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Offline jmcreynolds

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Re: OATS Procedure Recovery
« Reply #15 on: March 25, 2005, 05:06:12 PM »
Janice,

I went to PT at first for ROM which I got back pretty quickly and then for strengthening.  For strengthening, the SLR with the weights seem to slightly aggravate my defect area.  Therefore, I'm not using that much weight.  I am also doing the stationary bike for 30 minutes a day.  Last week, that began to annoy my defect area also so I have skipped a day here and there and lessened the resistance (was at a 2 and I lowered to a 1).

Why did you feel your grafts had failed over the course of the first 12 months?  What made you think that?  Was it specific pain you were feeling and if so, what was the pain like?  My current pain is upon weight-bearing only.  If I walk for more than 3 to 4 minutes, the pain becomes worse and then hurts even when I sit down.  This is the same as it was before the surgery.

Why did you feel your grafts had failed over the course of the first 12 months before the scope?  What made you think that at the time?  Was it specific pain you were feeling and if so, what was the pain like?

Joy in Dallas

Scope 10/04 and debridement of chondral defect,  OATs on 1/05

Offline kathleenj

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Re: OATS Procedure Recovery
« Reply #16 on: March 25, 2005, 06:01:53 PM »
It seems like the weight bearing issue always comes up.  Why so many doctors have such different protocols is beyond me.  I suppose the difference is the size and location of the lesions.  When I had the first Oats my doctor said 6 weeks of NWB and me being the stubborn person I am...I pushed it at about 5.  I guarantee that the reason I needed the second Oats was because of my own stubborness.  After the second one, my OS initially said again 6 weeks but as I was healing he said to go ahead at about 5 weeks...which I did.  The second plug was smaller and he felt it was doing well enough to handle the partial weight bearing. I went partial for about 2 more weeks although I was extremely hesitant given the fact that I messed up the first one.  I wanted to be extra cautious.   As it turned out he was right and my plug healed great.  Although I am still having problems and needed a chondroplasty...the site of the plug is doing great.  The plug is flush and incorporate with the surrounding cartilage and my OS says it looks great.  The problems now are due to additional lesion that I have since developed.  The Oats itself has been a success and I truly believe it is because I restricted the weight bearing as required and took it very slow and easy the second time around. 

Janice is right...it does take time to heal.  I think so many of us are looking for things to be better immediately.  I know I was.  We hear the doctor say '6weeks no weight bearing and then gradual increase to full activities'  and think that after that we will be 'healed'.  We dont realize that we had a major surgery and it takes a long time for everything to get back to normal.  Gosh, the muscles alone seem to take the longest and until the muscles are back to 100% we will continue to experience all sorts of problems which make us wonder if we made the right decision in the first place to even go ahead with the surgery. 

I'm not really sure what my point is here...I just felt the need to add my 2 cents.  Basically I think we all should be given a course in 'patience' before any knee surgery because you need more than you ever imagined when healing after the operation.  The surgery itself is the easy part. 
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline jmcreynolds

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Re: OATS Procedure Recovery
« Reply #17 on: March 28, 2005, 09:35:36 PM »
I saw my OS today for my 10 week post-OATs follow-up.  Before he came in, I explained to the PA (Physician's Assistant) that I trust the doctor but twice he has been incorrect... for the 1st 3 months of my pain, he said it was patella tendonitis and that it would go away with PT.  I ended up not having patella tendonitis and the pain did not go away.  I then had a scope which he debrided said the pain would go away due to the debridement.  Well, after 3 months, I still had pain so he did the OATS.  I asked the PA to tell the doctor all of this before he came in so that he would know I needed some extra reassurance other than...it will get better since he's said that in the past and it hasn't come true.

