POLL: OA of Knee

[shadehawk]

Hello,

I see that there are not many recent posts about this procedure.   

I was hoping this procedure would offer long-term relief, but upon reading some articles that seems to not be the case. 

http://www.arc.org.uk/about_arth/booklets/6027/6027.htm

I just had this procedure.  Now that I have read a little about this condition - I do have the pain described.  My diagnoses is patella-femoral OA - so I presume this is why I feel totally raw right under the patella.   Meds do not seem to touch this pain but realize this is early.  My surgeon is only waiting for three months to see if I have pain relief & then make a decision how to best treat my condition. 

I was just curious how other people with OA have done after a debridement/lavage procedure.  If they had complete pain relief or if they had to move onto another procedure. 

Looking forward to hearing some info from other's.

Shade

[katmomx2]

Shade

I had debribment and lavage in jan of 2004. My OA was in my lateral compartment of my left knee. I also had grade IV chrodromalcia and a severe tear in my lateral meniscus. I did not see alot of improvement after my first surgury. I went on to do the hyagan series. I did not see any relief there either. I ended up in a donjoy lateral offloader (off the shelf not custom) This seemed to help mostly with hyperextension. It did not allow me to hyperextend. My lateral compartment was severe bone on bone. If I had been 10 to 15 years older I would have had tkr. I wore out the lateral compartment so bad I ended up with the osteotomy. I know my damage is different, but I hope this imput helps a little.  Good luck with your recovery.  Kat

[shadehawk]

Kat,

Thanks for your imput.   Even though your OA is in another compartment, it really helps to hear from other people that have the condition.  I was just surprised when reading that not many benefitted from debridement/lavage of OA - too bad as it is a much less invasive procedure than osteotomy or TKR.  Maybe there are other procedures available also.....
Think this procedure was done to me as a way to help relieve some pressure on patella and help with the pain....Hopefully, it will give me some relief once the surgery site has healed.
I am really hoping that I do not have to have another surgery on the same leg, but guess time will tell me these things and I will just play this one day at a time....

Good luck to you Kat,

Shade

[Patty0513]

Hi Shade,
   I have had OA of the PFJ for about 30 years.  I have had about 11 debridements.  The first time I got it it helped for quite a while, but as the OA got worse, it helped for shorter amounts of time.  It is certainly worth trying for a while, as you said, it is less invasive than a TTT.  But unless something is done to correct the problem, it will just keep getting worse.  If a TTT is the solution, then it is definitely worth going through.  Did the OS tell you what he thought was causing the OA.  Is it from previous injuries, maltracking, etc.  Did he do the medial reefing(am I rememering correctly that this was something he was going to do)?  Anyway, just my 2 cents on the debridement procedure.  Good luck and I hope the rehab is still going well.

Patty

[shadehawk]

Patty,

I have not seen my operation report yet and I am not totally certain at this point everything that was done.
I did have a bad fall off my horse approx 9 yrs. ago & landed hard on both knees - so this possibly started my problems.  I have had several other falls since....Last bad fall was 18 months ago. I have always been a very active person.....

You said that the first debridement helped you for a long time - approx. how long??  I agree with you regarding TTT - if it is a solution then a person should go for it.  I do not know what the next step will be for me - as I sit here in my immobilizer - 10-days after surgery - I just hope that this surgery works....My pain seems like a deep-ache that you just can not touch....Don't know if that makes any sense, but that is what it feels like to me.......

Thanks for your response,

Shade

[Patty0513]

Hi Shade,
   I wish I could say for sure how long the first debridements lasted, but it has been so long ago and at my advanced age.....     I know it was less than a year, but longer than a month or two.  Does that help?  The last time I had just a debridement done the OS said I should just come back every month and have it done!  Oh yeah, really good idea!     Eventually it just got to the point where there really wasn't anything left to clean up and it wasn't helping.  I understand completely about the pain you are describing!  I wish I had a magic solution for you, but I don't.  However I will be happy to answer any questions or just be supportive!

Take care,
Patty

[shadehawk]

Patty,

Thank you so much.  I could not imagine getting this done every month - surely your OS was just speaking from frustration.....  Glad that there are still options left for people - that does help. 

