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Author Topic: ACI if older than 50 ?  (Read 1170 times)

Offline Faklanman

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ACI if older than 50 ?
« on: February 12, 2012, 09:24:21 PM »
I have a defect in my knee and my doctor told me he will microfracture it instead of ACI because I am 59 years old.. Is this normal or should I ask other doctors as well ?

My other knee is totally destroyed and bone on bone.. I really want the best for my other so if there is any big guy here that had ACI please let me know :)

Offline Flyinglion

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Re: ACI if older than 50 ?
« Reply #1 on: February 13, 2012, 08:45:00 PM »
A couple of questions for you: How large and where is your defect?
My O.S. mentioned Microfractures for defects greater than 2 cm = Poor success rate.
Age is also a significant factor or the younger the better chance of the procedure succeeding.

February 2011 - Injured right knee playing indoor soccer
April 2011 - MRI showed patella & trochlea grade 4 kissing defects
June 2011 - Right Knee Scope/ACI Biopsy
November 2011 - Synvisc Injections
May 31, 2012  - Denovo NT Patella & Trochela, Lateral Release/TTO/MPFL Reconstruction

Offline CR_UK

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Re: ACI if older than 50 ?
« Reply #2 on: February 15, 2012, 11:27:50 AM »
Hi
I am now 50, had a failed microfracture on MFC in 2007 and MACI in October 2010 so 16 months ago. I have not had the expected results and although walking now, and only since 10 days ago doing staircase "normally" I still vacillate between thinking that possibly I'm just slow in recovering(despite constant setbacks still improvement such as the steps) or that it has failed. Certainly I feel that my muscle strength and altered gait for so long prior to the procedure has had a negative impact( despite the daily rehab) I still battle with muscle imbalance which affects normal movement and glide over the condyles and hence impacting negatively on the graft site. I cannot walk for longer than 30 minutes or stand still for longer than 10 minutes before I need to sit again. Therefore cannot still do normal things like shopping, cooking a meal without planning and pacing.
From other blogs it does seem that younger people with sports injuries seem to do better . I think its related to their muscle strength and fitness  as well as a more active approach sooner, as apposed to conservative management ,by Orthopaedic surgeons in younger patients.
I think your baseline muscle strength is important and if your other leg is poor (which needs to support you in this long rehab) it may prove difficult.

I certainly would get another opinion from someone experienced in ACI. From my physio who recently attended a talk by an OS they are starting to do ACI as a single procedure arthroscopically using your stem cells harvested from your bone marrow mixing it with thrombin to make it sticky and then gluieing it into the defect. This sounds promising to me and she will be sending me to this OS for an opinion as I would rather try this as an alternative before considering a major knee op again. Don't know much more about it at the moment, but it's certainly a good starting point for you to do your research on. Apparently it's only become available over the last 6 months.
Hope this helps

Offline Rupert

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Re: ACI if older than 50 ?
« Reply #3 on: March 07, 2012, 12:30:09 PM »
I'm also 50 and in the UK. Have been offered miicrofrature by a very good OS who has done over 200 of these (with and without HTO)  I'm anxious to be as informed as possible about the various oprions and if the size of lesion etc permit, might look at ACI\MACI  I've been in touch with Tim Briggs at RNOH and may go and have a consulktation with him but any thought you might have really would be helpful

 See my contact details for e-mail address
 regards,
Rupert

 















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