Well, the PA told this to the OA and when the OS did come in, he wasn't very comforting at all.  In fact, I think he was making a point not to promise me any good news because of my scepticism.  He took an x-ray and said the plugs look fine and he would be happy to do a scope a year-out from my surgery if I wanted.  He thinks the grafts did not fail.  He said he only had one OATS graft failure when he first started this procedure 10 years ago.

He said that when people come in with articular cartilage damage, it is usually due to a degenerative disorder.  He does surgery but the surgery inself does not correct the underlying degenerative disorder.  Therefore, the grafts take and heal fine but the pain may continue.  I asked him where my pain was coming from and he said he didn't know;  that the list of possiblilities was quite lengthy.

He wants me to be more aggressive with PT and see him in one month.  I think my discussion with the PA at the beginning backfired on me and the OS withheld any 'promises'.  I really needed reassurances like 'it will get better, just give it a couple of more months'. 

Of course now I'm all sad and worried.  It's such a big waste of time to worry, cry, etc.  I want to be strong about all of this.  I want to look back some day and say 'it all eventually got better...I should have just been more patient and not worried about it while it was happening'. 
Scope 10/04 and debridement of chondral defect,  OATs on 1/05

Offline JG

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Re: OATS Procedure Recovery
« Reply #18 on: March 31, 2005, 07:23:28 AM »
Joy,

You are ONLY 10 weeks post op.  You are not going to feel 100% right now.  At this point, you need to take a deep breath and take it one day at a time. I cannot tell you this enough...this takes time to heal.  It sounds like your grafts are well placed based on the x-ray.  Again, true graft failure (failure to incorporate) is really not common and it happens almost immediately from what I understand. Be realistic.  It takes a good year to start feeling good.  If you were 18, I would say you are going to be full speed ahead at 6 to 9 months.  The patient prior to me the day of my surgery had the same procedure as I did, but fewer grafts (I think 8 all on medial fem chondyle).  He was 17 years old and was fully recovered in about 9 months.  My surgeon looked at me and said, "...don't expect a 9 month recovery, he is 17 and you are 35."  From day 1 both my PT and OS said it would take 18 months.  Please, please don't over react.  Please do be diligent about PT, keep an even head.  High highs and low lows are not good, mentally or physically.

As I have mentioned to a few people on this board, you need to manage your knee.  It's really not the responsibility of your surgeon or PT.  Your surgeon is just that.  My surgeon seems indifferent about things when I visit him, but he is an excellent surgeon and that's what I needed. You may see your surgeon once every 1 or 2 months and your PT 2-4 hours a week.  You need to come up with a game plan.  Use your surgeon and PT as sounding boards.  I usually come up with a month plan for my rehab.  I run that by my PT/trainer.  If they have any serious objections, I usually listen to them.  But I really come up with my routine once I walk into my PT's office.

In terms of why I thought the grafts had failed all those months...my knee wasn't what I viewed 100% better from a surgery that was suppose to make me new again.  I had medial joint pain off and on from the time I started walking to about 9 months post op and then consistent pain (weight bearing and non-weight bearing) from 9 months to 12 months.  Prior to my 1 year scope, we did an MRI which actually showed the underlying bone part of the grafts were cystic (which you cannot see during the scope).  This is often seen in advanced arthritis.  However, the scope show nicely healing grafts...not healed, but healing.  So he believed the bone part was still healing not dying...just taking it's time.

Seriously Joy, I understand your concern and anxiety, but you are so so close to your surgery date.  Give it time.  It certainly will get better.

