The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - ACI & MACI (autologous/matrix-induced autologous chondrocyte implantation) => Topic started by: chr12t1ne on January 02, 2003, 02:09:26 AM

Title: ACI Success!!
Post by: chr12t1ne on January 02, 2003, 02:09:26 AM
Just had my check arthroscopy 1 year after ACI surgery and have been told that my grafts are doing great and have all taken.  I had 2 grafts to the patella and 1 to the medial femoral condyle and feel like I've got a new knee.  

This my best christmas present and I am really happy with the outcome, not without a lot of hard work though!

This procedure has no doubt got a great future, lets hope it is made more readily available soon!!  Anyone who is truly struggling with knee pain, this could help you big time!  My knee is virtually pain free now.  Good luck to everyone going thru the rehab you'll get there just dont give uo!  Sue
Title: Re: ACI Success!!
Post by: muffy on January 04, 2003, 08:14:01 PM
How were you feeling at 9 months Post op? Did you have pain then ? What kind of exercises are you currently doing? How old are you and who did your surgery? Thanking you in advance
Title: Re: ACI Success!!
Post by: chr12t1ne on January 05, 2003, 02:49:06 PM
9 mths post surgery I had intermittant pain caused when I twisted on my knee.  I did not have any pain in between times as long as I didnt overdo thins too much.  I walk my dogs daily for about 2 miles without too much pain, I was going to the gym about 3 times a week but sticking to the static bike and treadmill.  I have been restricted in getting back to sport because I also have problems with my left knee.  I have never had to stop my sports coaching but this doesnt mean my having to run around too much.  Since my last arthroscopy the surgeon seems to have sorted out the pain I was having so now am just about pain free, just a bit of soreness post-op.  My surgeon was Prof George Bentley at Stanmore Middx UK, and I had the surgery at 41.  If I was a bit younger I probably would be keen to get back to competitive sport and I think my knee would hold up it feels pretty good, I will get back to sport soon but am in no rush I need to be sure the muscles are strong enough.  Hope this helps Sue
Title: Re: ACI Success!!
Post by: muffy on January 06, 2003, 04:17:49 AM
Than You Sue,.... That was very helpful. So you had an arthroscopy after the big surgery? Interesting. That is what he wants to do with me.. I am 9 months post op. The MRI seemed like everything was OK then pain out of no where. After examination, it seems that clinically I have an overgrowth of the graft, meaning he will have to go in and shave the excess. The never ending dilemma of my knee.... Let me know when and for what you had the scope done. Thank you much
Title: Re: ACI Success!!
Post by: Helen_uk on January 06, 2003, 12:24:09 PM
I am 5 monthes post op from my grafts and I cant say it hurts it just feels odd and still swells but not painfull like the other so if it does well I will have the other one done But first I need to feel well as this has really run me down.
Glad you are doing so well keep up the good work
H xxx ;)
Title: Re: ACI Success!!
Post by: chr12t1ne on January 07, 2003, 12:23:02 AM
I always knew there would be a check arthroscopy at the end of the first year.  My scope was done Dec.  The surgeons know that the graft can overgrow I was told this before I had the treatment and of course if this is left untreated can cause problems with the mechanics.  As far as I know my grafts had not overgrown my surgeon didnt say they had and I didnt feel any crunching or grinding in my knee before the scope.  I see the surgeon in a couple of weeks so maybe will get a better idea of exactly what the knee looked like and the quality of the new cartilage.  Having had the joint opened up for the ACI procedure the scope is merely a walk in the park!!  
Title: Re: ACI Success??  I worry I tore the graft!!
Post by: wonderworm on March 13, 2003, 02:29:28 AM
     Can those of you with a succesfull ACI tell me how many times you bumped, fell or twisted your leg in the first 3 weeks after surgery?  Also, did you keep your leg locked for 4 weeks or was it hinged open to bend a little?
    I have a large trochlear implant.  

I Slipped a couple of times on the crutches and my ACI leg had to catch my weight to keep me from falling and I felt sharp pain as i caught myself.  I didn't fall each time, but I did put weight on it within the first 2 weeks because of these slips.  Now I'm at week 5 and I've noticed a catching sensation just like I had before the operation and I'm worried I tore open the patch and leaked out all my cells before they matured.
    I sure hope this whole thing wasn't for nothing because of a minor slip shortly after surgery.  My brace wasn't locked in full extension at the time so my knee could bend.
Title: Re: ACI Success!!
Post by: muffy on March 13, 2003, 02:59:01 AM
I think time will tell. We have all put weight in an unexpected fashion on our bad leg at one time or another.  I believe doctors get concerned on falls and not on an occasional slip. I for one had my share of problems and I am still facing big ones as we speak...Do not be concerned you will have other episodes,  trust me.... Be calm and take things one day at a time.
Title: Re: ACI Success!!
Post by: Linda on March 13, 2003, 03:10:47 AM
Hey Wonderworm,

The catching could be from many different things, so don't stress over it too much. My knee still occasionally catches and my OS and PT are confident that it has nothing to do with the implant.

Good luck!


Good for you! I am glad that I am seeing more and more success stories. There are a few around my PT place, and I spoke to a few from my OS's office prior to my surgery.


My OS said that there might be overgrowth, but he said that it is no big deal to go in and shave it off. He said that it is much preferable to no growth. It is an easy scope procedure that you actually walk away from. Hang in there. All is not lost if your only problem is overgrowth.

