The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - Osteochondral autografts and allografts (eg OATS & mosaicplasty) => Topic started by: scottrayden on February 18, 2004, 12:19:54 AM

Title: 7 days out of OATS surgery. Will it get better???
Post by: scottrayden on February 18, 2004, 12:19:54 AM
Well I'm now 7 days in recovery from my OATS surgery. I also had a partial Miniscus tear that was fixed.

The pain has started to go away and I'm at about 90 degrees flexation on my CPM machine.  I can't put weight on it for 3 weeks.

Today is my first day back at work (sitting at a desk) and I'm having a really hard time sitting here. My leg isn't raised above my heart but is raised somewhat. I know this can't be good.

I'm starting PT in two days and hope this will help. I would love to hear from anyone who has had this about how the first month and second month goes.

Can I hurt my knee from sitting here at work and not having it in the CPM machine and not having it totaly elevated?????

Title: Re: 7 days out of OATS surgery. Will it get better
Post by: kathleenj on February 18, 2004, 09:30:47 PM
Hi Scott,

I am about 10 weeks post op Oats.  It has been a tough 10 weeks but I must honestly say that it definately gets better.  The 1st month was the absolute worst.  I was non-weight bearing for the 1st 4 weeks and then partial until about 2 weeks ago.  I am just now able to walk without the crutches but I still have severe quad lag.  Walking up or down stair are impossible still.  Things definately do get better.  I developed some scarring of the patella tendon which slowed me down a bit but overall I am pretty happy with the way I have progressed.  I still have alot of rehab ahead but I feel pretty optimistic right now.  Maybe that has to do with my ability to walk without cruches now :)
Just a bit of ice ice ice.....if you can, do it at work.  I am still not back to work, althought, my job requires me to be on my feel all day.  
Good luck...and if you have any specific questions just ask.
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on February 18, 2004, 10:24:48 PM
Thanks so much for the reply!!! It's very comforting to hear from someone that has gone through what I am going through right now.

I have to say the two worst things are sleeping and Showering. It's been a very long week.

The pain has pretty much gone away but it's still pretty uncomfortable. Did you have a problem when you put your foot down and all the blood would rush down to it??? How long does that last for??

Any advice on building back my quad?? I know it's only been one week but I want to make sure I stay ahead of this. I start PT tomorrow but would love to even start today.

What things did you do to help you through your first few weeks????
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: kathleenj on February 19, 2004, 02:14:46 AM
Sleeping and showering.......yikes, that was definately the worst.  Just hopping into the shower was a very difficult experience.  Sleeping wasn't too bad at first as I took lots of pain meds before I went to sleep and slept on the couch with lots of pillows.  As I went up to the bed I struggled with pillows and tossed and turned most nights.  I am still unfortable sleeping as I wake up a couple times a night but it is getting better.  I dont really have any helpful hints there because I was never able to get totally comfortable.  
As far as the blood rushing to my foot...sorry to say that it is still happening.  Not as bad, but still happens.  I swell up alot and my OS says that is very common with the type of surgery and it could take up to 12-16 weeks for that to subside.  
As far as quad strengthening goes...its been taking alot of time for me to get a little back.  I still have a ways to go.  I am sure your PT will give you lots of advise to get them going again...I didnt start PT until 4 weeks post op but I wish I had started sooner.  As I am sure you know, it doesnt take much for them to shut down.  I'm not really sure what you can do only after 1 week so I really cant give any advise there...better off waiting to see what the PT says.  
I was really happy to get off those darned crutches but do use one in the evening as my knee begins to get sore and swell quite easily.  Come 5pm it is shot and buckles out alot because of my quad weakness.  But most days I can run about my daily life.  Well, hobble, really.
Getting thru the 1st few weeks was tough.  Most of it was spent on the couch.  Like I mentioned I am still out of work so I mostly just hung around...iced contantly, always elevated and tried to keep it moving as much as possible.  I also relied alot on my family and a few great friends who helped with the kids.  
Just try to take it as easy as possible.  You dont want to push yourself.
Hang in there and let me know how PT goes tomorrow.  
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: JG on February 19, 2004, 08:59:59 AM

I am 10 month post-op OA allograft plugs using mosicplasty technique.  I don't know the extent of your surgery or where the graft(s) was placed.  The best advice I received was from my surgeon and it was echoed by my PT.  The very best thing you can do for the grafts is give them time to heal and be very patient with rehab.   He said that he would rather me do absolutely nothing, let the graft heal for the first 12 weeks than do too much.

I had 18 - 10-12mm grafts placed in the trochlea and medial chondyle regions.   I was NWB for 10-12 weeks (not even allowed to touch my toe to the ground), CPM for 8 weeks (which was worse than the crutches for me).  Like you I returned to work, but way too early.  I was suppose to be off work for 3 weeks and then go PT for another 2 before going FT again.  I started about 10 days post op.  

