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Author Topic: I took the plunge, Lateral Meniscus Transplant + OATs  (Read 4467 times)

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Offline LateralMeniscusIssuesGuy

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #15 on: December 04, 2017, 04:12:37 pm »
badleftknee, I'm glad things are going well for you.  I enjoyed aspects of the NWB phase since I was at home and could manage my diet and plan my comeback, but you do get to the point when you just want to go up stairs again without a whole procedure.  Hang in there, sounds like you are nearly at the other side.

The little I have made sense of, I believe swelling is moved primarily through knee flexion (either through the activation of lymph nodes, or pressure in the knee capsule expelling excess synovial fluid), so when you become more active I would hope that reduces down for you.  I say that when I still 5 months on have stubborn swelling, I presume the healing environment in my knee requires the swelling environment as it is still raw healing phase, it would be nice for it to not be there, and get back proper knee function (I have read swelling interrupts brain to muscle messages contributing to poor coordination) but I guess that will happen with time.

I'm rooting for you.
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 fro60ol

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #16 on: December 15, 2017, 08:35:13 pm »
thank you for all your posts!

i posted in my own thread that i am looking at OATS as well and seeing how you guys are handling it is giving a good sense of what i have ahead of me. 

Offline badleftknee1

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #17 on: December 27, 2017, 04:29:11 am »
Hey guys, quick update (also in my thread)- now 8 weeks post microfracture and full WB! Damn, it feels good. Progressively came off crutches over 2 weeks, which was absolutely required given I am still a bit unsteady, having to walk slow to avoid odd pains/sensations that seem to come from some locking of the patella (particularly with initiating gait after standing for some time). I am doing ok getting around, but long walks are definitely slow and cautious. I, thankfully, don't seem to have pain emanating from the microfracture site. I still have some very mild residual swelling when I put my knee into full flexion, you can feel bulging around the soft spots around the patellar tendon (this has drastically gotten better with weight bearing). I will say that some of my stiffness issues I had prior to surgery (I was having a lot of "classic" arthritis symptoms with stiffness after periods of immobility, particularly in the back of the knee) are better even with the residual swelling.

The next biggest step for me is gonna be weighted knee bends, e.g. stairs, squats, cutting motions. If I can't do these, than I really haven't gotten anywhere with the surgery given these were the deficienes that got me into this surgery! So I am trying to stay optimistic that all this wasn't for nothing! I am now good friends with my PT, who I am gonna start seeing 2x per week in addition to daily workouts, somewhat more extended on weekends, though all are somewhat limited still.

Will keep you updated, and look forward to hearing more about your cases.

Offline LateralMeniscusIssuesGuy

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #18 on: January 12, 2018, 08:30:05 am »
Hi all, 6 month update post surgery:

My 6 month anniversary was last week, and I had my first post surgery MRI on that day specifically to mark a kind of milestone.  I saw Tim last night to discuss the scan, it was an anxious night worrying what news he would tell me despite my steady progress.

To my relief, the meniscus is in position and intact, the OATs plug has fully taken and given me a full articular cartilage again, the donor site has a good layer of fibrocartilage, and amazingly, the full thickness fissure in the articular cartilage in my kneecap groove has vanished, I now have a perfect cartilage surface!  I take the latter with a pinch of salt, as despite taking every supplement I have ever heard of to assist with cartilage health, I know it doesn't grow back easily, but the MRI showed a perfectly continuous smooth full thickness articular surface, where as previously it was a plain as day sharp fissure.  Perhaps the defect somehow fell between the thickness of the MRI slices, but given the nature of the defect previously, it was visible on several pictures / slices, its a welcome surprise.

