Advertisement - Hide this advert





Author Topic: I took the plunge, Lateral Meniscus Transplant + OATs  (Read 1334 times)

Offline LateralMeniscusIssuesGuy

  • Regular Poster
  • ***
  • Posts: 58
  • Liked: 4
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

  • MICROgeek (<20 posts)
  • *
  • Posts: 8
  • Liked: 0
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

  • MICROgeek (<20 posts)
  • *
  • Posts: 17
  • Liked: 1
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

  • Regular Poster
  • ***
  • Posts: 58
  • Liked: 4
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

  • MICROgeek (<20 posts)
  • *
  • Posts: 17
  • Liked: 1
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.