KNEE ARTHRITIS - Autologous chondrocyte implantation (A.C.I.) :

My Trochlear ACI failed.   - - Posted by wonderworm (wonderworm), 11 May 2004

I'm 29 and had my first ACL tear at 19.  3 ACL recons later I have a large Grade IV lesion in my trochlear and Grade 2-3 on my patella as well.
 I did the ACI in Feb. and had a scope 6 months later.  That was how my surgeon noticed that the ACI patch had torn open.  It had torn open somehow and I had hardly even been weight bearing at all.  We think the problem was the rough cartilage on the patella that constantly catches and ripped the patch open.  I was very depressed because I have been dealing with this knee for most of my life.
    There was a bright side however.  I could see from before and after photos of the large defect that the hole was smaller and that it was pikish which showed that the cells were still trying to heal and grow.    It's now a year later and I am about to have my last operation to replace my lateral meniscus.  I will let you guys know how the defect is doing when my doc takes the intra-operative photos next week.  It will probably be the same or worse, because I feel now that in order to heal cartilage you have to be basically in a wheelchair for a year and just get out of it twice a day to do Straight leg raises and stretching.  Unfortunately, I and most everyone find the prospect of no weight bearing for a year or so extremely difficult to accomplish.
    I am going to try to do it, however, and I'm also seriously considering doing the IAGH as well, since I plan to be non-weight bearing for a long time.
Posted by collins8 (collins8), 15 May 2004

I can relate!!  I have bad trochlear grooves on each knee and I have had ACI implants TWICE on each knee.  I can tell you from experience it does not take much to rip the grafts out!!!
Good luck!
Posted by pcfu (pcfu), 16 May 2004

gday guys.
could you physically tell that the graft had failed by the way that it felt, or did you think that it was all going well but only realise it had failed from an MRI or arthroscope??
thanks
Posted by collins8 (collins8), 16 May 2004

You know when it fails!!  Once you have lived with a cartilage defect in the trochlear area, you know the pain all too well!!
The trochlear area is hard to heal because of the angle/ shear forces that part of the knee undergoes.
I hope one day they figure out how to make our bodies heal the articular cartilage itself.  

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