My best advice for you would be - be patient, it gets better but give the grafts time to heal.  Unlike Kathleen, I started PT in earnest at week 12 (when I could stand).  I basically checked in with the PT 5 days post-op.  I got my OS on the phone to discuss rehab and we decided that I would check in every two weeks until week 8 than 1/week for another 4.  She gave me the same exercises I would do at PT but for home.  I had an unusually rehab protocol because the protocol for the trochlea was contraindicated for the chondyle and vice versa.   If you can weight bear, early rehab might be better.

There will be a huge difference between each week and you will be surprised how fast everything comes back, but stick to the rehab protocol to a tee.  Last week I talked my PT into letting my run and I am paying for it.  My surgeon said we would discuss it at my annual.  He thought I should really never run again, but maybe as a cross training thing at 18 months.

Good luch...Janice
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on February 19, 2004, 07:08:20 PM
I just wanted to thank everyone for replying to me. It's so great to find other people going through and have gone through what I'm doing right now.

I start PT today and will let ya know how it goes : )

Title: Re: 7 days out of OATS surgery. Will it get better
Post by: JG on February 19, 2004, 08:51:38 PM

Another thing that really helped my is a shower chair.  I don't need to tell you, but standing on one leg to take a shower for more than 5 mins. is difficult.  The shower chair saved me for more than 3 months.  Also, make sure you ice at work.  10 months later, I have no problem with icing at work..always feels good.  The PT I work with (Lisa Giannone) wrote the protocol for OATS and other cartilage restoration procedures.

You can find the protocol at:

Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on February 19, 2004, 08:54:26 PM
I'm definitely going to get a shower chair. I get so tired just from standing in the shower and trying to work my way in and out of it. Thanks for the suggestion.
I'll read up on that link you sent me.

Thanks again for taking the time to get back to me

Title: Re: 7 days out of OATS surgery. Will it get better
Post by: David 69 on March 23, 2004, 04:47:15 AM
Hello Scott
I am curious to see how your are doing with your post op OATS?
How many plugs did you have and what size were they?
Were the plugs your own or allograft?
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on March 23, 2004, 11:12:55 PM
Hey Dave,

Let's see I'm now 6 weeks out of my OATS and mediscus surgery. Things have definitely improved in a big way. Once I started to put weight on my knee (3weeks post op) it really started to heal quick. I can walk now with almost no limp and have been biking my knee every day for about 20 minutes followed by quad sets (squats, lunges so on). My knee is definitely still not close to 100% but it's well on it's way. The pain is pretty much gone. It's more just little aches and pains now and then. Everyday seems to be a little better.

I had one plug done that was my own. I'm not sure of the size but I think it was pretty big. My doctor is saying I should be able to get back into basketball and be active again, considering I have already had 3 surgeries on my left knee I might have to hang up my basketball shoes. (two prior ACL surgeries and MCL surgery).

Anyway, Things are good and I'm getting better each week. Biking seems to really be helping it the most.
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: kathleenj on March 23, 2004, 11:56:06 PM

Glad to hear that you are doing so well.  I had my Oats in December, one graft about 10 mm, and still can't do half the things I did before the surgery.  I  believe that my lack of progress right now is due to my patellar tendon and quad lag.  I am sure it will all come back in time but I'm a bit of an impatient person and am constantly frustrated.  Stairs are still impossible as are squats and lunges.  To top it off,  I have begun to  maltrack and my patella is tilted which causes constant grinding and pain. Also the spot that the OS took for the graft, the donor site just to the lateral side under the kneecap, has filled in with a little too much scar tissue and is continually catching and grabbing causing my knee cap to pop. Ouch!!!
Even though things aren't exactly where I would like them to be, I am pretty much pleased with the surgery.  I know I can work through this rehab and be back to normal soon.  It is great to hear that you are doing well.  It definately inspires me and keeps me working harder with my PT exercises.  
Thanks for posting.  
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on March 24, 2004, 12:28:47 AM
Hi Kathleen,

I'm sorry to hear that you are having some problems with recovery. It sounds like overall you are doing good but just not where you would like to be. Hang in there! If you stick with your PT excersizes and keep a good attitute and don't give up, you will find yourself running up and down stairs in no time!
I have had 3 prior knee surgeries. One thing that really really really helped with each one is riding the bike.  Riding the stationary bike helps to keep flexability in the knee, it helps to circulate blook through the joint which speeds overal healing, it helps to break down scar tissue that might be starting to build and for me it was the fastest way to build up my quads.  I try and ride a stationary bike for 10-20 minutes (depending on how I feel) each day.  Then I try and do, Squats, Lunges, calf raises, step ups on a small platform and step downs. Three times a week. Monday, wed, and either Friday or saturday. This has been my recovery for all 3 surgeries and it's been a huge help.