Things have developed significantly over the last month in function.  Still I have persistent low level swelling permanently, which gets worse as I sit at my desk all day, but can be reversed after 20 mins of focused activity to move the fluid back out.  Otherwise I am lifting all manner of weights in the gym, progressing on balance work etc.  For day to day activities, walking on level or gradients, and stairs (up and down) istrivial.  No stiffness first thing in the morning, in fact that is when I feel best, and I have ditched the 20 pillow leg raise over night to my wife's relief.  Needing to go to work, fit in a proper gym session and get at least 6 hours sleep means my family have bore the brunt of it, seeing me perhaps an hour a day.  While my wife has been supportive she has voiced that this can't go on forever, and I am thankful for her tolerance.  The most tricky part of all of this has not been the discipline or enthusiasm to keep on with the process, but this social aspect.  It isn't trivial and while I had her complete buy-in at the beginning, it has been tested to the extreme in reality.  Of course the unexplained aches and pains which can be present for a week at a time are alarming if you have a sensitive disposition (as I do), but so far I have rode them out, with just a few more grey hairs to show for it.

I'm still not at pre surgery levels in terms of comfort because of the residual swelling, my only idea to relieve some of that is wear a pair of compression socks while I am at my desk to assist with blood and lymph flow around my legs, but it feels like a long shot.  I think it is mainly synovial pooling rather than lymph which would mean needing to compress the capsule rather than the calf tissues, but will try and see how it goes.

All in all, Tim wants me back to sport in the summer.  It still seems like a pipe dream but he wants me focused on that, not that I need a timeline to continue to be motivated, I don't think I can find much more time to rehab in my schedule, or push much harder. He inferred he speaks to other patients of his about me and my progress, so think he is partially keen for me to return to sport to report back what is possible, not that he wants me back irresponsibly early, I think in his mind wanting to wait longer isn't necessary, where I would be willing to wait as long as necessary if it meant long term, worry free sport participation.  Maybe too he has an eye on statistical lifetimes of transplants, and if i spend too long rehabbing, statistically I won't have as much time with it before predicted failure :( that is just conjecture on my part, I remain positive for the future.

Anyway, enough for now, nothing is certain for the future, I still want this knee to last me for the rest of my life which based on statistics still seems like a pipe dream too, yet that is my goal, so i will give it the 5 star treatment every day and take it a step at a time.
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 badleftknee1

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #19 on: January 16, 2018, 02:15:21 am »
Amazing news! I can only imagine how excited you are....after all the effort, the weekly ups and downs....good news is so vital. I really think you are going through this process well, and now to know that you made the right decision!

The swelling is going to have to pass eventually, right? I can't imagine it would stick around too much longer. I am curious if it is some sort of warning sign that you still need to ease into things, no matter how stable and pain free you are. Perhaps, or possibly even more movement will help it further recede? Either way, small potatoes. I am curious, are you able to walk for extended periods of time at this point or does fatigue and discomfort kick in?

Please do take it slow though, you can't let your cartilage reach where mines at or it gets a lot worse, quickly, and that meniscus is your last resort. Just food for thought, coming from someone who wishes he had caught his pathology as early as you did....when I got my second opinion at Brigham and Womens and was recommended for meniscal transplant, I was told specifically no pivoting sports following; this seems to be the consensus amongst the majority of cartilage restoration specialists and it has to be for good reason. I absolutely want you to reach your goals, but would be crushed for you if something traumatic happened too early in the process. I have read a few stories out there going for second rounds of meniscal transplants after the first one goes!

I still go back and forth on whether I should go through with a meniscal transplant, even while waiting to see how things work out following my microfracture. This, despite my poor cartilage status (given that all major academic articles except those by Stone Clinic seem to predict failure for me with meniscal transplant). I dream (basically, just unrealistic expectations) that even over the last few years surgical techniques have improved, and literature hasn't yet had time to catch up. I will update my thread in a few weeks at the 12 week mark with my progress, but I can promise you lots of ups and downs. I find it difficult to take a step back and grade progress on tiny biweekly and monthly increments, when just months ago I had zero limitations.

