The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - ACI & MACI (autologous/matrix-induced autologous chondrocyte implantation) => Topic started by: Gimpy47 on June 03, 2017, 11:38:54 PM

Title: S/p left medial epicondyle MACI and TTO
Post by: Gimpy47 on June 03, 2017, 11:38:54 PM
I am a 47 yr old former athlete who at the age of 32, hyperextended my left knee playing basketball and fractured my tibial spine but no other injury clinically was noted.  No MRI done at that time.  I spent 8 weeks in a knee immobilized and resumed my athletic endeavors.  Fast forward 9 yrs and I started to get pain and swelling in that same knee after playing basketball.  MRI revealed osteochondral defect on medial epicondyle.  I tried PT with no improvement so I opted for micro fracture surgery in Nov ' 12.  Needless to say it failed.  Instead of cartilage forming, a thin layer of bone formed and pain increased.  I live in Michigan and work in the medical field.  After endless research on the internet, I figured ACI was probably my next option.  I flew to Boston and met with Dr Minas.  MACI and TTO and ACL repair was performed on 5/16/17.  I am 18 days post op.  Swelling is subsiding, but with my leg straight, certain movements give me that sharp stabbing pre surgery pain
medially.   Is this normal, I have had 2 PT sessions and this last one made me feel like I've taken 10 steps backwards.  I realize this is a marathon, but can't help worry about graft failure.  I'm past 90 degrees on leg dangling over the table and continue my 6 hrs in my
cpm to 40 degrees.  I've read many posts and diaries and get the sense that this may be normal but I can't help worrying.  Any comments or suggestions?
Title: Re: S/p left medial epicondyle MACI and TTO
Post by: stinkroach on June 12, 2017, 11:30:09 PM
Hi Gimpy,

Mind if I ask how big the defect was in your knee and how long you tried PT before trying microfracture?  I'm 44 and former gym rat and pretty maniacal basketball player and got diagnosed with osteochondritis 8 mo ago, the injury was a bout 1.5cm x 1.5cm and the knee hasn't totally healed yet although I can walk around fine, it's just that running feels like it is 4-6 mo away.  Gets sore if I go on longer walks. 

Anyways, my doctor said that usually these thing heal within 6-8 mo and highly likely that I have a defect and to fix it, surgery would be needed but depending on the outcome of my MRI which I am getting this afternoon.  He said could be very minor surgery to something more aggressive like microfracture.

Title: Re: S/p left medial epicondyle MACI and TTO
Post by: Gimpy47 on June 15, 2017, 05:28:48 PM
Hi stinkroach,

My lesion was 2 cm x 2 cm but was down to the bone.  I tried PT for about 6 months, it got a little better but I would still get an effusion and pain with playing basketball.  Granted w micro fracture and biopsy for MACI, the lesion got bigger.  Looking back, I would have waited till it was intolerable, but being over 40 and with each passing year, the success rates for anything goes down.