 day, right?

Jess

[casey2291]

Oh, it looked to me like just a week and a half ago that you were only doing 20 minutes...my bad!! I guess the good news is that you have slowly been able to add more time before it starts to hurt.  Hopefully, in the very near future you will be able to post that you are doing 45 minutes pain free.  Hang in there!!!

Casey 

[kathleenj]

Jess,

Sorry to hear that the elliptical is bugging the knee.  I was really hoping to hear that you were able to do it with no problems.  What is it with those things?  I really miss being on mine.  I stare at it while I am riding the bike wishing I was able to get back on it.  No such luck yet   But I will not get rid of it yet or completely give up hope.  I just had my second synvisc shot yesterday so I am hoping that some day to be back on the elliptical...I'm going crazy with boredom on the bike!!

Anyway...I'll keep my fingers crossed for you.  Maybe you were just doing a little too much too soon. 
Kathy

[blackbeltgirl]

Update on the elliptical -

I've gone back to doing 30 minute sessions, without too much pain.  I also discovered the "Arc trainer" at my gym.  Not nearly as much fun as the elliptical, and it doesn't help with the muscle strengthening in the same way, but it is a good cardio workout, and pretty easy on the knees.  I think I'm goign to try to do water class twice a week, elliptical once a week, and the arc trainer once a week, and see how that goes.

Hope everyone is recovering well.
Jess

[shadehawk]

Jess,

Wondered how you were doing with the Arc trainer now?   They look like they would put pressure on the knee - but I have never tried one. 

It is always nice to hear about other equipment that might help.  Hope that this will work out for you.  I am hoping to graduate to some other equipment sometime also......

Have you ever tried the recumbent bike?  - Just a thought.  Seems like the only equipment that does not cause me knee pain due to the no stress on knee joint.....I used to use stationery bike but not allowed to use that anymore either......


Shade