What procedure best...

[amr1809]

I am new here and really glad i found this knee forum. What a wealth of info from people who have gone through so much.
I wish to ask a question which i hope some could give insight into.

I am a male, 35yrs of age and recently diagnosed with an OCD on my L knee in medial femoral condyle via MRI. I was told that it was not too large. My Medial meniscus is also extruded but not torn or damaged in anyway. I am in fair bit of pain and am unable to completely extend my L leg. (Flexion is no problem). As a result, i am walking by compensating with my R leg, the good one.

One consultant has seen me and has suggested ACI., but passed me on to another consultant who specialiises in this area. I am awaiting a consultation. I have read a bit on ACI and it seems horriying. 2 procedures, the second very drastic and vast rehab. I was also told of microfracture. This seems less drastic but i am still concerned with the rehab.
Also mentioned, plugs and Mosaicplasty? Can anyone give more insight into these?
As i suffer from bow-legs, my knees are malaligned and i have read these procedures are not beneficial with knees which suffer either bow or knock-kneed.
Of greater concern to me is the fact that i am self-employed and am active in my job travelling around. The implications financially are massive.?
Can anyone give advice to me as to what procedure would best suit myself?  What risks are there with these procedures? Also, are there any other alternatives, ie non surgically? Would leaving it too long cause any long term effects? It has been 4-6mnths already i have been living with the problem. All thoughts greatly appreciated.

A worried patient. Huh
 
 

[Artica]

I have been postponing surgery on my OCD as well.  It's been a year now and I'm still seeing doctors and researching what surgery to do.  I can't seem to decide if I should do Microfracture or ACI.  Have you decided on surgery yet?

[jt801]

I feel for you-articular cartilage injuries are so tough to treat. According to my OS, most doctors prefer the microfracture option especially on smaller lesions. The reason being is that its done arthroscopically (read: least invasive) therefore is less traumatic for the knee as a whole. He also said that in the case of the mfx failing is when he generally looks at ACI or OATs. Whichever option you choose you are going to be looking at a long non weight bearing period (i.e, 6 weeks) after your surgery. As for which procedure is "best", i think the jury is still out on that as all of these techniques are fairly new. I am personally just a bit over a year out from my mfx and my knee feels ok, i sometimes wonder if one of the other procedures would have been the way to go. That being said, i can now do some things i couldnt do before i had the surgery. Its just been a long road back. If i were you i dont think i would just let this go-some of the stuff i've read suggests that the sooner after injury the defect is treated, the better the chance of it healing properly is. Whichever way you choose to go, best of luck.