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Author Topic: OATS Knee to Ankle  (Read 69201 times)

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Offline Audrey

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Re: OATS Knee to Ankle
« Reply #15 on: November 08, 2004, 06:41:58 PM »

Hi PJ13

I recommend that you send the questions in advance of your meeting with your OS.  This is allot of information and will be hard for you to retain all of the answers.  I sent my questions weeks before my meeting with my OS and asked for answers in writing.  This gave me a chance to mull over the answers and verify them with the conventional wisdom from other OSs, websites and just to see if they make sense to me.  Also having something in writing helps refresh your memory about a particular process months later.

I would have had my surgery in the winter.  I had my surgery in May 2004 and missed all the summer fun activities with my leg elevated.  Also, having the surgery done in early winter, you recoup at home while its cold and icy.  Then you will have the spring and summer to become more steadied on your feet before dealing with the snow and ice.

While recouping you will want to get out of the house.  I suggest asking you OS to complete the paper work to authorize you to get a temporary handicapped tag (the red one).  It is a simple half page application. You take this application to the Department of Motor Vehicles and they issue the HC tag in 6-month intervals.  In my state, it can be done before the surgery.  The HC tag saves time, for example, my sister had to drop me off at the door and had to return to the parking lot to find a park.  Easily a 30-minute task, I live in the northeast.  It would have been easier to park in the HC and roll me on into the store.  Lastly, when you are on crutches every step counts, you will appreciate parking close to your house and storefronts.

Get a plastic armless shower chair.


This is all for now, keep writing and I will do my best to answer.  Thanks A

Offline love2run

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Re: OATS Knee to Ankle
« Reply #16 on: January 18, 2005, 08:53:16 PM »
Dear fellow ankle sufferers,

Thanks to all of you who posted your experience with the OATS procedure for the ankle.  I just had the OATS surgery on 1/12/05 and so far am doing well.  Its been a week and I'm already back to work (staying sedentary though).  I really had minimal pain after the surgery b/c they gave me a nerve block right above the knee.  When I awoke from the surgery, my leg was numb from the knee down.   I then had to take morphine that night for several days.  I think the pain medication was the hardest part.  It made me SO sick that I had to stop taking it.  Thankfully, I wasn't in pain by the third day and motrin was enough to subside any discomfort.  

My surgeon was going to take plugs of cartilage from my knee to place in the defect in my ankle.  However, during the surgery he found that he could take "enough extra" cartilage from a different area of my ankle to plug into my talar dome defect.  I feel really lucky that he didn't have to invade the knee.  I'll be casted and on crutches for at least the next 6 weeks.  Once I begin the physical therapy, I'll then be able to tell if the surgery was a success.  My goal is to be able to run again in moderation with little to no pain.  

Thanks again for all of the doctor questions and feedback everyone provided.

Sincerely,
Love2Run :)

Offline Audrey

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Re: OATS Knee to Ankle
« Reply #17 on: January 18, 2005, 10:23:44 PM »


Congratulation on a successful surgery.  You sound very optimistic and ready to tackle whatever is ahead.  Please take it easy for the first 6 weeks.  Happy running.

Offline pj13

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Re: OATS Knee to Ankle
« Reply #18 on: February 14, 2005, 06:43:59 PM »
Hi all,
Just in case you are curious, here's my update.  I just want to get a second opinion before I make a final decision.  I signed up for an appointment back in October, waited 3 months to see the 2nd doctor, then I got a call a couple days before my appointment and they said "oh, by the way, we don't take your insurance".  I still don't know why they didn't tell me that when I first gave them my info.  So, I'm not real happy about that right now.  I'm still trying to get a second opinion, and it's been a frustrating experience trying to get my records sent from one office to another.  I was hoping to get this over with quickly if I need to get it done. 

In the mean time, I've reduced my high-impact sports (soccer, basketball).  Now that I'm paying more attention, I think that my pain is at least partially weather related, more moisture in the air tends to make the pain worse.  I've still been doing things like hiking and dancing, and that doesn't cause too much pain. 

Thanks for sharing your experiences, its been really helpful.  I'll try to keep you up to date whenever I finally get to see another doctor.

-Phillip

Offline pj13

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Re: OATS Knee to Ankle
« Reply #19 on: April 21, 2005, 08:01:33 PM »
Okay, I finally got a second opinion about my ankle, and now I think I have more questions than ever. 

The second doctor offered a non-surgical physical therapy regimen to try before surgery.  If it doesn't work after 2-3 months, then he would recommend surgery.

He recommends a microfracture surgery that, in theory anyway, stimulates a natural healing process around the damaged area in my ankle.  The surgery supposedly has a 90% success rate.  The recovery time is shorter for this surgery than the recovery time for the OATS procedure (4 months instead of 6 months). 

