The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - Osteochondral autografts and allografts (eg OATS & mosaicplasty) => Topic started by: IamNate on November 22, 2016, 08:34:08 PM

Title: OATS- My Story, Poss. Failure, Re-Do Autograft And Allograft with Stem Cell Inj
Post by: IamNate on November 22, 2016, 08:34:08 PM
Hi My name is Nate.

Alittle backgroud about mysef: I'm 29 Registered Nurse, Health Coach, and Personal Trainer.

During summer of 2015 after working out, I noticed knee pain and instability. MRI eventually showed subcondral defect on the medial femoral condyle. The deft was too big for an autograft, they would of had to use many areas from the donor site and the best situation seemed to be allograft.

On October 14 2015 I had the OATS allograft. It was the most painful thing I've ever experienced and that overnight stay in the hospital was brutal. The whole way home was brutal and the first week. I questioned myself then what was I thinking!? and that I would of never had it done if I known it was this bad. I have an amazing pain tolerance, but this pain was bad.

For weeks I didnt have any nerve feeling in my right leg, Friends and Family helped me get to the rest room. Mentally it was just ass depressing ass painful. The depression caught me by surprise. But sitting there for week after weeks not being mobile, so much pain, and being the furtherest thing from the days of independence.

Fast forward 3 months later, my knee is feeling great , great enough to be tempted to play, but I didnt

6months post op. Im supposed to Jog. I cant jump, i can have a fast limp gait if you call that a job, this was the first real time i started to worry. I've felt like I've been through hell, and the time to start seeing the hard work paying broke me down. I cant run!

But I felt machines that was pretty pain free, i worked my ass off, i even went vegan. i lost 30lbs prior to surgery and was looking n the best shape in the world 6'4 197lbs 3.4% body fat just month from surgery. I refused to allow myself to quit. ...But the knee wasn't close to normal.

A few MRI's later shows that the graft, it took! its healthy!! So we was wondering why i'm having so much pain.
I still went to the Gym almost everyday, did my cardio on the machine, held on tight do that  i could do, and i could get through it fine. Unfortunately always, either immediately after or hours later my knee would be so tinder and I would limp for days.

Because MRI's looked perfect
I was told to stay away from gym, n stairmaster, no cardio, I was given Prednisone and told not to workout. I followed Dr instructions. No gym, just swim and prednisone. I HATED THIS MONTH. No cardio machine, the meds gave me a crazy apptite non stop eating, mood swings by the time the month was over weight 215 i was so sad and depressed.

12 months post op  I am very depressed now, Months ago i fought through all the adversity I got to the best shape in my life after oats, Modified all exercises so my knee isnt used in anything.The pain in certain movements, pivots, still very painful to walk downstairs, and I still cant fun or play basketball.

13 months later: I do a knee scope. The knee scope and MRI confirms everything look "PERFECT" in there, "a graft cant be placed any better than that"Dr  Now the mystery begins. Why am I having so much at 6 months I was supposed to be walking, Im not. I dont think anything is getting better I feel like im just adjusting to a "new normal"  Being active is a big part of  life and this knee surgery has really effected my life, it has set me back in so many areas and my motivation is all but gone. I'm 29 years old, I would love to be active again, have kids one day chase them around, thats looking real slim these days and its a very tough pill to swallow.

Today: My Dr gave me another option. 
Option 1: Zimmer Subchondroplasty
Option 2: Oats (Autograft AND Allograft) with Pelvic Aspirations of Stem cels to inject the areas.

Im really worried about this. This seems very rare. The autograft worries me, robbing peter to pay paul, possibly a new donor site/pain area.

I just decided today to go with the OATS (Allograft and Autograft with Pelvic Aspiration) I want to be confident with this decision, but I'm not. Nobody knows why i'm experiencing these pains, all the prior images look great, no sign of failure.  These knee issue over the past 2 years have been difficult, all I want to do is be fixed return to "my" normal. Athletics, being Active is my passion, I just want to be normal again.

Can anyone relate? If anyone has any advice, suggestions, or words of encouragement,please free to let me know. I need it all at this point.
Title: Re: OATS- My Story, Poss. Failure, Re-Do Autograft And Allograft with Stem Cell Inj
Post by: dal_knee on November 22, 2016, 09:01:16 PM
What does the post surgical MRI report say?
Title: Re: OATS- My Story, Poss. Failure, Re-Do Autograft And Allograft with Stem Cell Inj
Post by: Barmski on November 25, 2016, 10:50:37 PM
Sorry to hear about that, where exactly was the lesion on the condyle and how big was it? I just had OATS done on the medial side with a BMAC Hip stem cell injection. My inflammation is low and I feel like its working cause the natural cells created from the OATS are combining with the stem cells from my hip. The incision looks really good.
Title: Re: OATS- My Story, Poss. Failure, Re-Do Autograft And Allograft with Stem Cell Inj
Post by: dal_knee on November 25, 2016, 11:27:23 PM
Hi,  I was just trying to help with your query by asking what's in the MRI report.   OK, be prepared that I won't try to tip-toe around here with my following commentary, but this makes no sense that the surgeon recommends a subchondroplasty 1 year after the allograft procedure, when the post surgical MRI is "clear" and "normal" and showing full incorporation of the transplant.   It suggests presence of subchondral edema, when he/she recommends a subchondroplasty as option.  Now, I do believe, if you do extensive reading & research subchondral edema can be "normal" for about 1.5 years (max) post autograft or allograft.   After this point, continued presence of subchondral edema at the bony margin of the transplant is considered "failure".    If you are able, perhaps consider waiting another 6 months and avoiding impact activities to allow for additional healing time.    If I were you, I wouldn't jump in quite yet into replacing this current allograft with both an autograft OATS and another allograft OATS, without knowing the reason for the unexpected continued pain. Anyhow, if interested, perhaps consider copy/pasting the impressions from your latest MRI report.  Perhaps others will comment as well.

To answer your questions, my defect was approx 1.4cm x 1.9cm at the time of last surgery on a weight-bearing area of the medial femoral condyle but I'm not sure how to additionally explain its location other than "weight-bearing" area.   
Title: Re: OATS- My Story, Poss. Failure, Re-Do Autograft And Allograft with Stem Cell Inj
Post by: IamNate on December 06, 2016, 10:10:21 PM
Thank You. Sorry for the delayed post.

There is full-thickness chondral defect in the posterior medial femoral condyle, the weight bearing aspect of my knee.  The lesion is 16.9mm deep. Im trying to be optimistic. This has been very frustrating. I will continue to research subchondral edema. I have taken a few months off activity and taking prednisone intermittently without any signs of improvement. It's not painful daily activity, however I do limp at times.