One last thing (in attempts to not completely overwhelm your thread), definately agree with the social impact of this process. I am finally able to walk the dog and do household chores with somewhat more comfort, so my wife is pleased (who has been so helpful through this).  But, I have had to avoid so many get togethers, ski/hiking trips, etc in just the last 3 months that it really puts a perspective on the ability to be mobile. I know there are younger patients than I with worse knees, and I envy their will power and strength. And then to realize that we are talking about knees, when in fact there are those out there fighting much worse. Its an eye opening and humbling experience, to say the least, something that I likely needed. 

Keep the updates coming. After perusing this website and others, I feel like long term outcomes are so hard to find and so many people will benefit from hearing your story for years to come. Thanks again for the insight.



Offline Mr. Potato Head

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #20 on: January 26, 2018, 02:17:03 am »
Lateral meniscus Guy thanks for your updated report. For all of us thinking about MT its great to follow your progress.  Bad left knee and I are in the same boat. Haha .  Went snowboarding a month ago and it totally swelled my lateral compartment. Knee inflamtion consistent but finally get better.   Got HA injection last week and thats felt great.  Oh knees!!!

Offline Tai-pan

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #21 on: February 04, 2018, 10:04:17 am »
 LateralMeniscusIssuesGuy

This LOG is a great read. It goes without saying, I really hope everything works out for you.
I will keep following and look forward to hearing the day you are back doing sports...pain-free!
 

Offline LateralMeniscusIssuesGuy

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #22 on: February 12, 2018, 01:48:02 pm »
Hi all, approx. 7 month update.

It doesn't feel like there have been many gains since my last update, but a few new developments.

I have subjected myself to more open chain exercises (leg extension and ham curl) than over the rest of my rehab.  Specifically my physio (Isokinetic, Harley Street, London) had me on their machine which is a combined extension and curl device, which you strap into and it limits the time it takes to move in the arc, irrespective of the force applied, and so can gauge leg power generated and compare hams to quads.  Seems from those tests (which I suffered no ill effect from pushing as hard as I could!! a mini milestone for me) indicate understrength quads.  I guess I know this as I am squatting and deadlifting what my able bodied peers are, but then can't do other more quad dominant exercises anything like as comfortably.  So I am reducing the frequency of the big compound exercises to focus on more functional movements (such as single leg straight leg box squats) trying to activate my quads more.  They look flexed but I'm not convinced they are doing what they should in some movements.

I have put on 5-7kg since my lowest point post surgery, I imagine lots of that is fat, but went with a clean high calorie + protein diet trying to be an anabolic as possible, not sure how effective that has been but it might have fast forwarded me a bit, as least my mind is clear that from a fuel perspective I shouldn't have lost out on any gains in the gym from not eating enough, trying to watch my weight.

I am still low level swollen, I would say where it was reducing month to month, that it has remained constant this month.  That said my flexion has increased minutely again, and I've had improvement again with how quickly at the end of the day I can get full passive end of range movement (down to about 20 seconds now).  I would like swelling to go down as surely that is indicative of the joint being unhappy, but no one has really shouted out about needing to take any action on it yet, so I suppose wait and see.  I would perhaps consider an injection in the joint, maybe removing the fluid in my knee and replacing it with fresh HA, in case something about the fluid in there is preventing it's dissipation.

In terms of problems, I really do have a complaint about the medial edge of my kneecap.  It is near an entry point to the surgery, and when my quad is under load and bending, it is painful, it feels like I have an thickened or scar tissue structure there (perhaps MCL or the ligament type material to the medial side of the kneecap) and that can get irritated with too much stimulation, to the point where flexing past the limit of active ROM is painful.  I've been exploring the pain with my box one legged squats and it wasn't as bad today as last time, so perhaps it is scar tissue breaking up, or its irritation where I have inadequate muscle control for some movements meaning some structures are interacting when they shouldn't. 

