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

Need recommendations... - - Posted by chad (birdman33), 30 October 2003

Will try and make this short  I had ACI a little over 2 years ago on the trochlea, along with an Elmslie-Trilliat procedure.  I've had 4 subsequent arthroscopies to clean out the knee - and to debride the cartilage because it kept growing at the ACI site.  For some reason the cartilage was stimulated and kept growing - I had catching and grinding before the surgeries.  Had my last surgery a few months ago - and knee felt pretty smooth afterwards.  The implant has been holding up great, though.

However, I'm frustrated.  My knee still grinds very much - and with activity it seems to irritate it.  I have no doubt things are not very smooth in there and that is the cause.  I want to get back to jogging/sports.  Right now I can bike, do the stairmaster, walk without much problems.  But, the catching is starting again.  Just saw my doc and he just said to avoid doing the exercises that bother it - which is most things.  In the end he wants me to cut back and I can't make gains by cutting back - I would make NO progress doing that.  It's been 5 years since my injury and I'm frustrated.  I trust this doctor and mean no disrespect to him, but I think he won't be able to help me much more.  I also worry about doing more damage to my knee if I keep pushing it.

My thinking at this point is to keep going a few more months with my routine, try to get it stronger and see where I'm at.  I'll go see him again and then decide on what to do.  My gut tells me I'll need to get another opinion.  I hate to do that because I like this doctor and he is one of the best out there, but I can't accept the state it's in.  He said this may be as good as it gets and that's hard for me to take.  Any suggestions?  Can anyone recommend someone who would be the one to go to for another opinion?  I'm willing to travel across the US for this - that's how much it means to me.  Thanks!
Posted by HelenaM (HelenaM), 30 October 2003

Have you been checked out by a GOOD physio?  Sounds like it would be a good idea to have someone look at muscle balance, posture etc.. are you working one muscle more than another all that sort of stuff?  My ACI grafts didnt look completely smooth at 1 yr arthroscopy and I occasionally get the odd catching and grinding but my physio has also been helping with posture and alignment which does make a difference and it helps to have someone watching and correcting when you excercise.  Just a thought!
Posted by receo (receo), 1 November 2003

where r u at?
Posted by chad (birdman33), 1 November 2003

I'm in the Rochester, NY area...  I have seen a decent physio - and they did check my form and all that.  The problem is they had me doing things like mini-squats and lunges - which seems to be the only thing that really make my knee stronger.  At the same time, though, it irritates it.  Simple leg raises and those types of things just aren't helping - they aren't strenuous enough.  I feel the knee needs to be pushed, somewhat cautiously, but even then it's hard because I make gains but then have to lay off a bit because it's irritated.  I'm sure form and everything isn't perfect, but until the strength is back it's going to be hard to have it that way too...

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