Author Topic: HTO and Articular Cartilage Allograft  (Read 1231 times)

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #15 on: June 04, 2017, 03:10:58 PM »
Week 6 Follow Up Appointment

The good news keeps coming. Doc said my healing is coming along well. The X-ray showed a nice fuzzy strip of the bone matrix healing up. My weight bearing was upped to 40% and can go up to 10-20% per week. Truth be told, I've been bearing 50-70% since the week before this appointment. I'm almost to week 7 and I can walk pretty close to normal without crutches, shhhh don't tell my doctor I tried.   :-X

My swelling is almost gone, but is still in the joint. It is the only thing really holding my ROM back. As of my last PT appointment my extension was 0* and my flex was 110*. I was able to start doing more muscle strengthening exercises and moving away from ROM only. I've started the exercise bike, and brought my stationary bike home from my mom's place. My next appointment with the doc is 6.13, I'm hoping to dump the crutches and the stupid brace soon. Hopefully I'll be cleared to start chipping and putting before July. Frankly, being able to walk my dog would be a blessing at this point.

My weight needs to be at 180-185 to be at optimal BMI for this procedure. I'm currently at 205, down from 230 6 weeks ago. Once I'm cleared to walk I'm going back to the gym as I've been only doing resistance bands at home. They are good, but being in the gym is better than working out at home for me personally. I plan on starting yoga to help my golf flexibility. Being away from athletic activity this long has me a little stiff in the hips and back.
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

Offline slightfield

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Re: HTO and Articular Cartilage Allograft
« Reply #16 on: June 05, 2017, 05:39:28 PM »
I am happy to hear about the union of the allograft/bone wedge at your last appointment! It is really interesting for me to read your posts. The surgeries we had are similar, yet the post op protocols are different. I sit reading your thoughts and think to myself, I wish I could do that. My doctor wants me completely non-weight bearing for anywhere from 6 to 8 weeks. My guess is that we are only a little over a week apart. Your week 6 was on June 4th and mine will be on June 14th. So you must have had your surgery on or around April 30th is my guess. When did you start putting weight down? I will do a toe touch if I am standing for long or put my foot down on the floor when sitting. I even get nervous about doing that. So it is very interesting for me to read our differences in recovery and yet we are similar in ROM! At my 2 week follow up my doc said I don't need to wear the brace at home, even to sleep. I only will wear it if I go out, so that has really helped my sleep. I am sorry you are still having to wear that big bulky thing!

You are coming along great! You may need to go shopping for some new clothes once you ditch the crutches completely (congrats on the weight loss, a nice bonus of major surgeries usually). 0 degrees extension is something to celebrate! I'm sure that you are happy about being able to ride the stationary bike at home. After my most recent PT appointment last Friday, my therapist, (did I mention how much I like him compared to the last one??) he had me try a full rotation on the stationary bike in the clinic. I was successful after needing a "stretch run" where I went almost all the way around but stopped just shy to feel a good stretch before allowing myself to go completely around. When my therapist (I love him, did I already say that??) saw that he released me to start the stationary bike at home too. So, I am also equally happy as I can imagine you being. I too would absolutely love to walk my dog, but for now I have to watch as my husband takes her out on nice long morning hikes. Completely sucks to see him leave with her and have to stay home and do my boring exercises. But it's worth it when we go to PT, right?  Stay positive and keep up the great work toward getting back on the green soon!! Best wishes!

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #17 on: June 12, 2017, 12:23:33 AM »
I am happy to hear about the union of the allograft/bone wedge at your last appointment! It is really interesting for me to read your posts. The surgeries we had are similar, yet the post op protocols are different. I sit reading your thoughts and think to myself, I wish I could do that. My doctor wants me completely non-weight bearing for anywhere from 6 to 8 weeks. My guess is that we are only a little over a week apart. Your week 6 was on June 4th and mine will be on June 14th. So you must have had your surgery on or around April 30th is my guess. When did you start putting weight down? I will do a toe touch if I am standing for long or put my foot down on the floor when sitting. I even get nervous about doing that. So it is very interesting for me to read our differences in recovery and yet we are similar in ROM! At my 2 week follow up my doc said I don't need to wear the brace at home, even to sleep. I only will wear it if I go out, so that has really helped my sleep. I am sorry you are still having to wear that big bulky thing!

You are coming along great! You may need to go shopping for some new clothes once you ditch the crutches completely (congrats on the weight loss, a nice bonus of major surgeries usually). 0 degrees extension is something to celebrate! I'm sure that you are happy about being able to ride the stationary bike at home. After my most recent PT appointment last Friday, my therapist, (did I mention how much I like him compared to the last one??) he had me try a full rotation on the stationary bike in the clinic. I was successful after needing a "stretch run" where I went almost all the way around but stopped just shy to feel a good stretch before allowing myself to go completely around. When my therapist (I love him, did I already say that??) saw that he released me to start the stationary bike at home too. So, I am also equally happy as I can imagine you being. I too would absolutely love to walk my dog, but for now I have to watch as my husband takes her out on nice long morning hikes. Completely sucks to see him leave with her and have to stay home and do my boring exercises. But it's worth it when we go to PT, right?  Stay positive and keep up the great work toward getting back on the green soon!! Best wishes!

