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

First Appointment at RNOH, Stanmore - - Posted by Lizzie (Lizzie - UK), 18 April 2004

Had an appointment on 7th April with my existing OS and he is now referring me to the Royal National Orthopaedic Hospital in Stanmore, Middlesex.

My first appointment is on 5th May with Mr Skinner.  I'm also due to see Mr Briggs.

My existing OS says that he thinks that I would be a prime candidate for ACI.  He says that I may also have to have a HTO.

I wondered if anyone has had to have both?  Or who has been to the RNOH?  I'm going via the NHS system, but will probably go privately for any procedures as I can't be bothered to wait or even go through the useless NHS system.

Can't wait to get the ball rolling as I am wanting to sort my knee out, once and for all.

Would appreciate any advice.

Thanks Lizzie
Posted by dmarkovina (dmarkovina), 20 April 2004

Just (17/04/04) had my second stage of ACI (Medial Posterior Femoral damage size 3 cm sq) and ACL reconstruction done at Stanmore by Mr Skinner.

Everything done in 2 hours under general. I have hardly any pain post-op. Stayed in hospital until yesterday, i.e. tree days - two nights. Already PWB, have to take it easy initially.

So in RNOH there are two private wards: Ian Monroe and Phil Newmann. The whole site looks a bit dated but inside the wards are quite OK, I prefer Monroe as the rooms are bigger and looks a bit classier.

As to Mr. Skinner, he is a true professional; my PT has never seen so thoroughly written observations on my injury pre-op (after only one consultation!) The op was done on Sat; He come on Sun to visit me and see how I was doing, obviously again on Mon to set the tasks for me and local PT. I have appointment 10 days post-op.

According to what I have heard he is in the top league - I can only confirm that, from my experience.


Posted by Lizzie (Lizzie - UK), 20 April 2004

Thank you very much for replying.

I wish you a speedy recovery.  Just make sure that you keep up to date with taking regular pain meds.

It is good to know that he is such a caring and thorough surgeon.

What condition was your knee in before you decided to undergo this kind of surgery?

I would be really interested to know how you progress.

Take care and take it easy

Lizzie
Posted by dmarkovina (dmarkovina), 20 April 2004

All was fine until 29th Nov 03 when I had a ski accident in Italy.  I was diagnosed ACL tear and cartilage damage, 1 cm sq according to MRI - it turned out to be 3 cm sq.

I was doing OK; had one arthroscopy before seeing MR Skinner.

I was walking up/down stairs with little pain, no pain at all when walking on straight surface.  I couldn't run though (or didn't dare...). I am 34, keen skier and tennis player so the choice was obvious.

My first PT was waste of time - I had no pain whatsoever and was sent of to the gym where I made things worse (stairmaster) I got another PT - what a difference!. The first thing we tackled was knee swelling - it was still substantial more than a month after the first arthroscopy (8th Jan). The key to success here is AIRCAST Cryo/Cuff - the first PT has not ever mentioned it. I recommend you get it; I got mine from Norlite.

As to the pain - I am PWB (up to 50%) going up/down the stairs with two crutches form day 3 post-op and have hardly any pain at all ?? I had the option of using Morphine to reduce pain immediately post op - I used it here and there out of curiosity.

Should I be taking pain meds regardless?

I thought it was going to be much much worse - very happy at the moment.

What is your knee history?

Take care
Posted by Lizzie (Lizzie - UK), 21 April 2004

I suffer from Fibromyalgia (Chronic Pain & Fatigue Syndrome) so I take pain medication regularly.

I went on a Pain Management Programme, which lasted 10 weeks at my local hospital and was told that it is best to keep your pain levels to a minimum and to do this; it is best to take your pain meds regularly, so you won't suffer any peaks or troughs in your pain levels.

I've been a keen skier since I was 4 years old, but have had to give up skiing as I have bilateral OA in my knees.  I've also been diagnosed with hypermobility syndrome too and at 36, I am being told by my old OS that skiing is now out of the question

I did think that I would be able to ski with my Innovations Sports Cti2 OA brace, but my medical insurance wouldn't cover me!  Life can be a real b1tch!

In total, I have had 15 arthroscopies, ranging from washouts to menisectomies to lateral releases and medial plications.  I have owned a cryocuff for some time now and it is great - I bought it with the electric pump so that I can have it going during the night, at least this allows me to sleep better (that's when I do sleep!).

I can't wait to see Mr Skinner, as I want to see what he has to say.

On your first appointment, did you have to have tests, X-Rays etc?

Appreciate your replying back to me.  Where do you live?

I also recommend that you regularly take Arnica - this will help with tissue repair and pain.  You can get it in tablet form from Boots - the manufacturer is either Boots or Nelson.  Also recommend when your scars are healed to acquire the massage balm that has Arnica in - you can get this from Holland and Barratt - it will help break down any scar tissue.

Take care my frind and here's to your rehabiliation.  It is going to be hard, but it will be worthwhile.  

Lizzie
Posted by dmarkovina (dmarkovina), 22 April 2004

The initial appointment is just a consultation; bring with you everything you have, scans, reports etc, so that you can have a constructive conversation. -  I  brought MRI scans, Arthroscopic images etc. I had no x rays as they are useless in my case.

What is OA - Osteoarthritis? and what is the size of your carilage damage and where is it?

I live in East Molesey in Surrey - SW London. Where do you live?

I visited to my PT yesterday (who is very close, in Hincley Wood) and have a plan of action: easy for the first couple of weeks - static quads and hamstings, patella mobilisation, maintaining extension, active ROM to 90 (not being agressive) - and af course icing.

i had a typo in my first post the duration of the operation was 3 and not 2 hours; Mr Skinner has done 2nd stage of ACI and ACL reconstruction in one go.

Many thanks for the tips and all the best

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