Overall I am progressing slowly, but to be honest the introduction of a deadline from my surgeon has introduced a bit of panic into my rehab, and anxiety that I might not be moving at the rate required to meet that goal.  SO I think to enjoy the process more, and stay sane, I will ditch the timeline mentally and focus on the small goals letting them happen when they do, just giving the best effort and attention I can spare.

For all my complaining I am very mobile now, I think I could stand or walk for hours without any real negative effects, joint isn't too noisy (silent after a gym session curiously, make crackly sounds when 'cold', what's that about?  muscle activation? reduced fluid in capsule?), and pain free in the lateral compartment 99% of the time.  I think I get a mild ache one a week for about an hour, something like 99% issue free in my limited but fairly rewarding current level of activity.

Thanks for all the advice and support everyone, I am still aiming for sport return, however reckless, but feel strangely strong and robust, more so than I imagined I would after the surgery, it is almost feeling like my leg now, I often forget that I have had a transplant.

Please all keep updating with your own progress and decision making, as this site was invaluable to me getting this far, I plan to donate in the very near future.
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 badleftknee1

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #23 on: February 23, 2018, 03:27:16 am »
Keep up the hard work. It sounds like things are continuing to move in the right direction. I'm hoping that swelling goes away for you completely over the next several months- no rush though, as you are now very functional and nearly uninhibited by most activity it would seem. Next up is agility movements, perhaps some running? Looking forward to hearing your continued updates. I still find it hard to find documented success stories despite the growing number of procedures being performed (and knowing that there are many success stories out there).

My microfracture rehab has been a bit shorter than yours from a post-surgical standpoint, but does not obviously offer the degree of benefit that a transplant will. As an example, swelling was nearly completely gone by 3 months, and I don't really have "risk" of tearing an implant (meaning I can start more aggressive rehab earlier). I have started some light agility training at this point, light jogging but mainly only the length of a gym floor. I still have "twinges" often in my medial compartment- isolated knee bends at 30 degrees (hiking, etc) or cutting motions are the worst, and the running isn't great. At 4 months I am trying to determine what success is- and I tend to think its based on 1) progression and 2) my expectations. Currently, my progression has slowed but not completely plateuad, and my expectations are not completely met despite being better off. Gonna repeat an MRI (suggested by the OS) to look and see if the microfracture healed in and see if there is continued bone marrow edema (if so, would suggest continued lack of protection of bone). OATs/MTS remains in the back of my mind....


Offline LateralMeniscusIssuesGuy

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #24 on: March 12, 2018, 10:05:07 am »
Hey all, brief 8 month update.

Things have progressed positively on all fronts over the last month, however in tiny bitesize bits.

The negatives first, I still have residual low swelling.  I bought a set of very light compression knee sleeves, not wanting to cause any patella irritation, but hoping the light compression could do something for the pooling of fluid that can happen during my 10 hours sat at the desk each day.  The initial response is positive as my selling has halved and occasionally has been near zero (near zero visible from sweep tests anyway).  So will continue wearing while at my desk to see if I get it flushed more.  I still have some end of range resistance if I donít bend my leg fully at all during the day, can take 5-10 seconds to get entire heel to glute flexion, but if I stretch that a couple of times during the day is is basically always immediate.  Also the joint is noisy when bending past around 110 degrees, I feel what I imagine to be the MCL flicking over part of the knee architecture, and there is a second less extreme noise when getting to 120 deg.  I wonder if some of this is due to the level of swelling still present on the capsule, or whether it is due to thickening of the ligaments and / or scar tissue making their movement during flexion more prominent.  For the avoidance of any doubt, the same clicks are observable in my good knee, but you have to hold the knee to be aware of them (i.e. feel the flick), the noise is so much more subtle.

The good progress:

-   I can comfortably sleep on my front, I spent so many years now sleeping on my back to protect my knee, to sleep on my front is a real treat
-   Fairly impressive increases in functional exercises at the gym (squats, deadlifts, also open kinetic chain exercises are pain free with challenging weight i.e. as hard as I can go)
-   Good balance work
-   No reactive swelling response to any intensity of workout, tho they are all performed carefully with proper form of course
-   Ability to graduate walking down stairs very slowly and carefully and controlled, more so than before surgery
-   My upstairs performance feels identical for both legs, even for double steps
-   95% of the time I forget I have any issues with my knee, and it feels entirely like my knee.

