Has anyone had the Arthrosurface Hemicap? New PKR option

[kathat]

I'm 36. I figure that I could try ACI, and still have time up my sleeve for hemicap surgery if ACI fails, or even if it is successful and lasts the expected 10 years. Providing hemiCAP is suitable of course. I know the rest of my cartilage is supposed to be in good condition. Whether it stays that way will remain to be seen. If the rest of my cartilage starts deteriorating then I am stuffed regardless of what I choose to do now. I could just as easily lose more cartilage AFTER I have further surgery and I'll still be stuffed. I must admit though, more surgery makes cartilage loss much less likely, as there are no edges to erode away and no "bits" floating around to damage the good cartilage (which I think is how I got the MFC defect). My patellar damage was due to patellofemoral dysfunction, which I have had LR surgery to correct. It is why I am so up in the air about having more surgery in the first place. I don't really want it yet, but I may burn my bridges if I choose to wait. Oh well. I guess I'll just have to see what my OS has to say on the matter. Thanks for your comments. They have been really helpful. Good luck in returning to your job, Rotten. Hope it all goes well.

Kathy

[rottenkid]

Kathy
Good luck to you hope you choose the right path for you. With any luck you should start being better soon. I know the LR suck coming back from. I had a Bi-lateral release on the right knee back in the late 80's that took almost 6 month to be normal again. I had nothing but problems with my right knee for about 6 years or so it was drained several times along with being scoped three times. All that is in the past and it is doing great so there is hope for my left.
 Have a great New Years
 Rotten

[kathat]

You are not wrong about the LR surgery being difficult to recover from!! It has been 3 months and I have not made any real progress. I am still pretty much where I was before surgery, though I now have a solid diagnosis and can be more proactive with keeping the aching at bay because I know what causes it and what is likely to aggravate it. I just wish I could get some quad strength back!! Happy New Year!

Kathy

[stgiles16]

kathy , are you having a lot of pain with the knee? if so, that could be one of the reasons that you are not gaining quad strength, heaven knows, i have been told that i have had that problem often enough. it stinks, and there doesnt seem to be anything else that they can do for me.
good luck
missy

[kathat]

Missy,
Yep, the knees (both of them!) ache a lot when I'm on my feet for a while (R>L). I am starting to wonder if I might have a chance of building up the quads if I keep off my feet as much as I can, which will reduce the aching. I'd either have to sit around doing nothing or try crutches or something in order to get around. I am going to quiz my PT about it. I want to be sure I have exhausted all options before surgery. Currently I can cope with day to day stuff (laundry, getting kids to/from school, work (thank goodness for night shift), and basic housework), but things like food shopping, going to the kids' sports day, walking to/from the car on an outing, going for a decent walk etc really set my knees off aching - the more I do, the longer they ache for afterwards. A few hours of Xmas shopping caused two days of aching. I try to avoid setting them off, but sometimes there's no way around it. It is why my PT now thinks that surgery may be the best option. I'll keep you posted anyway. My OS appointment is in mid Feb (16th I think).

Kathy

[stgiles16]

Kathy, i go back to my  OS in mid feb. too. there is no change so i personally think that the appt is needless but what do you do?

just keep in mind that if you have lots of pain in the knee, it can cause the quads to NOT grow, no matter how much you work. after my last surgery, the head PT said that with all of my scar tissue in there and with all of my pain, i could have worked out for years and my quad would have never gotten any stronger.  i hope that you can avoid another surgery and still get well but a second surgery is not the end of the world, you are strong, you will get thru this.
let us know how your OS appt goes.
missy

[kathat]

Missy,
Thanks for the vote of confidence. I realise more surgery isn't the end of the world, but I feel that I am hitting the big guns of surgery now and with each surgery I am going to be exhausting an option. I am worried I'll run out of options before I'm old!! If I can cope with things now, while I am young (well, sort of) and capable, then I'd rather put surgery off. I don't want to be facing TKR revisions when I should be enjoying retirement! I'd rather be just getting over initial TKR surgery in time to start retirement with re-vitalised knees! Oh well. What happens will happen. I just want to make sure I am well informed so that I can get things right for me.

Cheers,

Kathy

[kiddthekatt]

Hello all;
  I wasn't given the option of the Hemicap, but then my medial side of the right knee was bone to  bone. I had the PKR on March 22, 07. I then had to go back for a revision on May 17, the femural componet broke loose. 5 days later, the spacer shot out and lodged in the medial side of my knee. On Oct. 22 I went in for a TKR, that was 3 surgeries in exactly 7 months on the right knee. I was 52 and I've had it with this knee. The truama from having the surgeries so close together caused scar tissue to try and take over.
   My second OS didn't handle pain control after the TKR and all I had to try and function for the 1st two weeks after the TKR was hydroco 5s, and I was in misery!! I found my pain management doctor and thank God I did. He took over and my knee is virtually pain free even without the meds I have to take. I am now fighting severe nerve damage caused from th truama of having my knee operated on so much. The nerve pain is by far worse than the knee ever was, it's horrible. I am in the process of having the lumbar injections and they are helping tremedously, although I do still have the pain in my right hip and down my right leg, but it's getting better.
    I chose not to have the forced MUA, my OS might have been able to get the scar tissue broken loose, but the chances of it coming back due the the truama of the MUA was very high, and I chose not to get on that merry-go-round. My Chiropractor(sp) worked on my knee Tue and it feels wonderful. I had a flexation of around 85 and when I left it was close to 97 without force. I could feel the scar tissue breaking loose, but there was no pain. He is going to work on my knee in several sessions and break he scar tissue loose slowly, maybe the scar tissue won't come screaming back. I havn't used my crutch or the cane since Tue. and I've been able to walk heel to toe and for me that is a miracle.
   This might not work for everyone, but it's working for me so far, and that is good news for me. I just can not force myself to let my OS do the MUA, not if I have another option. I want my life back and I'll try this to see if that might be possible in the near future.