I've read lots of other people's diaries and other surgeons' protocols. I've found that the post op timeline from weeks 4-10 can vary. I started putting some weight down after 4-5 weeks. I have my 8 week follow up on Tuesday. I'll update my doc orders then. Hopefully it gives you another point of reference in your recovery. My extension is odd. I got it down to zero one day, but then it will sneak up to 4*. Currently riding the stationary bike with no resistance for 10 minutes a day. I'm still feeling a bit tight in the patella.
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

Offline slightfield

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Re: HTO and Articular Cartilage Allograft
« Reply #18 on: June 14, 2017, 03:41:13 PM »
Hi GolferJ,

How did your 8 week follow up go yesterday? I had my 6 week follow up yesterday. The OS said I can be weight bearing as tolerated. It was very nice to hear. I started walking immediately down the hallway at the clinic right after the OS left the room. Does your OS spend much time with you when you go in for your follow up? My OS came in, looked at the xray and said "everything looks good". Not like I am wanting to hear news of doom and gloom, but perhaps a bit more would have been nice. Maybe I am unrealistic in my expectations, but explaining the xray would have been a good start! Looking forward to hearing what's new with you!

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #19 on: June 18, 2017, 01:08:20 AM »
Hi slightfield,

Here are my follow up notes. But yeah, I don't get more info than "it's going good" myself. I think the docs do this purposely so you don't get too far ahead of yourself.

8 weeks

Doc shot more X-rays, at this point the bone healing is still on track. He expects it to be pretty well healed at the 3 month point. My PT will be more focused on muscle strengthening vs the past couple of weeks which was ROM balanced with strengthening. My last two sessions have been great with my stationary bike moving up to 20 minutes. He gave me the green light to ween myself off of crutches, which I have been trying to do the last couple weeks. He told me his approach weeks 0-8 tend to be very conservative. Now the training wheels are finally off. Today I walked my dog crutchless for a half hour in the morning and the night with no pain or swelling. Next week I'll be going back to the gym for the first time in two months.

I'll try to post again when I have a breakthrough on muscle strengthening. As of now my quad and hamstring are still pretty small. Hopefully this helps anyone going through the early stages of this process.
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

Offline slightfield

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Re: HTO and Articular Cartilage Allograft
« Reply #20 on: June 18, 2017, 02:11:38 PM »
Great to hear all the progress! Must be nice to finally get out and walk your dog, too! How did the weaning off crutches go? Are you taking small shorter steps or limping at all? 

My doc said weight bearing as tolerated. My PT said walking using one crutch. It is so nice to finally put weight on it and i find myself taking short steps without the one crutch at times. Do you ever have pain? If so, when and where? 

Good luck!

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #21 on: June 24, 2017, 10:07:12 PM »
Great to hear all the progress! Must be nice to finally get out and walk your dog, too! How did the weaning off crutches go? Are you taking small shorter steps or limping at all? 

My doc said weight bearing as tolerated. My PT said walking using one crutch. It is so nice to finally put weight on it and i find myself taking short steps without the one crutch at times. Do you ever have pain? If so, when and where? 

Good luck!

I haven't really experienced much pain. I would say that at times below the lower lateral knee compartment can have a dull pain sensation. I think it's from the last little bit of swelling that has to flush out of the joint. So far I've not dealt with any shooting pain. My walks are slow and I'm typically still wearing the brace just to be safe. Once I get passed this week I think I'll start working away from the brace altogether.
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

Offline Gimpy47

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Re: HTO and Articular Cartilage Allograft
« Reply #22 on: June 29, 2017, 03:47:54 PM »
Hi GolferJ,

Thanks for posting, I'm glad things are progressing well for you.  Just a quick question, I saw you had your surgery thru UM, where are you doing PT?  I live in the Plymouth area and went to medsport at domino farms in AA, and they have never dealt with pts w ACI. They had me do some exercises the first day that potentially could have harmed graft.  Needless to say, I've found a new PT that deals w ACI.  It's always nice to have a few options w PT.  Thanks!

Brian

Med fem epi lesion LEFT KNEE
Failed microfx 2012 LEFT KNEE
TTO, ACL, MACI Med fem epi and trochlea 5/17 left knee

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #23 on: June 30, 2017, 07:38:03 PM »
Hi GolferJ,

Thanks for posting, I'm glad things are progressing well for you.  Just a quick question, I saw you had your surgery thru UM, where are you doing PT?  I live in the Plymouth area and went to medsport at domino farms in AA, and they have never dealt with pts w ACI. They had me do some exercises the first day that potentially could have harmed graft.  Needless to say, I've found a new PT that deals w ACI.  It's always nice to have a few options w PT.  Thanks!

