KNEE ARTHRITIS - Autologous chondrocyte implantation (A.C.I.) :
MACI Recovery - - Posted by JulianUK (JulianUK), 24 March 2004
Hi All,
I had my left knee done in August last year at Stanmore, UK. I had the newer treatment where they grow the new cartilage in a matrix sheet and then stick it on to your bone.
I've only just started to feel the real benefit of this procedure as it takes a long time to grow. The one thing I learnt is that you have to be patient and not to push yourself too much in the early stages - by that I mean the first 6 months. I can now walk up to 3 miles with little discomfort, having not done so for 2 years it's a great feeling.
It's still early days and I won't know if it has been fully succesful until August when I have a follow-up arthroscopy.
If anyone wants further info then just feel free too ask.
good luck to all facing this long rehab, just stick in there.
Jules.
Posted by Sarge (Sarge), 27 March 2004
Sounds like you had the same procedure as me JulianUK. I had mine done in Feb 03 in Melbourne. Just had the screws taken out and clean up arthroscopy last week. Surgeon tells me the graft took well. First couple of months a hard slog, but I have almost full strength back in the knee now, although they say 18-24 months before complete recovery, I have to say if you do regular physio and gym rehab three or four times a week it will speed up recovery. Will have to have the other knee done next year so am sort of looking forward to getting it over and done with.
Pre Op the pain in my legs was unbearable, couldn't sit for long periods of time, couldn't get up stairs or even out of a chair without pain, was on anti-inflammatories constantly.
Anyone out there thinking about the surgery... do it!!
Posted by jackpowell (jackpowell), 28 March 2004
Hi Sarge and Julian
Are you both saying you have reached the point now that you are in less pain than before the surgery?
If so that is great news. I am hoping to have the surgery soon and I can't walk without limping. It is misserable.
Posted by Sarge (Sarge), 28 March 2004
Yes Jack, there is NO pain in the leg I had the procedure on. Unfortunately there is still plenty of pain in the left knee and I will be taking anti inflammatories until I have it operated on next year. With the rapid recovery of my right knee since the operation a year ago, I may even have the left knee done later this year. Good luck with yours!!
Posted by JulianUK (JulianUK), 8 April 2004
Jack,
I have to agree with Sarge, the rehab is long and hard with PT three times a week but it is worth it.
I couldn't walk without a crutch to help me pre-op and had to take co-codamol, ibuprofen and diclofenac just to enable me to keep going to work. Post-op I took pain killers for 4-5 months but now I don't take any at all. It's great not feeling doped up and tired all day long. I still get fatigued with all the PT but it's a small price to pay.
If you're having the op then get in the gym now, lots of leg raises and closed chain work is recommended.
If you want any more advice then just ask.
Glad to hear you're doing well Sarge, keep it going mate.
I'm probably going to have my right knee done as well at some point but I need a break before doing it again.
Take care both,
Jules.
Posted by mayme (mayme), 8 April 2004
Hello Julian,
Thank you for the good and encouraging information in all your posts.
Since you had the matrix ACI (MACI) and your OS didn't need to use the periosteal flap, I'm assuming they made a shorter incision than the traditional ACI surgery. May I ask how long your incision actually was?
Also, I read some internet info saying that they've just recently started doing arthoscopic MACI in Germany and Australia. Is there any possiblity you can hold out for the arthoscopic procedure for your right knee?
Continued good luck with your knee!
CJ
Posted by JulianUK (JulianUK), 9 April 2004
Mayme,
Thanks for the message. I'm going to set up my own website after 12month arthroscopy, waiting for definite proof it has worked before I do it. I should also have the before and after pictures then to show the difference. I will also be including other people's experience and a case study report from my PT.
I had to have a large incision because they needed to do my patella as well. I have read they are now doing the second stage by arthroscopy as well, but I think thats only been done on medial condyle injuries and not patella. I will definitely be holding out for the arthrscopic option if possible. The less invasive the better, certainly would help the rehab and pain post-op.
Have you been done or waiting for an op.
kind regards,
Jules.
Posted by mayme (mayme), 10 April 2004
Hello Julian,
As always, thanks for the info. Also, I think setting up your own website is a great idea.
Yes, when I referred to having the procedure done arthoscopically, I was referring to the second stage (sorry, should have made that clearer). And you are right, at this time it is only for medial condyle defects & not the patella. Do you already know that the patella needs to be fixed on your other knee? It would be nice if you got a break and didn't have to have that worked on as well. And who knows, by the time you need it, they might also be doing the patella arthoscopically - there seems to be rapid advances with this procedure.
