KNEE ARTHRITIS - Autologous chondrocyte implantation (A.C.I.) :
ACI Surgery - - Posted by richie (richie), 23 September 2003
Hi
I am due to have the first stage of aci (arthos) in a couple of weeks and hope someone can give me some information on a few matters.
How long are you on crutches for?
How long do you spend in hospital?
What is the earliest time you can drive?
How long has everyone taken off work?
sorry for all the questions but best to get prepared.
cheers richie 
Posted by receo (receo), 24 September 2003
Dont want to seem like a jerk. But I think you should get that info. from your Doc. Better to get that information from the guy thats cutting you open and has been to medical school.
Posted by richie (richie), 24 September 2003
thanks for the reply, however, it would be nice to get the opinions from other people who have had the surgery and not just from the Orthpod's mouth.
cheers anyway
Posted by receo (receo), 24 September 2003
I'm 13 days post op. There is zero pain sitting here. Have not taken pain meds for 3 days. Looks like hell. Started driving a few days ago (little painfull getting in and out of car). My advice is get your self in the best shape of your life. Like 10% bodyfat. And get strong. Go to the gym and hold a 25 or 45 pound plate. Feel how Heavy that is. If your 25 or 45 lbs overweight that is so much more extra weight on your knee. Weight lose helps in getting around when using the crutches for ten weeks. Say during that time you slip and load up your bad knee, that extra weight might be the difference between the patch getting ripped off or not. Also the implatation surgery was a piece of cake. Outpatient. Got home about 2pm. Sat in the Lazyboy chair just as happy as a clam. Had femoral bloke so very little if any pain. Was feeling abit scared of the surgery. And it turned out to be easy. The only thing to fear is fear itself.
Posted by lbdeharak (Linda), 24 September 2003
Hi there,
I was up and walking right away after the first stage. It was easy. Back to work the next day.
After the implant I was in the hospital for one night. Looking back, I should have stayed one more. I was back at work (desk job) after one week. It was tough and it would have been better if I could have stayed home longer. I started driving as soon as I was no longer taking pain meds during the day. It was a little over a week after the surgery. My ACI knee was the left one and I drive an automatic, so I did not need to use that leg. It was difficult getting in the car and finding a comfortable postion for the leg with a brace on. I was on crutches for three months. For me that was by far the most difficult part.
Good luck to you!!
Linda
Posted by noddy (noddy), 25 September 2003
Hi Richie
Just so you can see everyone is different I was on crutches for about 3 months, although at the end that was only one crutch. I was in hospital for 4 days, that time being attached to a cpm machine, which is standard here. I could not drive for probably 4 - 5 months as my right knee was involved and I could not even drive an automatic car. Also I was in a brace for much of that time and could barely get into a car let alone drive. My brace was locked in full extension. I was off work for nearly 3 months for many reasons including pain, allowing for physio and hydrotherapy and also because my job involved some standing and walking around. I hope this helps.
Noddy
Posted by Jules (Jules), 31 October 2003
Hi Richie,
I'm still waiting for my date, but like you I had questions and wrote and asked my surgeon.
He said about 6-8 weeks on crutches.
3 -7 days in hospital
About 6-8 weeks until I can drive and 4 months off work as I'm on my feet all day.
I suggest any questions you have write or call your doctor prior to surgery, your contact his reg or sho to gain the information.
Good luck and keep us posted.
Jules
Posted by dhalem (dhalem), 31 October 2003
In regards to the first stage of ACI, I am probably an exception to the norm in this case. You should be up and walking within a couple of days after harvesting, stage I.
I had the first stage done in Nov-02. I was my OS first case for an ACI procedure and I should never have let him harvest the cartilage/bone for ACI. This should be done by an experienced OS who has done plenty of these. I can not prove it was the OS fault, but it is not a very challenging scope and one should be able to walk almost next day. I ran into massive complications afer my harvesting procedure which turned out to be Arthorfibrosis. I had a ton of scar tissue develop which basically shut down my knee for 10 months. I was not walking well days after the harvesting and had to go to NYC for business the next week. From all the walking and pounding in NYC, I think I aggrevated the knee more and caused more bleeding in the knee. This hardened over time and thus I could not move forwad with phase 2. If I could have walked ok just after harvesting then I think the NYC trip would have been fine and this is why I think the OS screwed up doing the harvesting.
My path greatly changed after the harvesting procedure, and I recently had a bone graft to repair my defect and removal of scar tissue twice. I may not need ACI implant down the line. Will have to wait and see.
Hope this helps.
Dan
Posted by richie (richie), 14 November 2003
An update on my aci surgery
Harvesting was a sinch, back at work walking around a day.
re-implantation- well two days post-surgery, stayed in hospital for one night. Glued implant in so no need for periosteum cover which has saved a little of the pain.
some pain but the painkillers stop that in its tracks. Have a cricket pad knee brace on to stop any flexion/extension, physio in one week.
Been told to weight bear gently on it so hopefully this will help the rehab.
thanks to everyone for information, if anyone nees any info let me know.
Posted by becks23 (becks23), 17 November 2003
Hi i am 6 weeks post ACI and down to one crutch. I am also nearly fully weight baring and pain free. What i will say is that i had 2 hydro session a week in the pool for 5 weeks which i feel really helped me.
All is well with me and cant wait until next stage of re-hadand do some real work 
Mike
Posted by richie (richie), 17 November 2003
Hi there
glad it is going well, i am now five days post-op and no painkillers needed. Feel as though i have no strength in my left leg though.
I have a cricket pad splint on, how long did you keep your brace on?
Have physio on friday, what did you do on your first visit?
cheers
rich
Posted by becks23 (becks23), 17 November 2003
Richie i had a plaster on for 10 days after my operation which was removed with the staples in my knee on the 10th day. Once the plaster was removed i had no brace or strapping just had the aid of crutches.