Oh, I wish there was a magic potion or solution....I would be right there in line waiting...  I'll definately be giving you questions (if you do not mind) when I find out more about this stuff...

Thanks for the info, I liked the statement about the advanced age.  I am older than you are.....


Shade

[Patty0513]

Hi Shade,
   I am more than happy to answer any questions and help out in any way I can.  I keep trying to convince my OS that I am only 29, unfortunately he always refers to my chart.    I don't think you are older than me, sometimes I feel like Methuselah!!    Good luck with your rehab and remember to take it easy.

Patty

[shadehawk]

Patty,

I'll try to take it easy & hope that the rehab gets moving along nicely.

I read somewhere that if they find arthritis while doing debridement then that lowers the success rate of this surgery to 50%.  That does not give a person much hope that debridements work.....

Catch you later,

Shade

[Natalie.D]

Shade,

I had my first debridement/lavage in November last year, it did help but only for 3-4 months and then the pain and sticking returned.   I really do not relish the thought of having to have this done every few months to keep things under control.  I personally would not have it done again as I think the benefits are too small and each time you have surgery it worsens your OA - kind of a never ending circle.

Natalie.

[shadehawk]

Natalie,

Thank you for your response.  I am only recently out of the surgery - three weeks this Friday, my only difficulty is with weight-bearing.  Did you have this same problem after your debridement?  My surgery seems to be right on the weight-bearing part of my knee. 

Any pointers or advise would definately be appreciated - I have 100 degress ROM to date.  There is no way that I would have this surgery every several months.   I have to travel to have this procedure & it just would not be a feasible thing to be doing.  I could not imagine having this done on a regular basis.....
I'll look and see if I can find your Post-Op Diary.....

I am now using a TENS unit for pain relief as well as percocet.

Thanks,

Shade

[Natalie.D]

Hi Shade,

Sorry but I didn't do a post op diary  so not much help there! 

I have to say that I didn't really have any weight bearing problems after my debridement, I walked out of the hospital on the same day as the op without any crutches and full weight bearing, as long as I took it slowly I was okay and pain was minimal (after the initial pain when I woke up from surgery which was incredibly bad! but I had a meniscectomy at the same time and I think that was what was causing the pain), but all in all I seem to have had an easy time of it as far as this particular surgey is concerned, I just stuck to the RICE thing for a week or so and took it easy and I was okay, I was back to work the week after with no problems.  It wasn't until about 3-4 months later that all my original problems returned (sticking, locking, pinching etc).

The surgey you had 3 weeks ago was not just a debridement though was it?  (was it not also a proximal realignment?), if this is the case then I think you're doing pretty well for only 3 weeks out, after my TTT I wasn't full weight bearing until about 7 weeks after surgery.

Glad the TENS is helping. 

Natalie.

[shadehawk]

Natalie,

I did have a proximal realignment procedure, which is a small procedure - not like a TTT.  It surprises me that most people walked out of the hospital without crutches with debridements. 

As I stand up & my patella makes contact with the groove that is when I feel pain....   I am expecting I'll just have to give it more time, I have been too anxious. 

I know everyone heals differently.

Thanks for the help.

Shade

[Natalie.D]

Shade,

Yeah, I know what you mean, I was the same after my big surgeries, I kept thinking, well I'm 2 weeks out now and no change, 4 weeks out and not weight bearing, then it was 8 weeks and ROMs not great etc etc, I think most of us are just in such a hurry to get to being 100% better that we forget what we've just put our bodies through and that things like that do take time to heal and at different rates for different people (I know you know all this anyway, just reiterating).  Stick with it, try to be patient (I know its hard) and try to think of the bigger picture, time hopefully means total healing.  Good luck. 

Natalie.

[shadehawk]

Hi,

Well, from looking at this poll so far - it really does not look like many people have had much luck with debridement procedures.  Maybe for the short term, but eventually had to have a bigger procedure.

Right now I am five weeks out of surgery and still waiting for the pain-free part. 
 
I have no regrets about this surgery & maybe will have to wait several more months until my patella heals according to my doctor so it definately will be taking awhile longer for me to tell if this surgery was successful or not.....So I'll have to hold off on this vote for the time being.

Shade