Author Topic: I took the plunge, Lateral Meniscus Transplant + OATs  (Read 404 times)

Offline LateralMeniscusIssuesGuy

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I took the plunge, Lateral Meniscus Transplant + OATs
« on: August 09, 2017, 04:26:59 PM »
FYI after much deliberation and then months on a donor list, I went ahead at the beginning of July with a LMT and OATs plug for my lateral compartment of my right knee.  Performed by Tim Spalding at Warwickshire Nuffield, UK.

As a reminder I had a very thin rim of meniscus remaining (part of one horn lost) from two previous surgeries.  I am 34YO male, 5'11", 80KG, always been fit.  Had remaining meniscus removed and replaced with a donor flown across from the US.  Also had a single 8mm diameter plug from my own trochlea, into my femur (the area that taken weight at 20-30deg bend).  It was commented that I had grade II thinning on a 20mm diameter area of both my femur and tibia.  It is hoped that the replacement meniscus better protects those thinned surfaces going forward.

Very early days, rehab has not been pailful but has been very inconvenient. Am gingerly able to walk pain free but not with a full gait.  Am wearing a DonJoy unloader brace that was provided for free with the procedure.  Will likely get something custom in the future.

I'll update when I have significant news to provide.  Hopefully this is helpful to people.  It will be something like a year or even two to see whether I am in a better situation than I was before.  I do have perhaps unrealistic aspirations of returning to competitive sport, its has been done once before on a mid 20s patient of Tim's who with the same procedures returned and still plays professional rugby.

I will persevere and try to do everything right, lifestyle permitting.

Partial Lateral Meniscectomy (2/3 removed), pristine articular cartilage...2013
Return to impact sport, continual responsive swelling ever since
Mild pain onset..2016
Arthroscopy reveals grade 2/3 articular cartilage damage lateral compartment behind kneecap
What now? Allograft / brace / nothing?

Offline LateralMeniscusIssuesGuy

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #1 on: August 31, 2017, 10:40:17 AM »
8 week update:

Seems things are on schedule with respect to swelling, flexion, strength and scar mobility.

Have had several instances of pain in localised areas during the 8 weeks, all have come and gone, I am now relatively pain free.  Nothing was ever excruciating, but as I am a worrier my mind would always go to the worst circumstance and assume I had a major issue.  I will not be having a follow-up MRI until 6months so am hopeful so far that everything is as expected with regards to the meniscus condition and the OATS plug.

I have approx. 100deg action flexion, approaching 115deg passive.  Almost waling with a normal gait, however slower than normal speed and being careful not to pivot.  Can walk up stairs slowly but walking down is not possible without taking much of my weight through my hands on the rails.  Physio work is mainly all done sitting or laying on a physio bench using ankle weights or thera bands, no machine or free weights and no exercises while standing to still reduce the stress on the meniscus.  I am also having fortnightly MLD massage, not sure how effective it is but my swelling seems less than I expected as a result (I am a notorious sweller).  Diet still quite clean too, hope that has helped reduce the atrophy to a minimum, tho has certainly been some (perhaps 25% of VMO lost, possibly more its difficult to say, even more perhaps lost on outer quad).  Am inching the recumbent cycle saddle slightly more forward weekly to increase flexion.

So long long way off knowing whether I am in a better place, but for now I seem to be somewhat on schedule or slightly ahead in some categories.

Will probably post again at the 4 mth phase when I should be starting to embark on regaining muscle bulk.

Hope this is useful to anyone looking at either procedure.

Partial Lateral Meniscectomy (2/3 removed), pristine articular cartilage...2013
Return to impact sport, continual responsive swelling ever since
Mild pain onset..2016
Arthroscopy reveals grade 2/3 articular cartilage damage lateral compartment behind kneecap
What now? Allograft / brace / nothing?

Offline LateralMeniscusIssuesGuy

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #2 on: September 26, 2017, 11:41:38 AM »
A very brief 12 week update:

Several instances of pain around the kneecap while trying to increase range of motion and mobility, most seemingly due to muscle imbalances, most pain has gone now.  My ROM has progressed to approx. 130 degrees.  I am walking without any issue on flat ground, and climbing stairs without much issue.  Decending is still very gingerly.  I think my muscle firing is off as my VMO doesn't seem to be doing anything when walking stairs, so I have lots of training to do.  I am moderately swollen at the end of each day, which goes away over night.

Focus is on ROM and muscle firing, bias towards the former based on the assessment of my PT.

Am now managing to cycle with moderate cadence and some resistance, and I am managing to get on it about every other day.

Scar mobilisation is decent and I continue to work ok it.

So far no major setbacks, next consultant update at 4 months.
Partial Lateral Meniscectomy (2/3 removed), pristine articular cartilage...2013
Return to impact sport, continual responsive swelling ever since
Mild pain onset..2016
Arthroscopy reveals grade 2/3 articular cartilage damage lateral compartment behind kneecap
What now? Allograft / brace / nothing?

Offline akawai

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #3 on: October 04, 2017, 09:28:11 PM »
keep at it. keep us updated.

Online badleftknee1

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #4 on: October 22, 2017, 07:50:18 PM »
Lateralmeniscus guy,

Thanks for sharing your story. Would be interested to see how the progress is going. I am 32 yo M very active in football and skiing with prior menisectomies, 3 months ago while playing football noted swelling in my knee- turns out I have full thickness chondral defects of large area in tibia and femur- life changing findings that I did not expect and its tough to deal with- being recommended OATS (allografts) + meniscal transplant though its scary to think about give mixed outcomes. Another is recommending symptom management as long as possible followed by partial knee replacement. Read my full post if you are interested, would be very curious to have your guidance.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=71161.0

Anyway best of luck, I know how scary it must have been to make the plunge. Best of luck and keep us updated.

 

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