The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - Osteochondral autografts and allografts (eg OATS & mosaicplasty) => Topic started by: and4400 on December 15, 2009, 10:26:19 PM

Title: OATS and Osteotomy
Post by: and4400 on December 15, 2009, 10:26:19 PM
Well it's  been a while since I've been on here. My story is long but I'll keep it short Have OCD grade4 lesions on RT MFC, I've had seven surgries on it and still not good. Basically had Bone grafts, ACI(both open) and alot of scopes. So now I'm going on the donor list for an Allograft. My ACI probably would've worked if I had the Osteotomy at the same time unloading the Medial side but didn't. My new OS thinks he can give me  some  years with the OATS and Osteotomy(open wedge) before my last option TKR. Anyone who has some input on either of these surgries I'd like to hear your experience. AND44
Title: Re: OATS and Osteotomy
Post by: jb110687 on February 07, 2010, 08:48:04 PM
Hey, I have an OATS operation commng up soon for my OCD in my right knee, I am a 22 year old male and I have had this problem since I was 14, this is my third surgery, I was just womdering what are the chances of getting OCD in both knees, If you can get it in one knee can you easily get it in the other?
How are you doing?
Title: Re: OATS and Osteotomy
Post by: and4400 on February 07, 2010, 09:56:00 PM
I'm sure the chances of getting it now at 22 in your other leg isn't very likely but possible. My knee problems started at 11 or 12 the doctor back then put me in a cast for about 8 months and was on crutches for like two years back then. After all that didn't work I had Micro fracture and I guess it helped for some years but I put off going back to the doctors for a very long time and the ultimate result is what I got now. I'm waiting for a donor for a Allograft for my MFC. I did have ACI (carticel) done in 2007 and the cartilage did grow but because of the way I walk I tore it up again that's why I have to have the Osteotomy done.
         I've been on the donor list about two months now, just wondered if your having Autograft or Allograft? My defect is too big for an Autograft so I had no choice.
Title: Re: OATS and Osteotomy
Post by: ski-bum on February 07, 2010, 11:39:09 PM
I've been checking this site regularly to get some info by people who have has successful OATS procedures.  I'm 38 and had a microfracture on my left medial femoral condyle 11 months ago.  I am still significantly worse off than before my surgery and feel that it has failed.  I saw another OS who believes that I am a good candidate for an OATS procedure.  I will be seeing my surgeon this week and I'm looking forward to hearing his opinion/suggestions.

1)Has anyone out there had an OATS after failed microfracture?
2)If so, what was your experience?
3)How bad was the recovery and how long did it take to feel better?
4)How active can you be after a successful outcome?

I am really bummed about the microfracture failing and need some reassurance that there are options for improvement.....

I appreciate any info and/or advice

Title: Re: OATS and Osteotomy
Post by: and4400 on February 08, 2010, 01:26:13 AM
Marc, I would say that there are many options after MFC surgery. I have not had my OATS yet but have had many other surgeries including Micro fracture (more than once).
      My ACI which is another form of cartilage repair surgery was along the same rehab of six to eight weeks NWB, CPM machine 10 hours a day etc. From what I read and what my OS has said OATS is a very good procedure if done correctly his opinion is to use fresh Allografts not frozen if you're out of range for autografts(your own tissue). I think that 85% is about an average number for positive outcome of OATS. I know in my case that all high-impact activities are out, including running but that's because I'm out of options after this surgery. I think you would have to ask your OS how active you can be after OATS everyone is gonna be different.  I'm 32 and trying to buy time before TKR .  I've had a rough couple years since 2006 (2 open 4 scopes)with this knee but gotta try and do all I can to buy time.
Title: Re: OATS and Osteotomy
Post by: and4400 on July 20, 2010, 04:23:40 PM
Finally after seven months I'm getting this done next week. I just got called yesterday its gonna be a long road to recovery be looking forward to putting this surgery behind me.
Title: Re: OATS and Osteotomy
Post by: and4400 on August 03, 2010, 02:29:25 AM
Well I can say wow this hurts . I had the spinal and after surgery epidural that was self controled. It didn't seem to do much until they removed it Friday then oh boy I couldn't get the pills quick enough. Anyway I had two hole plugged with donor cartilage one quarter sized and the other alittle smaller.
 Next I had a HTO open wedge to shift the weight off the medial side. The donor tissue was used to fill in the wedge and than a plate and four screws to pin it back together.
   So now that I'm home the pain meds are doing me good the only trouble is getting up, as soon as I stand up my leg instantly swells up and starts pounding. I have a lockable townsend brace locked in full extension. I'm using the cpm machine two hours on two off to 50degrees. Other than that Im in my berg ice machine 16 hours a day trying to beat the swelling. My first post op is Friday can't wait to ask questions.  That's all feel free to ask any questions I'll do my best to answer them AND
Title: Re: OATS and Osteotomy
Post by: and4400 on August 05, 2010, 08:04:42 PM
Had my post-op appointment today so a quick update. First my staples were removed, I have a small amount of swelling at the incision which I will start antiboitics to be safe. Also the plate was 10 mm space to fix the varus  (bow leg). The xrays they took today i got see the plate and screws pretty nuts. Also the the two plugs look smooth at the joint line.