Brian

Med fem epi lesion LEFT KNEE
Failed microfx 2012 LEFT KNEE
TTO, ACL, MACI Med fem epi and trochlea 5/17 left knee

Hey Brian,

I'm doing my rehab at Right Rehab in Sterling Heights. I've done enough research on my own to have a very solid grasp of what to expect from a rehab standpoint (exercises, timelines, and so on). Mainly because I want to know I'm on track and also to ensure my rehab team isn't pushing too fast. If you google your procedure by name and rehab, you will find that the literature is pretty similar on the process.
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

Offline Gimpy47

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Re: HTO and Articular Cartilage Allograft
« Reply #24 on: June 30, 2017, 08:14:36 PM »
Hey GolferJ

Thanks for the response, good luck with your rehab!

Brian

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #25 on: July 14, 2017, 09:33:08 PM »
12 1/2 weeks

12 week (technically 13 due to scheduling issues) follow up is July 18th, I'll provide a clinical update then. As of right now rehab has been increasing in terms of the overall intensity. I have all but moved away from ROM exercises, however my flex is still at 125* so I'm going to start actively working on that again. I've focused on strengthening so much that I've kind of let flex go by the wayside. Extension is perfect as I'm just below 0*. I've started doing exercises on the balance discs to get the stabilizer muscles firing again. Overall I feel pretty good and have only experienced soreness recently. I'm guessing it's due to the weather (rain and humidity).

I went out on the golf course with a couple friends July 3rd and hit chip shots from 50yds in and did some putting. No soreness at all after. That was extremely encouraging. My fraternity alumni outing is this weekend and I'm going to be doing the same thing (chipping and putting only). My goal is to be able to hit the majority of my clubs at close to 70-80% by the second week of August, which lines up to the day with when my doctor told me I would be able to golf without restriction. We will see how the visit goes, fingers crossed!  ;D
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

Offline rigman06

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Re: HTO and Articular Cartilage Allograft
« Reply #26 on: August 02, 2017, 06:38:28 AM »
Hello...I hope all is well
I just had my OWHTO on 7/14/17 and let me tell you, I have SOOO MUCH PAIN it is to the point that i am getting approx 30mins of sleep per night. I too started PT I go twice a week but i'm going to soon start only going once a week. I've had my 1st follow up appt and like yourself I had x-rays done. My dr said everything looks great but then said my knee cap looks to be sitting low. When I asked what that meant he starts asking me if I have pain or discomfort when bending my knee, I explained that my knee feels like its "catching" directly above my kne and he says ok we will keep an eye on it. I was then told that "we" have get my pain under control but in the next breath he says "we" gotta work on getting off the pain meds and just use tylenol. its funny because with the percocet my pain level is 7/10...hell if I stop taking that i'll be at a 20/10.  Honestly I have never been sooo depressed in my life.
I really hope you are doing better then me

Offline GolferJ

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Re: HTO and Articular Cartilage Allograft
« Reply #27 on: August 06, 2017, 03:24:40 AM »
Hello...I hope all is well
I just had my OWHTO on 7/14/17 and let me tell you, I have SOOO MUCH PAIN it is to the point that i am getting approx 30mins of sleep per night. I too started PT I go twice a week but i'm going to soon start only going once a week. I've had my 1st follow up appt and like yourself I had x-rays done. My dr said everything looks great but then said my knee cap looks to be sitting low. When I asked what that meant he starts asking me if I have pain or discomfort when bending my knee, I explained that my knee feels like its "catching" directly above my kne and he says ok we will keep an eye on it. I was then told that "we" have get my pain under control but in the next breath he says "we" gotta work on getting off the pain meds and just use tylenol. its funny because with the percocet my pain level is 7/10...hell if I stop taking that i'll be at a 20/10.  Honestly I have never been sooo depressed in my life.
I really hope you are doing better then me

It really goes in waves. This surgery's recovery is as much between the ears as it is on the body. You are going to have some moments of pain, doubt, optimism, regression, progress, and everything in between. I'm almost to the end of 4 months out (August 17) and even with my victories, I still am not back to normal. I loved golfing, with cold Michigan winters it was my summer release. Not this summer, I won't be cleared until September 18th. It's taxing. Months 0-2 suck, there's no better way to say it. You'll get there, just do the range of motion as instructed and know it literally happens millimeters at a time.
1996-meniscus clean up scope LK
1996-staph infection, scope to clean infection LK
2003-micro-fracture LK
2004 OATS autograft LK
2017-Cadaver allograft w/Open wedge HTO LK

 

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