I have not attempted jogging get.  I have tried some jumping and reacted well in a very controlled basic few attempts, but donít plan to no too much until the year is up.  Interestingly the IsoKinetic machine test at my physio (a combined leg extension and hamstring curl) measurement for power had me the weakest male in the gym that day, despite probably looking the most muscular, so I will keep my nutrition to be growth and low-inflammation focused, and work out as often as possible.

I do have one eye on whether a return to sport is possible, I know I would be in a very very small minority who managed to do something like that (just 1 in the c.200 of Tim Spalding went to professional sport and seem still fine, tho he was younger and stronger), but I am obsessed with it.  So to start to build a tolerance to playing I have just started kneeling most days, on my soft sport specific knee pads, just getting comfortable with that.  So far not too many ill effects.  I even got fully kitted yesterday (ice hockey goalie kit) just to explore some of the positions and range of motion.  I was slightly sore in my lateral compartment when I went to bed yesterday evening, which was a setback as hoped it would feel fine, but often through my recovery I have hit movements which have left me sore, even raw pain types, and those have all since resolved, so I hope this is similar to that, rather than indicative of those positions seriously jeopardising my lateral meniscus and repaired articular cartilage.  Iíll do something similar most days and just see how it does, if the discomfort doesnít subside in a few days I will cease until I see Tim again next month for the 9 month follow-up.

I can get into true full squats (ass to grass) but am avoiding doing it too much as my PT has said itís a position of extreme stress on the meniscus so why risk it if not necessary for day to day life or my sport.  I couldnít help but enjoy being in the position as it looks and feels athletic, and want to keep my with my 2 year old who pops down into it no problem, but will hold back.

In summary I am really happy, really relieved, but resisting the urge to step off the gas.  Since I said to people that my surgeon wanted me back in the summer, those I used to compete with have been checking in more often seeing when I am back, which while thoughtful, has added more of that pressure I mentioned previously, and I have to manage their expectations, as unless you have looked into it, no one realises how big a surgery this is or how much of an ask it is to return to sport, but thatís as I have wanted to keep it private so a situation of my own creation.

Iím still NOT at pre surgery capability, I used to run for trains and could be symptom free after (say a 3 minute sprint, most of the time would be fine after, wouldnít make a habit of it), and was leg pressing more in the gym, but the positions of my sport feel mainly pain free, so it feels like the surgery has addressed the lateral compartment issues, and that I still just have more rehab to do to understand my body and truly re-establish the mind muscle connection.  I consider myself a fairly present and thoughtful and dedicated individual, but to be at 8 months post-surgery and still remarking that it feels like my brain still isnít fully in control of my body, is surprising.

Hope thatís a useful update and not too self-indulgent!  My 9 month update will also include a surgeon follow-up.

Cheers all and please feel free to update this post with your own progress and decision making.
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 #25 on: April 27, 2018, 12:57:05 pm »
Hi all,

I missed my 9 month update as was away on holiday for a fortnight, so decided to wait for a 10 month update.

Itís been a really exciting few months, combined with some terror, but am now in a good place.

Around the 9 month mark I suddenly developed acute pain in my lateral compartment, right on the outside of the knee, as if no deeper than skin.  It was a fairly constant pain, and persisted for an entire weekend and into the next week.  I didnít panic too much, but did wonder if I was exploring the range of motion too much and had managed to tear the meniscus transplant.  When I was canvasing for a surgeon, I spoke with Dr Stone in San Fran, and I recall him saying that deep flexion seemed to be the reason for grafts failing, so those doing yoga should avoid sitting on knees etc.  I wasnít doing that, but was daily, getting my heel to my glute to keep full ROM going.  Anyway, fast forward a week and I realised my hip was very sore to touch, as was my calf, so I diagnosed that it was just a tight IT band from over training and not enough rest / foam rolling.  A few days later the pain was gone and I continue to do maintenance rolling and stretching and stepped down a bit on the volume of training, still in the gym daily, but fewer quad exercises, a bit more glutes and hamstrings (hip thrusts and deadlifts).