   Good luck to you all in your choice of getting relief. Nerve pain is horrible and has a way of taking over completely, the lumbar injections seem to help a lot, we'll see what has to be done when that option is exhausted.

Be safe and hopefuuly with less pain;
Angel

[stgiles16]

Angel, I am glad that the chiro is working for you but truthfully, i have torn scar tissue and it was agony, i cannot imagine it breaking up painlessly. during my fight with scar tissue, i tried everything, including the chiro and agressive deep tissue massage. unfortunatley, neither one worked for me and i have had several LOAs to cut the stuff out. like you, i did several surgeries back to back and my body has paid for it. I dont wish that on anyone.  i understand your nerve pain issues, my back to back surgeries ended up giving me fibromyalgia, another issue that i dont wish on anyone.
Good luck breaking up your scar tissue, LOAs HURT and are no fun to recover from. I wish that i had been lucky enough to have mine break up during some sort of therapy instead of all of my surgeries.
missy

[rottenkid]

Angle
Like you I was bone to bone patella to femur from 118 to 140 degrees of flex. With good therapy and a very progressive doctor we came up with the Arthrosurface procedure. Up till that point he had only done one in the knee but has had great results in the shoulder area. There are less then 100 doctors that do the hemicap on knees in the country and there has been less then 300 of these type surgeries done in the states. To anyone out there getting ready for a PKR please look into this have your doctor look into this. I am 1 month post-op I am at 140 flex and already working on strength. I have been walking without a crutch for almost two weeks. Do your homework, check all options and go to at least one other OS.
Peace and Happy New Year
Rotten

[stgiles16]

Rotten, i am 2 yrs post op hemicap next month. i could touch my heel to my butt in two weeks but could not do standard Pt due to my arthrofibrosis history. i did eventually get to strengthen the quad. i had had two microfractures and this surgery was ten times better for me. i would reccommend it to anyone who is in the group that they except. it really is a  great option. my only concern is , can they do two hemicaps on one chondyle. my microfracture looked fine during this surgery (it is a big one) but i had another bone on bone lesion that they put the hemicap in. i need to  find out the answer to my question before my micro wears out. I would hate to have to do a traditional PKR after going thru this one.
if you would like to chat some time about our mutual rehabs, feel free to send me a message.
good luck
missy

[rottenkid]

From what I understand is yes they can do more then one hemi-cap per knee. The only problem is that there has to be a certain amount of good cartilage in between the hemi-caps but i don't know how much. What state did you have the hemi-cap done in? I know a lot of studies were done in Atlanta. I am in Illinois and I was only the tenth person to have this done. I almost flew done to Atlanta for the surgery. Arthrosurface sent a rep from Atlanta to watch my surgery the pictures were amazing. I had about seven O.S. in the room to watch my surgery. My strength is starting to come back they told me it would be between four and six month till I am fully healed.
Rotten

[stgiles16]

I had my hemicap done in Columbus GA. and the president of the company was in on my surgery. I  was either number 2 or 3 for my surgeon, dont really remember anymore. i could look back at my journal and tell you if you would like. I live in SC so i drive 9 hrs roundtrip everytime that i see my OS. that drive gets old after a while. i love my OS but i sure wish that he lived closer.

My lesions are fairly far apart so i am hoping that it will work out for me to have two in the one chondyle. i dont have any other lesions in the joint so i would really like to wait a long time before doing either a traditional PKR or a TKR.

I honestly thought that there were more of us out there than what you say. i am surprised that there are so few of us, 2 yrs after my surgery. were you in a clinical trial too or was yours just an option offered to you?
keep in touch
missy

[rottenkid]

My became an option after the surgery approved in early March of last year. The clinical studies were done in the Atlanta area I do believe Columbus is were I would of gone. This type of surgery is taking off finally. There are less then two hemi-cap surgeries a day in the U.S. with the knee being the least likely spot. There are more chondyle hemi-caps done then trochial. My doctor given the chance would of sent me to Italy for a new procedure that uses a past to fill in the lesions kind of like bondo. When that dries they form it and buff it out and your as good as new. Now that they are out of the trial period for this procedure we should start seeing more people with this done. heck we might even get our own category.
Rotten

[DeborahinNC]

Hi all,

Everyone this is a great discussion and I appreciate the information.  I am now almost 4 months out from medial PKR on my right knee and my left is starting to act up in the same way so I like the new ideas and will keep them in mind should it happen to my left.  I'm not sure from what I read in the research if I would have been a candidate but I'm sorry that it was not know to me to ask before. 

I've had what I think is a successful PKR.  Still some pain but not nearly what it was before.  I can now go some days without any pain meds which is a vast improvement over the past two years. 

I just wanted you all to know that I appreciate the conversations and will keep up with how you are doing.  I love new science and anything that is easier on us as the patient is a good thing even if not encouraged at this time by all surgeons.

Be well all

Deborah