I will continue the CPM machine and also start PT next week. I am down to only 1 pain pill every six hours and the pain has really calmed down the last two days. I should metion that I got the Cpm at 70 flex and -6 ext . So besides the red swelling at the incision i'm moving along rather well. 
Title: Re: OATS and Osteotomy
Post by: and4400 on August 10, 2010, 02:30:17 AM
Well I'm ten days postop not much different. I still have some pain although it is not nearly as much.  I'm still icing regularly to keep ahead of the swelling , which really isn't bad now unless I'm up on the sticks alot. I'm at 80 degrees flex on the cpm machine which I try to do mostly while sleeping cause it sucks being on your back all day.  Thursday starts my therpy which will be a  new advanture I'm sure. That's all for now post more after pt this week.
Title: Re: OATS and Osteotomy
Post by: AndrewH on August 13, 2010, 06:54:42 PM
Good to have a fellow knee victim to follow their progress with mine!  ;D
Title: Re: OATS and Osteotomy
Post by: and4400 on August 15, 2010, 08:29:45 PM
Andrew thanks for the post good to know someone is out there.
     Postop 17 days now and feeling pretty good. I had one PT app last week but really didn't do much just went over exercises for me to do and took measurements. I am still using the CPM at 100 flexion but must admit it's really hard putting the time in because I hate being stuck. I struggle to do 5 hours a day now. I started sleeping up stairs now and the machine is down stairs so I can't use it through the night. 
   I can now shower without wrapping my leg with plastic wrap which makes it so much easier. I still have to sit on my shower chair but that's no big deal to me.

Well besides that I'm just working on my exercises SLR, heel slides, ankle pumps , etc. For some reason this time around I was able to move my leg completely without help. So I could do The slr right away something I was not able to do with my other surgries. So I feel I'm alittle bit ahead this time around. I  would say that I'm pretty happy with where I'm at so far. 
Title: Re: OATS and Osteotomy
Post by: Jallan on August 25, 2010, 03:53:03 AM
and4400-keep up the information. I am considering both and am very interested in progress. Of course, like you,  I'd like to be back to normal ASAP
Title: Re: OATS and Osteotomy
Post by: and4400 on August 25, 2010, 07:40:39 PM
Actually today I saw my OS for my four week post-op appointment. I had some X-rays taken and the graft sites weren't very visible which is a good sign that they are healing.  The osteotomy hasn't fused together so it well take some time to heal up.  I can stop the CPM machine (woo hoo) seeing how I'm in PT three times a week a during plenty of exercise. The exercises are rather easy for me at this point and I can't wait to add some new ones to change it up. Also my quad is just gone sad looking.  In two more weeks, which is  six weeks out I will begin weight bearing at 25% and working my way up as long as i can tolerate the pain. 
    The worst part at this point for me is sleeping at night, my leg gets really stiff and really bugs the crap out of me when I'm trying to sleep. I don't think I have slept through the night once yet since surgery, so when that night comes I'll really be happy.  I'm still icing a couple times a day and still elevate when I can. The one thing that is really weird for me is looking down and seeing my leg at a different angle, it looks totally different then before surgery.
    Jallan feel free to ask questions I've had lots of different stuff done on this knee so I can try and answer them.
Title: Re: OATS and Osteotomy
Post by: and4400 on September 20, 2010, 10:29:12 PM
It's been a few weeks but quickly started weight bearing two weeks ago 25% which really isn't anything but it's a start. I'm bored out of my mind with PT you can only do so many leg raises if you know what i mean... Tomorrow I 'm going back to the OS for an 8 week follow-up so I'll have more tomorrow, as where I go from here hopefully I can advance my PT with weights and such. Also I 'll have x-rays so I can see how the grafts and  Osteotomy is healing so until then Later...
Title: Re: OATS and Osteotomy
Post by: AndrewH on November 19, 2010, 03:32:29 PM
Calling and4400!

Any update? Progress?