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Author Topic: ACI procedure  (Read 473 times)

Offline Whibs

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ACI procedure
« on: May 03, 2012, 03:07:05 PM »
I have been advised to have a ACI on my right knee by Professor Tim Briggs, just been informed by BUPA that they will not fund this operation has anyone else had this problem, as it is not approved by NICE and the trail has ended.  BUPA are recommening a microfracture operation instead.

Online Vickster

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Re: ACI procedure
« Reply #1 on: May 03, 2012, 03:50:46 PM »
I can sympathise - although I didn't actually have the op in the end (due to kissing lesions) - I had a nightmare getting my then insurance company (PruHealth) to agree (this was with Mr Skinner, same team). 

They finally agreed to it as the surgeon wrote to them explaining that the operation was part of a trial protocol - which was the NICE viewpoint then.  I understood that BUPA were far more understanding - times must be tough, and taking a more recalcitrant stance (very costly procedure, £10k+)...re-reading your post, do you actually mean trial not trail?

Talk to Prof Briggs' secretary - will have seen all this before -  there are ways around it, or can you not get onto the NHS list - this is certainly done on the NHS (or was in 2010)?  What does he say about the microfracture - if he is recommending ACI which is a far bigger op with a much tougher rehab, there must be a reason - have you already had a failed mfx, or is it a big defect?

Maybe there is new data affecting the NICE situation - look at NICE's website, search for their documentation on ACI, cartilage transplant and similar key words.

Your other option could be Cartifill via Mr Shetty in Kent - however, again, this really is experimental, and again BUPA may well say no

Good luck - it really is a pain - you have private HC and still cann't get the treatment  :-\ 
I am about to try a course of 3 Synvisc jabs to calm my knee down again and may well have to pay despite having BUPA through work  ::)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
Partial meniscectomy, mfx not needed - smooth scar tissue over OC lesion, shaving of lateral aspect of patella - grade III defect
2nd scope on 16/12/10, chondroplasty & Durolane jab
Cartilage damage on femur & tibia
Knee being ignored ;-)

Offline CharlieWright

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Re: ACI procedure
« Reply #2 on: July 27, 2012, 08:06:08 AM »
Im suprised that they wont pay for it, I had ACI when it was experimental back in 2003 and SimplyHealth agreed to pay for it following a detailed report from the surgeon (Marcus Green in Birmingham). I may have to have some more ACI as my graft has partially failed after 8 brilliant years, so I will let you know if SimplyHealth will pay for it again.  Can you try the "I will need a knee replacement otherwise, which will need to be re-done every 10 yrs so this will be more cost effective in the long run" tack?
Good luck and keep us posted!
Medial ligament damage 94, ACL tear 98, ACL repair 02, ACI (dual surface) 2003 - 8 years with no pain and active squash player.  Microfracture to repair some additional trochelar damage June 12 and may need further ACI on medial femoral in due course as some of graft has failed.

Offline Whibs

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Re: ACI procedure
« Reply #3 on: July 31, 2012, 09:47:55 AM »
BUPA are saying that the trial has ended and that is why they won't approve it.  Professor Briggs has sent BUPA loads of reports and has been trying for months to get it approved but they won't change their minds.  It will be interesting to see if yours gets approved, i can then go back to BUPA and state this.