Yes, I've had the first phase done and currently waiting for insurance approval. I'm in the States and my OS is hopeful that he'll be doing the MACI by this fall, but no promises. I'm contemplating trying to hold out that long. We'll have to see.
I'm like you - the less invasive the better.
Thanks for your helpful posts and a good knee day to you!
CJ
Posted by blue_ezzie (blue_ezzie), 20 April 2004
Hi All,
This bulletin board has been so useful, thanks so much to all who are sharing information here. I am in a similar situation to Jack - the re-transplant of my harvested cartilage is scheduled for 6th May in Sydney, Australia (MACI). A fall down some stairs in late February resulted in (amongst other things!) nearly 75% of the cartilage behind my left patella being removed in a first operation.
Julian, the improvement for your right knee sounds really promising. How much cartilage was re-transplanted behind your patella?
Sarge, do you know whether MACI is a common procedure in Australia? This is my surgeon's first time and he is not aware of anyone else in Sydney who has had it done.
A further question regarding rehabilitation - my surgeon has told me that I will be on crutches for approximately 6 weeks after the op, but my physiotherapists have expressed surprise at such a short time. How long were you guys on crutches?
Thanks again for all your posts. It's been so reassuring reading about others who have made it through!
blue ezzie
Posted by Sarge (Sarge), 20 April 2004
G'Day Blue Ezzie!
I'm not sure about your exact procedure, it sounds similar to mine. There have been many such procedures in Melbourne, it has been happening for a few years now. My surgeon is Mr Raymond Crowe, 7th Floor, The Epworth Centre, Bridge Road, Richmond. Phone (03)9421 6155 in case your surgeon needs to speak to him about it. I am of the opinion that Ray has done this procedure quite a few times.
I was non weight bearing for six weeks, then partial only (on crutches for another six weeks or so). Good Luck with the op.
Sarge
Posted by blue_ezzie (blue_ezzie), 24 April 2004
G'day Sarge!
Thanks for the surgeon details, I'll pass it along to my surgeon. 3 months with the old crutches sounds more about it too...I've already been on them for nearly 2 months now but the idea of walking on my knee as it is at the moment is pretty scary.
Another question - what was your ROM pre and post operation? Mine is 5 - 75 degrees at the moment, following the operation I had 7 weeks ago. I'm a bit daunted at the thought of being put in a straight brace after the MACI! Were you in a straight brace or set at an angle?
blue ezzie
Posted by dmarkovina (dmarkovina), 24 April 2004
I had the second stage a week ago - 3cm sq defect on femoral condyle (medial posterior) - ski injury
I have been pwb 20% and 90 deg ROM (CPM) from day 2!
Is my OS too agressive with the rehab?
Thanks
I am not sure whether I had ACI or MACI
Posted by Sarge (Sarge), 25 April 2004
Hi Blue Ezzie,
The day after the operation they had me in an electrically operated device that moved and caused my leg to lift and bend... not sure what it was called, but it bent my leg gently for roughly twenty minutes per session. With the procedure it was imperative you didn't put weight on the leg for a minimum 6 weeks, but they encourage you to bend it. I was doing physio two to three weeks after surgery (spent the first week in hospital).
As for the leg brace, it was a straight one, which I naturally took off for the exercises. I think it was more of a precaution in case I accidentally put weight on that leg whilst hobbling around on crutches or the walking frame.
Off to MCG now to hopefully see Collingwood beat Essendon! Good luck, talk to you soon.
Sarge
Posted by HelenaM (HelenaM), 25 April 2004
Blue, 75 degrees after 7 weeks sounds a little slow, has anyone mentioned MUA or is the OS satisfied that your knee is progressing OK? I've had both knees done and the first one was very slow to progress due to adhesions, I had an MUA at around 8 weeks post ACI but my flexion was only around 45 degrees, beforehand, the MUA really did the trick and I progressed very quickly after it, you will find it very hard to walk without the crutches until your ROM has improved. Everyone will have a different story esp when the amount of work done varies, my first knee consisted of 3 grafts and microfracture, the 2nd, 2 grafts. It's interesting see how others are getting on. H
Posted by pcfu (pcfu), 26 April 2004
Hey sarge. bad luck about those pies, although i wont give you too much cause i barrack for richmond...
I had ACI in melbourne in december 03, by Ian Henderson. Just wondering if you'd heard much about him. i actually hadn't heard of Mr Crowe, but guess what? i just did a search on yahoo , and it came up with a Mr Raymond Crowe from australia who is a magican. so he must be good.