On that, when away for those 10 nights on holiday the hotel had a decent gym, no squat rack, but had a bar and weight plates.  I ended up doing german volume training style work with deadlifts, and so 1000 deadlifts over the 10 days.  The impact to my knee felt fantastic, stairs were not an issue when I left for holiday, but by the time I came back I felt I had full control through the entire graduation of knee bend when lowering my self down the stairs, just like my good leg.  So I have since kept that going 3 times a week, and feel great for it.

Still have the persistent low level swelling.  Not sure if I said before my doctor did say to perhaps expect that forever as could be a feature of how my knee is coping with the meniscus.  That doesnít sit well with me, the presence of swelling, even small, surely means the joint is unhappy.  My surgeon did say we may try HA injections after the 1yr mark if it hasnít resolved.

The knee is a little noisy, there is an audible click or pop when I get to almost full flexion, and is heard again when extending through that angle too, especially if under load.  My interpretation of that is that the excess synovial fluid is making the noises.

The plan with physio is to move into a room with cameras which can track the relative movement of the joints through certain movements (i.e. hopping, or changing direction when jogging) to assess and train proper alignment.  Itís exciting if it helps me further.  The doctor thinks that could also address the remainder of the noice and swelling I have if I perhaps have better movement.  I am certainly strong now, not very very strong, but near my pre surgery strength, which you may remember I boasted to be good, tho I was just restricted in what I could do.  Still on their quad and hamstring strength test I am not even in the top 10 strongest men that they have under their care, and not many of them are more than weekend warriors, yet I have hopes of returning to semi pro sportÖ seems I still have a long way to go.

I have recently been trying to up the work on my legs without more load, one by the GVT as mentioned a few passages ago, but the other with blood flow restriction training, allowing you to get similar muscle fatigue and growth hormone response from lifting just 30% of your 1 Rep Max.  Using it, I have been able to use the leg extension to failure several times a week, experiencing noticeable strength gains and DOMS too.  Itís been a great addition to my strength regime and I would hope the less load going through my joints while building the muscle will be a real help to me and is preserving the condition of the joint.

The surgeon and pts are still encouraging me to have an immediate return to gentle sport, expecting that at the 1 year mark I will be fully participating in team practice.  It seems more realistic since the improvements after the 10 days of deadlift.  My knee is painless all the time, looks very similar to the other in terms of muscle and shape, has full range of motion, and isnít ever stiff.  I couldnít ask for more at this moment.

I felt so confident that last night I got kitted in my ice hockey equipment and took 30 minutes of shots during the team practice in a very controlled scenario, I was not performing complex or kneeling movements, essentially just standing in a squat position using my hands to make saves and side stepping to move into the path of shots.  I didnít experience any ill effects during or after, so will work on a very slow progression while I need to order an Ossur CTI OA custom knee brace to offload the lateral compartment when I play, or at least reduce the peak forces that compartment may experience in instances of mayhem when I am thinking about the game, and not my knee.

I donít feel out of the woods yet, and am obviously anxious to not undo any of the work done my Tim Spalding, but he is encouraging me to get back, and I obviously want to, as being back continues to inspire my rehab efforts.  I still am not running or jumping, I have attempted them a bit without an issue really, but only light jogging for a few seconds, and small hops.  I donít plan to do much of them but soon I should build a tolerance / re-train the skill to do them a bit, which I will mention in the camera physio sessions.