BUT, if the microfracture surgery were unsuccesful, then he would recommend the OATS procedure as the next step. 

Does anyone have good information about the microfracture surgery? 

Now I wonder if it's worth trying the microfracture surgery, since the OATS surgery would be the 'failsafe' if it didn't work.  I'm sure that I don't want to do go through the recovery time for both surgeries! 

How is everyone else doing?  love2run, goingforit, Audrey -- any updates?
-Phillip

Offline blackbeltgirl

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Re: OATS Knee to Ankle
« Reply #20 on: April 21, 2005, 09:05:50 PM »
Philip -

Check out the Cartilage Stimulation board.  Most people posting there have had microfracture to the knee, or are considering it.  You'll get lots of great information.

Good luck.
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline call me laurie

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Re: I'm scheduling Oats surgery for OCD of talus
« Reply #21 on: February 01, 2008, 07:14:04 AM »


I've done some research on here. Very imformative. I'd like to know if anyone else has had OATS procedure & the success of it. I've already dealt with the arthoscopic surgery & it's a year later, now the ocd area is collapsing, pain is worsening. OATS is next in line.
I trust my OS.  He seems very knowledgable & works a lot with professional athletes for all kinds of sports/joing issues, etc.

my question is this:  my doctor said he may have to cause a fracture of my leg bone above my ankle just to get to the surgical site! Anyone else have that response? seems extreme. does that mean he hasn't done many?  I beleive he's said he's performed 200 approx of the OATS procedure.

Anyway, anyone heard of a surgeon intentionally fracturing your bone to get to the surgical site?????????

Offline karine

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Re: OATS Knee to Ankle
« Reply #22 on: February 19, 2008, 03:04:56 AM »
Who are the best surgeons, anywhere in the US, for OAT on the ankle? I have OCD in the medial talus and don't know what to do or who to see. I live in Canada where we have to wait 28 months to get an appointment for a consult so I want to travel to the US but don't know where to go. It sounds like you've done a lot of research on this and know the best surgeons. Also, am I right in thinking that this is sounding very much like an experimental procedure which may or may not work? I'm hoping to wear heels again and to run without pain.

Offline demogoat

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Re: I'm scheduling Oats surgery for OCD of talus
« Reply #23 on: April 06, 2008, 12:55:05 PM »
Yes!!!

Both OS I have consulted with have told me they need to cut the tibia in order to get to the talus bone.  Then it will be screwed back together before closing the site.  As if the surgery wasn't enough to recover from, throw in a broken leg too!

my question is this:  my doctor said he may have to cause a fracture of my leg bone above my ankle just to get to the surgical site! Anyone else have that response? seems extreme. does that mean he hasn't done many?  I beleive he's said he's performed 200 approx of the OATS procedure.

Anyway, anyone heard of a surgeon intentionally fracturing your bone to get to the surgical site?????????
Quote

Offline BumAnkleBach

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Re: OATS Knee to Ankle
« Reply #24 on: April 07, 2008, 04:50:28 AM »
I had the OATS done about 5 years ago and an X-ray taken about 3 days ago showed a collapse of where the donor bone was and numerous other defects.  MRI tomorrow on the knee and ankle.  Looks like more surgery for me.  I'm getting this next surgery done by Temple Sports Medicine in Philadelphia.

Offline BumAnkleBach

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Re: OATS Knee to Ankle
« Reply #25 on: April 07, 2008, 02:14:12 PM »
Demogoat,
Yes, in order to get to my talus injury, they cut my tibia or fibula...I'm not sure which one.  I'm going to go on a side track here....I've noticed that ALOT of people here know EXACTLY what their OS did during their surgery.  How do they know so much when they were under general anesthesia??  Did they read the report?  Did they get briefed before and after surgery in extreme detail?  This is what I remember:  "Hi, I'm doctor so & so, this is your ankle.  This is bad.  Surgery is good.  We're going to take the plugs from your knee and plop em in your ankle. You will be fine.  See ya at surgery.... (1 month later)..Hi Jim, we're going to mark your left knee and left ankle. Hi Jim, please count to 10 as we slowly put you to sleeeeeeeeeeeeeeeeeeep."  I woke up, looked at my knee and ankle and thought..what the hell am I doing???  I talked to the surgeon after surgery for maybe 5 minutes but I don't remember it because the anesthesia was still pumping through my blood..so I was pretty darn groggy.