I was just wondering what physio you go to / or did? and if you have heard of any top knotch ones?? i'm 20 weeks and 5 days so far, but haven't needed much physio. Doc has been really happy with recovery anyway, and says most physios would overwork it. So i do a lot at home, and i guesss i recover pretty well cause im still young 20, and im back to a normal life, better than before, but i spose still a long way from football again. Hopefully in a year or 2 i'll be able to let the great M. Voss know how good this op is!!
Posted by blue_ezzie (blue_ezzie), 26 April 2004
Hi,
Congrats to all whose MACI/ACI is progressing well, it's so encouraging to read about success stories! And Sarge, good luck for your left knee later this year.
Helena, I'm a bit concerned about my limited ROM and will see my OS in a couple of days. My MACI re-transplant is scheduled for next week. In addition to losing so much cartilage, I fractured my patella in two places and tore a (miniscus??) ligament, so I suppose this might be contributing to my difficulty in moving? Do you mean Manipulation under Anasthetic? I'll mention it to my surgeon when I see him...I wonder if he could do it during the same operation, prior to transplanting the cartilage culture?
Thanks,
blue ezzie
Posted by Sarge (Sarge), 26 April 2004
G'Day PCFU...
Haven't heard of Mr Henderson... Ray Crowe must be a magician..did a good job on me..perhaps he could work on your football team as he is in Richmond just a good 3 Wood from the MCG...
As for a good physio.. I go to Hawthorn Physiotherapy in Launder St, they actually are the mob that do the Hawthorn Football Club...started going just a few weeks after the first Op and am still going...
Work Cover is paying the bills, so I will continue to go until I am 100% right again!! I can't believe you are 20 weeks post op and had no physio...
Anyway.. good luck with your rehab.
Posted by HelenaM (HelenaM), 26 April 2004
Sorry Blue, I obv didnt read properly I thought you'd already had the graft done, and you're really getting a lot of work done so expect a longer recovery than most! You will probably have to take things a little slower with the patella involvement so listen very carefully to what your OS tells you! I wish you the very best of luck, but luckily the time passes pretty quick so just keep looking forward! H
Posted by blue_ezzie (blue_ezzie), 1 May 2004
Dmarkovina, I am envious of your 90 degrees after only a few days of the transplant! What was your pre-transplant ROM? And how has the last week or so been for you?
Thanks to everyone else for the encouragement - only a few days to go now, I'll let you know how it goes....dreading the hospital bit above all else!
Posted by blue_ezzie (blue_ezzie), 14 May 2004
Hi all,
Just thought I would update you with what has been so far my very positive experience with this op. It was nowhere near as painful as I was expecting and I was out of hospital the next day, off all pain medication 4 days later.
At the moment I'm in a straight brace and did not use a CPM machine in hospital...I see my OS next week for an update but am not doing any bending of the leg yet. I am totally NWB for the next few weeks at least, but at this stage my surgeon seems to think that I will be walking without the aid of crutches in 5 weeks. I'd actually rather take it a little slower! So let's wait and see....
Posted by pcfu (pcfu), 16 May 2004
Hey sarge. i have been to the Hawthorn physio in launder st before, but only because they could get me to see a second surgeon quicker than just waiting around for an appointment, but i have heard they are top knotch.
I know, from reading this site, and every other site on the net, it seems really weird that i haven't done any proper physio, and everytime i see the Doc i ask when i'm going to, but he reckons that they would work me too hard, and that because i was progressing pretty quick naturally that it was best to take it easy. I am nearly 6months and its going well, but....
i still have a tiny bit of swelling, which is normal i think for trochlea implants, so i am not concerned with that, but it has started to feel a little different,not pain really,but just different somehow?
has anybody esle noticed changes at around 5-6 months mark?? i dont think the graft has failed because there is not a heap of pain or any more swelling, but i wouldnt know how to tell if it had failed anyway. any ideas anyone??
Posted by Sarge (Sarge), 16 May 2004
G'Day pcfu,
I was encouraged to do physio ASAP after the OP mainly to get the knee bending properly not to put any weight on it. Once the six weeks of non weight bearing was over, I was given a gradual program to strengthen the quads etc. I am convinced the help of the physio sped up the recovery.
As they deal with footballers on a regular basis, they specialise in knee injury/recovery! I don't know who your surgeon is, but I can't believe he hasn't encouraged physio. I was going twice a week for the first three months. I am now 15 months post-op for the MACI and 6 weeks since having the screws removed and clean up arthroscope. I am back to full duties at work, with the surgeon telling me that as good as the knee is now, it will continue to improve for another 6 to 9 months.
Good luck with yours!
Updated Sat Nov 21 2009