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline jmcreynolds

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Re: OATS Procedure Recovery
« Reply #19 on: April 20, 2005, 02:15:05 PM »
Just an update.  At 11 weeks post-op, I noticed it was feeling slightly better every once in awhile (so minor that I thought I was imagining it).  Now at 13 weeks post-op, it doesn't hurt in the defect spot but about 50% of the time during weight-bearing like it used to.  It actually comes and goes now whereas before, it would hurt with each step in the defect spot.  It sure took forever for me to feel any improvement but now I am thinking I have turned the corner.  Yea!
Scope 10/04 and debridement of chondral defect,  OATs on 1/05

Offline kathleenj

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Re: OATS Procedure Recovery
« Reply #20 on: April 20, 2005, 04:50:30 PM »
Joy,

I am so happy to hear that you are beginning to feel better.  I'm sure things will continue to get better and better as the weeks go by.  Be patient as you may have some setbacks but remember that it WILL get better. 
Congrats on doing so well and keep up the rehab!!!
Kathy
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline Beauzer

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Re: OATS Procedure Recovery
« Reply #21 on: April 20, 2005, 08:07:21 PM »
Anybody ever heard of a Hoffmann brace?  My OATS is Monday.  The hospital just called me to size me for a post-op brace.  I've read a lot of stuff and have never come across anything like this before.  Did anybody else wear a brace postop?  I also have MCL instability, but don't see why that would matter when I'll be NWB for 6 weeks anyway.

Just wondering,
Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline JG

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Re: OATS Procedure Recovery
« Reply #22 on: April 20, 2005, 11:55:12 PM »
Danielle,

I wore a brace for about 8 weeks.  It was some type of DonJoy post surgical.  I think the only reason I had it was I had two compartments worked on, MFC and PF (trochlea).  I had restricted range of motion.  The nice thing is that at my 4 week visit, my OS broke off the bottom and top part (literally just snapped off the metal part).  The Donjoy brace allows for breakaway so that it's no longer full leg (ankle to upper thigh), but more like calf to mid thigh.

Good luck on Monday.
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline Beauzer

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Re: OATS Procedure Recovery
« Reply #23 on: May 02, 2005, 02:31:36 PM »
Hey OATS survivors,

I'm a week out now from my OATS to the weight-bearing surface of the MFC.  I just slipped today trying to sit down and whacked my right foot (the operated side) on the ground in the process.  >:( The knee was bent at about 45 degrees when I landed and I don't think I put more than half my weight on it but YEOWZERS!!!  I saw stars and darn near passed out.  It still hurts like heck and is much more swollen than it was before.

Anybody else have any issues with early or inadvertant weight bearing?  Did I do something bad here?  Should I call my OS?  If I was entertaining any thoughts about not being compliant with NWB, this pretty much cemented the idea that I can't walk on it.  OW.

Actually JG, as it turned out, I ended up not having a brace after all.  Once I'm WB again, I'll get one then.  But thanks for the advice anyway.

OW yet again.
Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline kathleenj

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Re: OATS Procedure Recovery
« Reply #24 on: May 02, 2005, 03:26:00 PM »
Hi Danielle,

OATS survivors...thats funny, gave me bit of a chuckle being one myself.  Thanks for that!!!

Anyway, I wouldnt really be too concerned about the little mishap.  I did that a couple times after mine.  It probably hurt like a dickens because the area was just worked on, so to speak.  If it continues to bother you I would give the OS a quick call but alot of people have posted about accidentally bearing weight and things turned out ok.  Keep an eye on it but try not to worry too much. 

BTW, I've been reading your post op diary.  It sounds like you are doing pretty good.  Keep up the good work. 

Good luck with the rest of your recovery. 
Kathy
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline RichE

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Re: OATS Procedure Recovery
« Reply #25 on: May 02, 2005, 03:51:19 PM »
Hi Everyone,

I've been following this and other threads in the lead up to my latest op (Chrondoplasty on Sat 7th of May). :-\

Having tried to do some research into the procedure myself and from the comments I've seen I don't know whether I'd be better off just leaving it alone and waiting for the inevitable TKR?

Perhaps people who have had better (I won't say good) experiences with the procedure just don't post to the bulletin board?

I'll try and keep posting as I progress whether it's good or bad news (hopefully only good).

Any words of encouragement gratefully received!!

Thanks,

Rich.