Let me know if you have any questions about he exercises your PT is having you do or if you have any questions about the exersices I am doing.

By the way, how far can you flex and straigten your knee??
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: kathleenj on March 24, 2004, 12:54:25 AM

Thanks for the reply.  I have been doing the exercises you mentioned but not as intensly as I would like.  My pt says to go only thru the no pan zone as I do have scar tissue on the patellar tendon and going thru the pain is the worse thing for it right now.  All my instincts tell me to work thru the pain but I need to trust my OS and PT.  I believe this has slowed me down alot.  
I was riding the bike everyday for about 15 minutes until this darned popping started.  I can do it for a little while if the kneecap is taped but it is still a bit painful.
Definately getting better as the quads get stronger.  My quad lag is down to about -5 now which is really good considering 2 months ago it was -55.  The VMO is finally starting to fire and I can actually feel muscles working that I almost forgot that I had.  My extension is -3 now and my flexion ranges between 120-130 depending on the swelling at that moment.  I am definatly coming along just not as fast as I would like.  Very slow.  Not good for a person with zipo patience.  
Thanks again for your reply...I am going to give the bike a few more chances.  Make sure I tape it everytime and maybe I can get rid of this darned quad lag.  
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: JG on March 24, 2004, 08:33:59 AM

Where was your graft placed?  The fact that you are doing squat and lunges at 6 weeks perplexes me.  It also leads me to believe it was not in a weight bearing location.  Also, you would have been on crutches for longer than 3 weeks.  Are you working with a PT or just rehabing on your own.  

Just curious...Janice
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on March 24, 2004, 07:04:19 PM
Actually it was in a weight bearing location. That is why I was told to stay off it for 3 weeks. After the 3 weeks was up I was walking without crutches 3 days later, then I was told by my doctor to start biking it 10-20 minutes a day. About 1/2 weeks after that I started doing light squats and lunges and now at 6 1/2 weeks, I can do 3 sets of 12 squats, 2 sets of 3 way lunges, walking lunges, step ups, bike for 20 minutes and then stretch.

I know that each person is different with healing and each doctor has their own recovery standard. I have always been in great shape and I have always healed very fast from these types of surgeries. I have had 2 previous ACL reconstructions and always amazed my PT's with how fast I recover.

I'm currently going to PT twice a week. I ride the bike everyday and Monday, Wed and Saturday I do the work out above on my own. My PT knows I'm doing this so when I see her on Tues and Thursday we have light workouts and she really focuses on balancing exercises and knee stability exersizes rather then really working my quads.

What about my surgery makes you think I shouldn't be doing this? I did a ton of research before I went in for my sugery and heard stories of people not doing well for 2 months after surgery and I also heard about people doing as well as I am.
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: mtnbikcowboy on April 07, 2004, 06:42:28 PM
Scott, I am where you were when you posted.  I am six days and wondering the same things you were.  I had a single medial condyle 15mm allograft on April 1.  Although not the first, autograft one year ago same location. I know what you mean about the desk thing.  Very difficult to be upright and sitting without ice and such.  My deal is a workers comp and my os returned me to light duty at first post op last time.  I work as a firefighter/paramedic and the department has a full time physician that you have to see before returning to any kind of duty.  After one day of sitting at a desk my knee was swollen, painful, throbbing, and discolored(well more so than normal).  The deparment doc took a look and discontinued light duty until free from crutches.  This allowed me to use the ice machine, cpm, and elevate any time I was not in pt.  Very helpful.  Post again with your progress.  
Title: Re: 7 days out of OATS surgery. Will it get better
Post by: scottrayden on April 07, 2004, 08:18:03 PM
Hey thanks for the post!

Yes the first time back to work was a little rough. I couldn't really elevate my knee that much and it just wasn't working. I basically took half days for a week until I could take it. My recomendation would be to take it slow. It does get better : )

Right now I'm 7 weeks out of surgery. Wow it feels like a lot longer than that.... Things are going well. I feel now pain other then a few aches here and there. I'm really working on getting stronger by biking, lunges, squats so on. I think in about 2 weeks I'll start light jogging if my doctor ok's it. I get the urge to jog now but I  now I should wait and not rush it. The swelling is still not totaly gone but it's a lot better. I do still get some clicking and odd things when walking every now and then but I think it will go away when the knee swelling is totaly gone. I'm very happy with the recovery as of now. The first month was the roughest though. I HATE CRUTCHES hahahah.

Let me know if you want any more detials from me. I'm happy to share my experience.

I've also had two previous surgeries o nthe same knee. Two acl's recons. I'm hoping this is my last one. Although I'm already craving to get back on the basketball court.