The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: brattkids2 on October 07, 2004, 07:27:26 PM

Title: oats with synthetic plugs??
Post by: brattkids2 on October 07, 2004, 07:27:26 PM
I had the oats proceedure in August 04 with synthetic plugs instead of plugs harvested from my knee.  I was wondering if anyone else has had these and your success with them.
I had a 1cm lesion on my medial femoral chondyle and  1cm and  1.3 cm lesions on the lateral femoral chondyle.
was having stabbing pains and swelling 6 weeks post op (was NWB for 4 weeks)
OS thinks one of the grafts may have cracked and I have been back on crutches  for two weeks to allow time to regrow.
OS says long term studies show a great success rate
so I am a special case as he has not had any other problems with these grafts.
Any advice would be greatly appreciated.
Title: Re: oats with synthetic plugs??
Post by: JG on October 08, 2004, 05:19:37 AM
What do you mean "synthetic" plugs?  What country are you in?  Are you talking about SaluCartilage synthetic plugs?  I know they are available in Europe but not the States.  I had a large mosaicplasty procedure about 18 months ago using 18 allograft plugs.  If the graft is synthetic how will it "regrow".  In my opinion, NWB for 4 weeks is too short.  I did 8 weeks NWB and another 4 weeks PWB.   I had much larger lesions than yours, the small being 2x2.5 cm on the medial fem chondyle.  The trochlear lesion was much bigger.

Title: Re: oats with synthetic plugs??
Post by: brattkids2 on October 08, 2004, 05:28:49 AM
I am in the US  MIchigan
the proceedure is very new just out this year
plugs are from a company call OBI
Im glad to here that they will regrow
OS only had me NWB for 4 weeks then progress off crutches (took me 3 days).
glad to here there is some success.
hope your knee is doing well
thanks for responding
Title: Re: oats with synthetic plugs??
Post by: JG on October 09, 2004, 02:16:05 AM
I guess I am confused.  I didn't have synthetic plugs, I had allograft plugs from a donor (in my case the person died about 3 days before I had the mosaicplasty procedure using osteochondral plugs).  The product you mention is not FDA approved.  See the bottom of this page:  It states, "These devices are not yet cleared by the FDA for sale or use in the United States. U.S. and international regulatory approvals are currently being sought."  Was your doctor an investigator for a clinical trial?

If you read about the product, I don't see how the synthetic plug will "regrow".  To my understanding,  it is resorbable, but it is the human tissue doing the growth/healing not the graft.

Title: Re: oats with synthetic plugs??
Post by: brattkids2 on October 09, 2004, 02:43:31 AM
Yes he is one of the investigative doctors and one of the developers of tools to use for surgery with the product.
hope your knee is doing well.
I couldnt do a traditional oats i am very small bone framed and OS said it could cause more problems to take from other areas. if this graft  doesnt hold i will be up for an allograf (sorry about spelling). Im just hoping that staying off it for a while longer will allow the broken part of the graft to re-attach.
thanks again for the reply
Title: Re: oats with synthetic plugs??
Post by: Psflash on September 18, 2005, 04:07:17 AM
I recently had obi synthetic plugs placed into the lateral femoral condyle of my right knee (June, 2005).  I was wondering how you progressed through your recovery. :o
Title: Re: oats with synthetic plugs??
Post by: brattkids on September 18, 2005, 01:33:07 PM

My experience with the obi plugs was a bad one. I had them placed on both the later and medial femoral chondyles and they failed. The material degraded and flaked out after about six months.

Hope your get better results

Title: Re: oats with synthetic plugs??
Post by: Psflash on September 18, 2005, 04:08:52 PM
Brattkids, Thanks for the reply.  How are you making out with the allograft?

 Last summer, my knee was continually locking as a result of an injuring I acquired when I was 12 (17 years ago).  I sought treatment from an OS who ordered an MRI and determined that I had a complete tear of the ACL.  His only answer was an allograft ACL (for which I sough an Patellar Tendon Autograph, as I am active and for the physical demands of my career).  I sought a 2nd opinion, in which the new OS told me that my ACL was losse, but functional - The MRI "missed it" and that my problem was related to a losse/mal-tracking kneecap.  After several months of therapy and the condition getting worse (an me repeatedly complaining about what felt like a marble next to/under my kneecap when the knee would lock up - an the new OS dismissing it as inflammed cartilage) -  He finally agreed to perform an arthroscopy.  As soon as he inserted the scope, he found a marble sized piece of bone/cartilage in the location where I was complaining.  Her removed that, shaved 3/4 of the damaged cartilage from under my kneecap (which I feel was caused by the "marbel" and not the kneecap tracking, and there was a 2cm x 3cm hold in the lateral femoral condyle (where the marbel originated).  He cleaned up the condyle and that was all.  The lateral side of my knee didn't bother me much until after the surgery (probable because I was now aware of it).  After 5 months of little improvement, the OS advised that the next step would be hyalgan or synvisc.  I felt that this is generally used to prolong a knee replacement, so I sought treatment from an OS in NYC.  He looked at the surgical report and pictures (also pointing out the "marbel fragment" that did appear on the MRI - which 2 surgeons and the MRI radiologist initially missed.  ANyway, he gave me the options: 1) Do nothing 2)  microfracture 3) OATS (for which the lesion was too large) 4) Carticel  5) OATS allograft 6) OBI plugs.  After discussing it, we decided that the OBI plugs were a good choice, as he had good results with them, and I would not be non-weight bearing nearly as long as the OATS allograft.  He also stated that if it didn't provide the results, we could still go back to the OATS allograft.  I had my surgey mid June, 2005 and I doing okay. The Os also thermally shrunk the ACL, as there was too much play (resulting in the aforementioned injuries). The recent X-rays looked good, but I feel popping and friction at full extention (which is where the weight bearing section of the lesion makes contact).  The swelling is pretty much under control, but I don't know what to make of it yet - There is more "poppping" than I would like.  I hope it works out in the end, but I am , mentally preparing myself for the Allograft next summer (another rehab.... :-\  -  I think my hip joint is going to be next from all of the damn straight leg raises, not to mention the hair on my ankle worm off from the ankle weight and the incumbant hearing problems from the continual sound of ankle weight velcro).  ANy information that you could give me on your overall experience (especially with the allograft) would be appreciated.  Thanks in advance.  I hope you are doing well.

Title: Re: oats with synthetic plugs??
Post by: brattkids on September 18, 2005, 08:12:48 PM

That is kind of how my obi wasnt working. My knee kept popping and adventually started locking up due to the obi flaking out and causing loose bodies in the joint. I had pain with my popping though. I couldnt get fully extended without pain.

The allograft is doing great!!! I have no pain on that side at all. I had a traditional OATS done on my medial side (with my own graft) and it has come loose. I go in on the 28th to get it pinned in and hopefully I will be good again.

The allograft rehab was the same as with the obi at least in my case. I know all OS have different protocol that they follow.

Hope you can get back to normal or at least a new normalcy soon!!!

And I know what you mean totally about all the damn straight leg raises. I could puke I do so many LOL  ;D
Title: Re: oats with synthetic plugs??
Post by: Psflash on September 19, 2005, 01:55:30 AM
 ;) Thanks for the information.  I meet with the OS Oct. 4th - I will see what he says then.  Good luck with your upcoming surgery.

- Paul