So apart from the IT band pain, things are going well, Iím trying not to get ahead of myself, but Iím obviously in a good place physically and mentally at the moment, so my family are reaping the rewards of a mobile and pleasant man around them, rather than the gloomy sod I was pre surgery.  The gamble is workingÖso far.  Remember, I wasn't that bad pre surgery and so I was chancing the house going ahead with the transplant in the first place, although the OATS was probably needed, and seems to have gone well.

If people are interested I can upload photos (if you can via this site) of the surgery pics, and my stages of rehab.
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 #26 on: June 01, 2018, 02:27:28 pm »
11 month update:

Things are looking fine at the moment.  Leg bulk seems to be more or less even across my two legs, and my single legged exercises seem similar in power and control (tho perhaps not endurance).

I'm mid way through 6 weeks of physio where I am getting assistance with hops and jumps and changing direction.  In these situations my rehab leg still has a way to go, this new training has really exposed me and so it looks like I need to change my training regime to be more quality of movement based rather than the usual straightforward strength exercises.

I do currently have pain on the outside of my knee and various places on the outside of my leg, it feels like a familiar pain from my time when I had (what I think was) IT band related issues, and admittedly I have neglected my glute foam rolling and perhaps not enough variation on my glute exercises.  Of course there is a nagging doubt in my mind that the pain is lateral compartment related, but I haven't been reckless in my training and can't think when I could have damaged my OATs or meniscus...time will tell if my IT band recovery training addresses my discomfort.

Got 3D scanned today for my Ossur CTI OA Custom, it is being built with 5deg of angle into it to protect my lateral compartment, but that degree shouldn't put irresponsible pressure on my medial side so said the fitter,  I will have it in 2 weeks and he feels confident it will be a really sensible addition to any kind of dangerous physical activity (i.e. if I should go snowboarding, or attempt a return to ice hockey).

Its a very similar regime of calorie surplus, eating clean, lots of protein, supplements to try tackle inflammation.  I can't believe it has been 11 months, time really has flown.  I can't imagine I will be playing sport in any sort of competent manner in a month from now, even with the brace, as my surgeon hinted he would like, but if it happened at all and I could compete in a responsible way, this will obviously be the greatest against the odds story of my life, so far the risk of the surgery is paying off.  I don't feel very different for the journey, still somewhat fragile of mind and feel like a boy in a mans body, things that I feel stopped me making it professional in my sport and impacted my relationships throughout life, but my body is different from the diet and dedication to the rehab, and I have a profound appreciation for anyone who has been thought any kind of body altering injury and returned to normal life.

Next update at the 1 year, which was always advertised as the recovery period, tho that recovery state was always disclaimer with impact activities not being sensible even at this stage of recovery.  Despite that the surgical and support teams behind me are keen to see how far I can go with this gifted meniscus.
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 #28 on: June 07, 2018, 12:58:06 pm »
I hadn't seen that!  That is truly unthinkable, but these athletes are barely human and very motivated and can rehab all day with the best equipment and physios...I wonder what the extent of the articular cartilage defects were, to bone implies grade 4 but how large etc.

The real truth will be in the comeback, tho they are willing to play through pain and dysfunction for the enormous paycheck where the normal man has to be more conservative.  If there were an article on me at this point, it would be saying how good the procedure is and I'm ready to return, but I honestly have no idea how far I can progress.

We are the same weight and height.  I can't see lateral or medial in any reports, I may have missed it.

Thanks for bringing the story to my attention, I will keep an eye on him :)
« Last Edit: June 07, 2018, 01:10:08 pm by LateralMeniscusIssuesGuy »
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 badleftknee1

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Re: I took the plunge, Lateral Meniscus Transplant + OATs
« Reply #29 on: June 08, 2018, 01:38:14 am »
Ya the degree of cartilage injury truly is the key. If the quick snippets of imaging they showed are in fact his- he looked to have moderate to severe medial joint space narrowing and extensive bone marrow edema on both tibia and femur- suggesting bipolar kissing lesions....makes it even more unthinkable.