MCL Repair 3/99
ACL Recon 9/99
Arthroscopy 2/05
Chrondoplasty 5/05 ???
 
3/99 MCL Repair
9/99 ACL Reconstruction
2/05 Microfracture
5/05 OATS
7/05 Knee Cap Lateral Release

Offline Beauzer

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Re: OATS Procedure Recovery
« Reply #26 on: May 02, 2005, 04:51:27 PM »
Thanks Kathy,

After some ice and vicodin things are already feeling much better.  I think I'm actually doing pretty good overall too, considering it's only been a week.  I'm doing my best to be compliant with the exercises and CPM and stuff, as I realize that a lot of my problem stems from the fact that I wasn't very compliant with PT in the past.  So I guess I've been scared straight.

Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline Beauzer

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Re: OATS Procedure Recovery
« Reply #27 on: May 03, 2005, 12:38:34 PM »
I ended up talking to my OS yesterday (he called to see how I was doing, talk about perfect timing) ;D.  He wasn't worried at all.  Actually he was pretty impressed by my ROM.  He cleared me for stationary bike with no resistance.  The pain is back to normal today, but I'm still really swollen.  Thanks,

Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05

Offline JG

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Re: OATS Procedure Recovery
« Reply #28 on: May 03, 2005, 03:34:36 PM »
Danielle,

That's impressive flexion.  Due to my trochlea area being gafted, I could really start much playing with my flexion until 12 weeks.  I still have limited flexion, maybe 125 degrees.  Additionally, I didn't get on a bike until week 12.  The bike will help with the swelling, get that fluid moving out of the knee.

I fell once during my 12 weeks on crutches.  A crutch tip slipped and I caught myself.  I don't think it had any adverse effect, but I wonder sometimes because I've had problems with my MFC graft for two years.

Did your physician use an intra-articular pain control device?  I had a Pain Buster which provides continuous infusion of a local anesthetic directly into the knee.  This was key for pain control, bascially I had no pain for 4 or 5 days. 

Good luck...Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline Beauzer

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Re: OATS Procedure Recovery
« Reply #29 on: May 03, 2005, 04:24:59 PM »
Janice, My OS doesn't like the intra-articular pain busters  :P.  I think he had a problem in the past with someone getting an infection.  So it wasn't even an option for me.  I've always prided myself on having a high pain tolerance, but I have to admit, the first few days, I couldn't believe how intensely painful it was.  I spent the first 24 hours home thinking I was going to die (and then being afraid that I wasn't).  It's really not bad now.  I still need some meds when I push the flexion on the CPM though. 

I'm actually up to 105 degrees today.  My flexion has been limited to about 110 since my MCL surgery in 2000.  That's how it works, trade flexion for stability.  I was up to about 125 preop though (that's one of the reasons we knew my MCl was getting stretched out, all of a sudden, my flexion was better).  I didn't think to ask my OS if I should stop at 110 or go to 125.  Hmmm.  I think I'll stop at 110 just to be safe.  Plus if I can get the capsule to tighten up again, maybe I won't have to get my MCL re-reconstructed later.  (Honestly, after this, I'd rather just wear the stupid brace indefinitely anyway).

I imagine with the trochlea getting grafted, the flexion would indeed be an issue.  I'm glad I don't have to wait that long to work on ROM.  That and I can't imagine being on crutches for 12 weeks.  I thought 6 weeks was seriously cramping my style.

I'm going to go buy a stationary bike tonight.  My OS wants me on it to preserve as much quad strength as possible.  I think it will help with the stiffness too.

Thanks everybody,
Danielle
32 - R knee gone to hell
lat. meniscus 94
ACL, chondroplasty 98
Chondroplasty 99
Screw fell out into joint, med. meniscus, microfracture 99
MCL/med. capsule recon, med. meniscus 00
Chondroplasty 04
Chrondroplasty 1/05
OATS 4/05 for OCD lesion
AVN, MFC fracture 10/05















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