I know these posts should go in the Rehab part of the board but I really just want to share my story with others who are facing a DeNovo surgery or have gone through it and to also answer any questions anybody may have about the procedure, which so far, is a resounding success. First off a little background:

I am 29 years old, I am a police officer and a National Guard soldier with two deployments to Iraq and Afghanistan. After those two deployments and the increased weight you carry with the body armor, my right knee began to falter and give me pain. My journey started on August 10th, 2011. I underwent a microfracture to repair a defected cartilage site of 1.4x1.9 cm. I had a tough recovery as the swelling on my knee was of gargantuan proportions. Even then, it felt like there was something wrong over the surgery site. There was just this odd, unexplainable pain that would never go away. I just chalked it up to the surgery and did not think anything of it. When I finally started weight bearing (nearly 2 months after surgery), I immediately felt like something was really wrong. My OS kept trying to assure me that it was just the immature cartilage still developing and that it will get better over time. It did seem to get better but it still hurt and my gait was God awful. Something just never felt right in the knee. Every time I made a step, when the right leg would go from flexing to extending, there was a dull stabbing pain where the surgery site was. On March 6th, 2012, I underwent another surgery to determine how well the cartilage settled. My OS told me that when he got in there, just looking at the previous surgery site, everything looked fine. Then, he said, he barely touched the formed cartilage and all of it just broke apart like a house of cards and flaked away. OS immediately cut open the knee and performed a DeNovo implant.

Immediately after surgery, I was placed in a full leg brace and my leg was completely wrapped from thigh to foot which was extremely annoying. It took a week to get that wrap off. My recovery has been pretty remarkable thus far. When I first got my CPM, I could not go over 25 degrees. Then I went to my physical therapist and after she worked on it for an hour, I went back to the machine and I could get it up to 90 degrees. Over the next 2 days, I maxed the machine out at 120 degrees. By the end of the first week after I had gotten the CPM (and only 12 days after surgery), I had achieved 135 degrees flexion. After 18 days, I got it to 142 degrees, nearly full flexion. Right now, my biggest issue is quad muscle atrophy. My quad had atrophied after the microfracture and it had just gotten back to about near 100% (after 3-4 months of working on it) before the DeNovo and now it is back to where it was after the microfracture. My PT tried doing the e-stim but it could not grab the muscle. She tried every different setting and every different position and still nothing. My PT thought my muscle had gotten so weak that the e-stim had nothing it could grab but we kept trying it every session and since ROM was no longer and issue, focused solely on quad/calf muscle strengthening. Finally, yesterday, when she put the e-stim on it, I felt it grab the quad and man it took me by surprise so it is improving. My PT and OS both think the quad muscle atrophy will not be a problem 3-4 months because of how well I was able to get that strength back last time.

So far, the DeNovo is night and day better than the microfracture. I had some swelling with the DeNovo but nothing like the microfracture. I now have no swelling, even after therapy. I take no pain pills because there just isn't any pain. I know when I move onto weight bearing status that I can expect the swelling and pain to return but until then I have just been enjoying no pain and the feeling of just wanting to throw my crutches to the ground and start running. A feeling I never had for the 6 months after microfracture.

My only question to those who have been through a DeNovo is to those who had very minimal issues in recovery. How long did it take just to get back to running? I'm not looking ever to get back to running 2-3 miles in the next 6-12 months but as a cop, I have to be able to sprint about 200 meters as most foot chases are less than 200 meters, anything more than that and we are told to consider the advantages/disadvantages of continuing the chase and more often than not, terminating the foot chase. (I can tell you that I've been a cop for 5 years and have only been involved in 3 foot chases and they were all less than 100m so it does not happen very often.) There's really no time limit I have to reach. They just want to be able to see if you can put out a 100% and run without stopping so I just want to know how long it would take to be able to reach that goal.

There is no guarantee that you will ever be able to run again. At least that is the case with many folks after going through this procedure.
I am one year out from Denovo and still nowhere near being able to run, neither are any of the folks that I know who have gone through this procedure. The ones that are running that I know usually weren't able to do such until the 2 year point.
I have heard of folks running before a year but they are few and far between.