Good luck!
Title: Re: ACI Success!!
Post by: chr12t1ne on March 15, 2003, 01:34:08 AM
Wonderworm, I reckon anyone who's gone thru ACI would've had the same worry.  I fell the day after the op trying to be too independent, and then slipped getting in the shower, getting out of the shower etc etc  I had my leg in plaster for 10 days post op and then nothing, no brace just back to normal except the leg was still very swollen.  I did have complications caused by adhesions but this was sorted by MUA at 8 weeks and scar tissue was removed back in Dec.  Anyway I have 3 grafts and after one year they were all still in tact despite all the knocks and trips so I figure they must be a lot tougher than we imagine, I have been informed that the cartilage at biopsy is still in a period of evolution 1 year post op.  Part of the synovium was removed in the Dec arthroscopy and this has resolved some of my pain problem but the pain I experience on occasions is nothing to what it was like before the ACI.
Best wishes Sue
Title: How bad was everyones' defect?
Post by: wonderworm on March 15, 2003, 02:29:54 AM
Thanks everyone.
    I went to the Doc yesterday and he eased some of my previous fears.  I do have a question about how bad everyones' defect was that warranted ACI.
   I had 2 LARGE defects, grade4 Troclear, and a Grade 3 lateral femoral condyle.  I had asked my surgeon before the surgery to to ACI on both, but he did not feel the grade 3 lesion warranted ACI (or maybe he was lazy) so he only repaired the Grade 4 trochlear.  Has anyone here had grade III lesion repaired with carticel.  I may have to do it all over again to repair the lateral one.  Wish i could have gotten both at once.
     I've heard that you can also stitch the periosteum patch and throw some stem cells or bone underneath instead of cloned cells and the result can be good as well.  Although probably not as organized as type II hyaline cartilage.  Anyone heard of this?
Title: Re: ACI Success!!
Post by: bjsolin on April 02, 2003, 02:53:44 AM
Hello everybody.

I was just looking around and saw this, so I would like to explain myself.  I am currently a 17 year old male, and I had an ACI repair about 16months ago.  I have always had knee problems due to me being an active kid, sports and whatnot.  The orthopedic MD I went to, couldn't figure anything out, and I had a baker's cyst also present.  After a while of messing around with therapy and anti-inflammatories, and rest, he decided to scope my knee thinking the a meniscal tear did not show up on MRI and that I would be playing soccer for my school 3weeks later.  This was not the case.

I ended up having a large articular defect on my tibia (doc said grade 4, the size of a quarter).  After fighting insurance company, i got approved and had the procedure.  I think that I actually tried full weight bearing before I should have, I think I tried at 3-4weeks.  Nothing happened, cool!  But I did have setbacks along the way, but now all is good.  At about 7-9months, I started to just get an annoying ache/pain, but no swelling, we went in, he took an MRI, negative, cartilage looked "great."  Pain persisted, went in for a scope, and found a smaller tear on the femural aspect, and he did a plugging procedure on that.  Ever since then I've been doing really well.  I started jogging at about 1 year.  I have been doing heavy weights and a lot of running since then, everything has been good.

I see the doctor in 2 weeks for another checkup, this i when I hope he'll tell me that it is okay for me to return to soccer.  This would be probably the greatest thing to happen to me, because it would be my senior season next year.  

If anyone wants to know, my knee feels 98-100%, and I would really recommend this procedure to anyone that needs it, and I would make the same choice again if i had to.  I know I probably had better results because of the fact that I am so young and my cartilage could recover and grow so well afterwords.

If anyone has questions, let me know, I would be happy to give advice.

                        [email protected]
Title: Re: ACI Success!!
Post by: Heather M. on April 10, 2003, 09:49:18 AM
I believe the latest figures I've seen indicated that there was a very low success rate for patellar the neighborhood of about 30%.  There is something about the shape, motion, and function of the patella that makes it very difficult.  I'm frustrated by this information, as I have pain mainly from osteochondral lesions on the back of my kneecap.

If you learn anything about patellar defects, please let me know.  I did most of my research in an online medical journal, reading abstracts which summarized the study results.

Patellar defects are the toughest to deal with, from what I've read.  It seems like patello-femoral replacement (like a knee replacement but only resurfacing the back of the kneecap and the trochlear groove) is the best bet if there are no tracking issues and only focal damage on the kneecap.  The success rates for these aren't that great, either, though.  Check out  under the surgery section and arthritis of the patella section for more information.


Title: Re: ACI Success!!
Post by: ALLPRESS on May 28, 2003, 12:56:40 AM
I am 32 years old and have damaged the medial side of my femur at the knee. The damaged area is about 2 cm diameter. The damage is due to the fact I used to be a professional soccer player and had torn my meniscus on three seperate occasions. I can no longer play soccer but can run, jump and climb and the injury does not effect my quality of life. I have been offered ACI but I am concerned as there are no guarantees and at the moment I feel as if the proceedure is a bit extreme. All I would be looking for from the proceedure would be a stabilisation of my condition and hopefully a better chance of avoiding arthritis and a ultimately a knee replacement. Can anybody help with advice?
Title: Re: ACI Success!!
Post by: chr12t1ne on May 28, 2003, 02:09:00 AM
The reason I had ACI was because my knee injury was affecting my quality of life, I couldnt even walk as far as I wanted let alone running, jumping etc.  Not even sure why you were offered ACI if your knee isnt giving you much trouble!  It doesnt come with guarantees, it might not even be successful for you, I felt I had nothing to lose but a lot to gain if it worked, the pain relief alone was worth it.  You have to bear in mind this is still a relatively new procedure but results so far look promising as far as delaying OA but I guess only time will tell.  If you're really not sure about going ahead then talk to a different OS and get a 2nd opinion they are the only ones who can say wether or not its going to prevent you getting any more damage. Good luck S