On the first physio visit all they really tested was the wound and what flexion i had along with ultra sound. If i can give you a tip its get booked in for hydro i made massive improvements in 2 weeks of having this theropy. I to had a very weak leg post op and it took about 4 weeks to get any muscle control back in this leg but stick with they exercises they do work.
I am now about a week away from being crutch free and can not wait lol. The physio have no plan for me to have a brace as my leg muscle is strong enough to support me.
Hope your re-hab goes ok and feel free to keep in touch.
Mike
Posted by richie (richie), 11 December 2003
Hello again
update on the rehab:
Having two sessions of hydro a week which are excellent, strength is starting to come back in the knee. Now four weeks post-op still on the crutches. Have first proper land session next week so hoipefully will see how the knee feels out of water.
I have some pain on the outer (lateral) side of my knee hopefully due to the implant and scar and not still due to my instability in this area. Well time will tell, can't wait to start exercising again but a lot of hard work needs to be done before then.
Have next meeting with manchester consultant in Jan so will post an update after that.
all the best
richie
Posted by richie (richie), 30 June 2004
A short update:
I have just had my results from my MR scan and it is very encouraging with the defect showing signs of the cartilage growing. I am now running three-four times a week for two miles getting my fitness back.
I have got to go for another arthroscopy at 12 months to see how the cartilage is forming which will give results of the ACI vs MACI treatments trial.
richie
Posted by Jules (Jules), 1 July 2004
Hi all,
Just an update to let you know I have finally had a provisional date for aci for the first stage 18th October and then the second stage 8th November. Thats at Oswestry. But went to see my local surgeon today and he said they are setting things up to do MACI at my local hospital so I might get it done about september time, but he wants to realine the patella and pin it! at the same time as the second stage. He said as I was an acceptional case he would put me first on the list as soon as the trust has okeyed the funding.
My knees have deteriorated alot since I last placed a message here, only a couple of weeks ago I was on crutches for a few days as my right knee gave way really badly, it has since gave way a further two times in the past two weeks and yesturday it gave way and I fell I my left knee, have got a nice bruise on the left knee to show for it. So September/October can't come quick enough for me.
Rich glad to hear things are going well for you, hope mine will too, if I ever get round to finally having it done!!
Keep you up informed.
Jules.
Posted by Jez (Jez), 28 July 2004
Hi All,
I have been advised to have an ACI in Chester -UK, after suffering a number of dislocations to my left knee. Once my insurance company- the lovley Clinicare saw the price, they got out the small print and decided I was not covered due to the procedure being a clinical test according to N.I.C.E.
So it looks like I'm going to have to sell the family's silverware to fund it myself. Before I do that though, I would like to know if everyone thinks its worth it? i get the general feeling they do, but to what extent? I'm pretty active bloke and would like to get back to playing football etc.
Any advice / experience would be top.
Jez
Posted by Jules (Jules), 15 September 2004
Hi all,
An up-date, i have recieved my date for ACI, going for my pre-op assessment on 22 sept 04 then first stage 19th oct 04 then second stage 9th nov 04.
Jez, i too looked into private care here and abroad, and the the average cost was £7,500, a lot of money if you haven't got it.
I then wrote to the cheif executives of both my local hospital and the one at oswestry where i'm having my ACI, you have to hit them with the 'undue delay' time in their policies, you can find info on the internet. Within 3 months of me writing to oswestry i have a provisional appointment. It's been almost 2 years since my last bilateral arthroscopy but, I feel that £7,500 was too much to pay out, especially needing both knees done.
So write to the top, and hopefully get yourself sorted on the NHS.
Is it worth it, my research proves yes, there are more positive outcomes to this procedure than negative ones, but have found this is usually due to the size of the lesion in the first place.
Rich, glad to hear things are going well for you, i'm nervous and excited that i am finally getting somewhere, but the long rehab will be pain staking as i am usually very active in my work and day to day activities, but look on the bright side, at least i get xmas and new year off, though i don't think i will be that active in seeing the new year in.
Would like some tips on how to cope when alone, like carrying in cups of tea from the lounge to the kitchen, or a plate of sarnies? I'm concerned that at night if i need the bathroom and i'm half asleep getting down the stairs as the bathroom is down stairs.
But suppose will have to sort that one out when i come to it.
Well all the best, keep you update as things progress.
Jules
Posted by richie (richie), 9 November 2004
Hi there
Glad to hear that you have finally got somewhere Jules. Hope all went well today.
I am due in on Friday for the 12 month arthroscopy to check the patch. I am having this done under local so i can see for myself what it looks like.
The bad news is that the same locking problem occurred again after 10 months so hopefully it has not caused any damage, also will see if the orthopod will have a good look around where i think the problem is.
Anyway, will let everyone know once i get the results.
cheers
Rich
Posted by Jules (Jules), 13 November 2004
Hi Richi,
Hope everything went well for your appointment yesturday, I have put my weeks diary on my other message board follow my ACI start to finish starts 18/10/04, if you would like to check it out.
Let me know how you got on.
Best Regards
Jules
Posted by richie (richie), 27 November 2004
Hi everyone
well this will be the last post on this thread for a while as i had my 12 month check up and they have said the cartilage transplant is working wel. They were supposed to take a biopsy for the clinical trial but forgot the needle.
However, they did find another tear in the meniscus so hopefully this will stop the problem once and for all.
cheers richie
Posted by Jules (Jules), 12 December 2004
Hi Richi,
Its good to hear your graft is working well, it gives us all a positive perspective of our own ACI operations.
I take it they corrected the tear, and I hope that this solves your problems completely now.
All the best for the future.
Jules
Updated Sat Nov 21 2009