So, I get home (yes, I spent no time overnight at a hospital) and fell right into bed.  I didn't want to eat, drink...all I wanted to do was walk. Oh yeah, walking is a big no no.  I was told that I would be NWB for 6 weeks.  Turned out to be 8 weeks.  8 weeks of pure, torture.  The pain 2 days after surgery was so bad, that the codeine and morphein and percocet's were some help, but simply not enough.  Sleep???  Forget about it.  How can 1 sleep when he can't sleep in his side or stomach due to the BULKY dressing on the knee and the cast on the ankle.  Yeah, I was casted.  SUCKS !!!!  The knee pain was BY FAR greater than the ankle pain...until rehab started.  I'm jumping around but this surger was 5 years ago and I promise to take better notes and document much better this time. 

Like I said before, my MRI is tonight on the knee and ankle.  The knee because that is where to donor plugs were taken from and there are apparently broken bone fragments sitting in the joint!!  Lovely huh?  The ankle because the bone apparently collapsed where the plugs were placed.  The way the doctor pointed it out...white is good, black is bad.  There was plenty of black around the talar dome and talus area on the X-Ray.  It won't look any better on the MRI.  He also said my ankle is pitched about 15 degrees so that's not letting my ankle heal properly.  He said my injury is what he sees when people jump out of a burning building and land on their feet.  All I did was break it at 17 yrs old and then break it again in the Police Academy.  A few sprains here and there of course.  Now....my ankle is shot...until this doctor fixes it.  I have faith.

To sum up my OATS experience.  Did it work..yes and no.  My body either rejected the donor plugs, I was weight bearing too soon or I have other issues that haven't bee resolved yet.  Pain level on a scale of 1-10:
Day 1: about 2 - The meds were still pumping strong
Days 2-7:      10++  - Holy Sh*t !!!
Week 2-4:     7 - Tolerable but still needed meds.
Weeks 4-6:    5 - Not as bad
Weeks 6-8:    3 - Ready to get out of the damn cast and walk, run, whatever.
Weeks 8-12:   7 - Rehab was ROUGH ROUGH ROUGH.  I will take my rehab much slower this time.  I thought I was a professional athlete who needed to get back on the field ASAP.  Faster was better.  Not so. I think I pushed myself too early and too hard.

If you are thinking about getting the OATS, get it done by someone who has done plenty of them, is willing to tell you the success rate of his surgeries & understands that this is a BIG BIG surgery.  This type of ankle surgery is starting to really pick up lately.  It's not for everyone.  TRUST me.  If I have to get a 2nd OATS, I will be more prepared this time around.

Feel free to contact me with any questions or concerns.  I will try to address them the best I can.
Jim

Offline demogoat

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Re: OATS Knee to Ankle
« Reply #26 on: April 07, 2008, 11:40:16 PM »
Jim,

Sorry to hear about your ongoing difficulties.  You are not the posterboy for OATS surgery but I really appreciate hearing about your experiences!!  I met with the surgeon several times before deciding to proceed with the surgery (which is scheduled for 5/19) so I got lots of information.  He also sent me off to get another opinion.  I will have two surgeons during the procedure, one for the ankle and one for the knee.  Having had a bone graft previously, I remember the site the bone was taken from as the most awful pain, not the actual injury.  So as I suspected, this is really going to suck!

If you have to face a second OATS, what will you do differently?  Any recovery advice or hints to share?  I have three kids (ages 3, 5, and 7) so I am expecting my stress level while NWB to be through the roof. 

Thanks,
Margaret

Offline Boston Steve

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Re: OATS Knee to Ankle
« Reply #27 on: April 10, 2008, 12:05:29 AM »
Hi All,
I just had the OATS surgery done eight days ago. I'm 31 yrs old and physicaally fit .As described in other posts, I had a bone plug taken out of my knee and put into my talus bone. To get to the area of my foot, my ankle bone was broken, or rather cut open to ge to the talus bone. I spent two and half days in the hospital after the procedure, attached to an IV, and a morphine drip for the pain. I had an epideral in my back prior to anasthesia to help with the pain after waking up. The surgery was a success, according to my doctor. I'm on my 8th day in bed. The pain is not as bad as long as I don't move around too much and keep my leg cool. I'm trying not to rely on the pain meds because of fear of getting hooked on them. Day 5-6 I did not take any pain meds, but unfortunately I have had to take some the last few nights to sleep. The cast is very uncomfortable and painful. I don't know what's more painful, the surgery scars, or my heavy cast rubbing against my surgery scars.