The #1 issue I am dealing with at the moment is quad muscle atrophy. I had a terrible PT the first three months after my microfracture who didn't really focus on quad strengthining exercises or an e-stim. By the time I changed PT's, my quad was in complete atrophy. It took about four months but before the DeNovo procedure, I had gotten my quad back to about 80% strength. My OS would have preferred my quad to be back to 100% but I couldn't waste more time waiting for it to get to 100%. My OS continued with the DeNovo, leaving my quad in the hands of my current PT.

It's been 6 weeks since DeNovo and my PT ordered something that would strengthen my quad. I have been using a Kneehab XP e-stim and man, the results have been pretty good so far. I can now see all four quadrants of the quad muscle contracting and I feel like I am a few days away from being able to do a straight leg raise. Quad muscle atrophy sucks but I know it'll get better with time. I have this e-stim rented for a month so hopefully the quad will get a good bit of strength back before the end of the rental.

Thanks for the replies.

2 1/2 months since surgery... That KneeHab XP E-Stim is a miracle worker! My quad has returned to about 90% strength. I can do straight leg raises with weights and everything now. I have just started full weight bearing and now use the e-stim when doing standing terminal knee extensions in hopes of it getting back to full strength.

I am ready to get rid of the crutches but unfortunately I am going to at least need one of them for another week or two before I start using a cane but I've taken about 3 steps at a time without crutches or a cane and I can tell just by the movement and the way the weight shifts through the knee that this surgery has fixed my issues... My steps/walk through motion is better than right before I had this surgery. I can only tolerate about 3 full steps before my knee exhausts itself...Still need to work on the weight bearing muscles and ligaments. I have had a minor issue with scar tissue that just won't go away with all the vitamin E and massage done by the physical therapist.

Has anybody had success with getting a massage from a licensed massage provider that has experience in massages of the knee after surgery? If so, did it help in your recovery?

It's been nearly 20 weeks since my surgery and things are still progressing. I seem to have plateaued a little bit. Where I was making great progress before, I seem to have slowed down a ton on recovery. The knee and the surrounding joints of the knee are nice and strong according to my PT and OS. It's the muscle weakness in other areas of my right leg. The back side of the knee, the tissue had become extremely soft and it took a lot of deep, agonizing "massage" (elbow digging into the back of the knee) from the PT to strengthen the tissue up. My calf and achilles kept locking up on me. Ever since I could put weight on it, I have been doing heel raises galore and gobs of stretching but despite all that, it still would lock up. The only way to cure it has been trigger point needling which is always fun.

The lower abductor (or the gracilis muscle in sophisticated terms) have been giving me issues. I am getting this wrap around pain at the top of my patella but more so on the medial side of the upper patella. The cure to this has been trigger point needling as well in the abductor. Once the needles hits the spot in the abductor, I feel an immediate release and the pain goes away around the patella (after about 20 minutes of my abductor feeling like someone took a bat to it).

By far, my number one issue at the moment is my right hip. I am not sure what happened because I have been doing exercises for my hip but it was not a number one concern considering my issues with the quad, calf, abductor and achilles. Last week my PT could not understand why it looked like I was dropping my knee when I walked. She did a strength test (made me lay completely on my left side and raise my right leg, then she tried pushing down on my knee) and I had zero strength to keep her from pushing down on it. That has been a major issue now because she believes this is the source of my knee dropping and causing a very slight limp.

Hoping that everything goes well and I can actually look like a normal person when I walk. We shall see.

Gijon,

I have the exact same issue with a dull wrap around ache on the top side of my patella. I am 15 weeks post
denovo for kissing defects in patella + trochela.  I need to ask my PT about trigger point needling. Right now she has me using a foam roller across the thigh muscle. It hurts like crazy but it does seem to help reduce the pain for a few hours but by the next morning it is back again. 

The dull ache started around 10 weeks post-op and continues. It affects how I walk and makes me limp more and it is driving me crazy. 

Has the needling procedure eliminated your pain?