The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - Osteochondral autografts and allografts (eg OATS & mosaicplasty) => Topic started by: Caroline109 on February 15, 2008, 11:08:13 PM

Title: Just found out I will need OATS in a year or two
Post by: Caroline109 on February 15, 2008, 11:08:13 PM
I just my 4th knee surgery (history is below my signature) last week, a torn medial meniscus. I found out Wednesday at my post-op visit that during the arthroscopic, he found a tear in my articular cartiliage by my femur. He says it's nearly bone on bone over there (I had no idea that I had this problem in addition to the rest of my knee issues. He says I probably will need the OATS procedure in a year or two, depending on how things procede. I know also I will need a partial knee replacement on my other knee in the next couple of years as I already have bone on bone arthritis there. ALso my case is complicated by a chronic (27+ years) of a low platelet count which always makes surgery a little more difficult to manage for me than for most people, although, as a big surprise, at my pre-op for last week's surgery, it came out normal for the first time in 25+ years. My OS does general orthopedics (he's actually a foot and ankle specialist) and will refer me to the doctor in the practice who does OATs procedure and also to the doctor in the practice who does the partial knee replacements.

I'm just looking for generalized information from people who have had the procedure and for how it went, recovery wise and any other information you can tell me!

Thank you for any information you can tell me!
Title: Re: Just found out I will need OATS in a year or two
Post by: plantgeek58 on February 16, 2008, 02:17:56 AM
Hi Caroline,
I had an OATS autograft on my right knee in '05. I can tell you that, while the recovery is long and not easy, the surgery has a pretty good success rate and it worked well for me. It's an open knee procedure and with mine, I ended up with a 5-inch scar down the center of my knee. The first couple of nights after surgery were very painful. The vicodan they gave me just barely took the edge off. After that it got easier, but it still hurt a lot to move the leg around. My quads shut down for several weeks, which is a common response to this type of knee trauma, but they eventually did come round again. I was NWB for 4 weeks post-op, then PWB for 2 more. It took about 2 months to get off the crutches altogether. PT went on for about 4 months. I went twice a week for half an hour at first, then moved up to 45 minutes once I got back walking. I had home exercises to do, also, twice a day, every day. My therapist also had me do friction massage over the scar once it had fully closed, to break up any adhesions underneath it. That hurt, but I only had to do it for a few weeks. Now my scar is just a flat white line. It takes about a year before you feel fully normal again and I've heard that you can continue to improve for another 6 months or so beyond that.
I can't think of anything else to tell you just now, but feel free to ask if you have any more questions.
Title: Re: Just found out I will need OATS in a year or two
Post by: Caroline109 on February 16, 2008, 02:34:27 AM
Thanks, Terre, for the response. My OS said it was a hard and long recovery (he actually said tedious) and what you said seems to validate that. He said it could be a semi-open procedure but yours was actually open. I'm wondering if it depends on where things need to be done. Thanks for answering my post which I can see now is full of terrible typos so I'm glad you could understand what I wrote! Considering that I already have scars on my knees, although they're all small, one larger one won't matter if necessary! I've had a lot of PT for my knees and other body parts so I'm used to doing the required exercises (including ones that stregthened the quads) and going to the required therapy sessions.
I'm going to have to look up some of the abbreviations you used because I;m not familiar with them but I';m sure soon enough I'll get familiar with them!
Thanks again for your response.
Title: Re: Just found out I will need OATS in a year or two
Post by: plantgeek58 on February 16, 2008, 03:45:56 PM
Hi Caroline,
I can clarify the abbreviations. NWB means non-weight-bearing and PWB means partial weight-bearing. For the first four weeks I had to use the crutches to keep my leg completely off the ground. Then for the next two I had to start with about 25% weight-bearing and gradually build it up. Depending on where the graft is located, you may have a longer or shorter NWB time. Each OS seems to have a different protocol anyway.
It would be great if your procedure could be semi-open. I imagine that would greatly reduce the pain and speed recovery.
Do you know if your OS wants to do an autograft or an allograft? An autograft is a graft taken from a non-weightbearing part of your knee, usually at the top of the femur. An allograft is one taken from a cadaver. There are pros and cons with each type. Some OS prefer one over the other, but it may also depend on the condition of the rest of your knee.
Title: Re: Just found out I will need OATS in a year or two
Post by: Caroline109 on February 16, 2008, 04:03:34 PM
Thanks for the clarification on those abbreviations. There sure are a lot of them in the knee world.

My doctor said it would be an autograft, taken from the back part of my knee or thigh (and this could be wrong-hubby who was with me, isn't here to ask), I think he said---but this was my meniscus OS, not the one who would actually be doing any  OATS procedure so of course, the one actually doing the procedure would decide. I would really hope too that the procedure coujld be semi-open given my low platelet count. The smaller the incision, the better, although I did manage to have 3 csections, but only after a few weeks of prednisone treatment before the actual csections. I know my hematologist was already getting worried when I mentioned that I would need a partial knee replacement eventually, telling me, in case I didn't know (ha!) that it was a much more complicated operation than all my arthroscopic procedures. As in the past, my hematologist, OS and primary doctor would have to work together to get me through each surgery without bleeding issues.

I really hate being on crutches because they bother my armpits and I have shoulder arthritis so they really bother my shoulders. For this last knee surgery, I got a cortisone shot in each shoulder prior to the surgery so I would be able to tolerate the cructhes for the few days I would need to use them. It'll also be hard keeping any weight off the involved knee but I guess I'll manage. How long total were you on crutches, regardless of the weight bearing issues?

Thanks again for answering my questions. I have a while before I'm going to actually deal with the procedure, I hope, as at this point, 2 surgeries I just had in a 3.5 month period is enough for me for a while!
Title: Re: Just found out I will need OATS in a year or two
Post by: plantgeek58 on February 16, 2008, 04:25:10 PM
I think it took me about 2 months to get off them completely, but for the last couple of weeks, I got down to one, and was really just using it for balance until my leg got stronger. I wasn't happy about needing crutches either, because I have tendinitis in my elbows, and they were getting pretty irritated.
I hear you about wanting to give the surgeries a rest. Believe me, after six of them, I've had it for awhile, too. It must be doubly hard with the bleeding issues.
Title: Re: Just found out I will need OATS in a year or two
Post by: Caroline109 on February 16, 2008, 11:02:28 PM
2 months on crutches doesn't sound terrible, although I'm still not looking forward to it. I don't know what I ahve going on in my elbows, but they do ache, especially at night when pressure in on them.  Noty sure if it's tendinitis or arthritis,but they're not terrible, but not completely asymptomatic). I had golf elbow once (pretty ironic since I don't play), medial epi....can't remember the rest of the name... and it was very painful.

I had 2 knee surgeries in 2003 4 months apart and having done it again recently, I'm not in a big rush for anything, unless, of course, things suddenly get intolerable pain wise. Certainly hoping that won't happen.

Again thanks for the information!