After reading some posts here, I plan on NOT rushing my recovery, and letting my leg heal properly. I've been dealing with problems with my anke since March 2006. My ankle felt funny after a basketball game. No swelling or anything, just a little weakness. I ignored it and kept playing. On top of that, I was part of a marching band and the style of the march was that you slammed your foot down consistently with force. We wore traditional costumes for the march, which includued wooden-bottomed shoes with metal spikes on them. I think the combination of basketball twice a week, plus slamming my foot down on the cement for blocks at a time in the marches, caaused the injury in my ankle. The problem is the injury was so subtle that I didn't notice it progressing. At first I stopped doing the marching. Then, I couldn't move around as quickly on the basketball court. Finally last summer the weakness in my anke eventually turned to a constant (but mild pain), and then progressed to a limp. Finally i said to myself "Something is wrong!" and went to the doctor. The x-ray did not detect any issues, but a n MRI exposed that I had necrosis on part of the talus bone. It lookes like a small circle of the bone is black on the MRI. My doctor recommended I have orthoscopic drilling right away. I had the surgery in August 2007. Basically I had the surgery, went through the post op down time, then physical therapy,etc. After about four months, my leg started to feel the same as it did before the surgery. My OS said a cortisone shot may help the pain, bit I insisted we do another MRI. The test revealed my lesion was getting bigger. In other words, the orthoscopic drilling was unsuccessful.

My OS recommended the OATS surgery. The conversation went something like this: OS: "You were right, your leg is getting worse. We're going to take a bone out of your knee and plug it into your talus bone and everything will be fine. I will setup a surgery date for you. Stay off your feet until then, bye."
THIS THE PART YOU HAVE TO PAY ATTENTION TO AND THE REASON FOR ME RAMBLING ON ABOUT MY EXPERIENCE:

I did some research on my own and basically th results doctors were getting weren't very good. Because there are very few people diagnoses of this injury (less than 20,000 a yr), the surgery is still not considered valid or beneficial by the medical community. Even worse, very few doctors are experienced in this surgery, making YOU the guinnea pig if you choose to go forward with it. When I asked my doctor about his results he said he had only done this procedure twice. Only one of the patients had successful results. I got a second and third opinion, but neither doctors had much experience with this type of injury. Finally I asked them if they knew any doctors that had done hundreds of the OATS surgeries. I finally found "my man" in NY. After a consultation with him, he confirmed he had done hudreds of these similar cases, and was getting 92% success rate. Not only did he perform the surgery, he also took stem cells from my hip and transplanted them to my foot. He also providied me with a "Game Ready" physical therapy machine that keeps my foot ice cold, and stimulates growth. i use it all day. Also he mentioned ten other doctors were doing this procedure ten different ways, but still getting only 30% success rate. I felt I had found a needle in a haystack by finding this doctor. I did it by doing a lot of research and asking many questions.......DON'T BE A GUINNEA PIG. FIND A DOCTOR WHO KNOWS WHAT HE'S DOING. THIS IS A VERY SERIOUS OPERATION. If I let my original doctor do this procedure, I basically would have been screwed!!!!

Good luck. Feel free to contact me if you have any questions.

Boston Steve




Offline demogoat

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Re: OATS Knee to Ankle
« Reply #28 on: April 10, 2008, 01:39:24 AM »
Wow Steve.  Thanks for all the good info.  Glad your surgery is over, you sound like you are in pretty good shape 8 days post-op, considering.  I haven't heard of the 'Game Ready" but went to their website and read about it.  Do you think it has been helpful?  I am wondering if I should ask my surgeons about it.

Any advice for when returning from the hospital?  Are you up and about the house on crutches or in a wheelchair? 


Thanks,
Margaret

Offline Boston Steve

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Re: OATS Knee to Ankle
« Reply #29 on: April 10, 2008, 01:57:57 AM »
Hi Margaret,
I'm glad my post was helpful. Make sure you get the "Game Ready". It looks like a toolbox that you fill with ice. It has a hose and a wrap that goes around my foot. It makes your foot ice cold, even with the cast on. It takes my pain away.Without it I would be popping painkillers like candy. The doc told me to use it for 8 hrs a day, 30 minutes at a time. It's a lifesaver. I rented it for $300 for three weeks. I will be renting it for another three I think.
The pain was unbearable the frist three days. Even the pain medicine didn't work!!!! To release me from the hospital, the physical therapists had to be satisified I could walk with crutches. The minute I took my leg off the bed, and the blood rushed down my leg I wanted to cry like a baby. I managed only a few steps, and got back in bed. My knee hurt more than my ankle. The drive home from NY to Boston was OK, because I was heavily medicated. My mother is a SAINT. She makes me meals, and fills my Game Ready with ivce every few hours. It would be impossible to do it alone. DON'T EVENN THINK OF TRYING!!! It's five steps on my crutches to the bathroom, and that's as far as I go. You would be suprised how refreshing it is to wash your hair in the sink, shave, and wash your body with a wet soapy towel. ;D















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