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Author Topic: meniscal allograft success? advice?  (Read 4159 times)

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Offline emorita

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meniscal allograft success? advice?
« on: January 07, 2003, 01:16:38 AM »
If anyone could help me out here, I would greatly appreciate it.  
I was scheduled to have meniscal allograft surgery today, but a few days ago my insurance company denied my coverage.  (I have Blue Cross Blue Shield in MA - USA.)  One of their reasons being that this procedure is experimental,  and claims that there is no hard evidence of success rates.

I need to appeal this decision (within 30 days) and give them as much information as possible.  If anyone would like to share any stories - good or bad, information/links, other people's stories, I would love to hear anything.  Also any advice on my insurance situation would be great too.

At 26 - my knee has been bad more than it's been good - even after 3 surgeries.  I really need to have the latest scheduled surgery done.  A donor meniscus and acl are waiting for me.  I appreciate all the help I can get.

Thanks and Happy New Year.  

-e

Offline skater

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Re: meniscal allograft success? advice?
« Reply #1 on: January 10, 2003, 07:39:18 PM »
You may want to look at this web site:

www.cartilagedoc.org

Under the section of knee library there are two very recent documents published regarding meniscal allograft success.   You will need acrobat reader to view or print the articles.

I may be facing a meniscal allograft and have used this site to gain valuable information.

skater

Offline richard_allison

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Re: meniscal allograft success? advice?
« Reply #2 on: January 15, 2003, 08:05:00 PM »
 :)Dear emorita.
 Although the meniscal allograft  operation is an experimental procedure so were heart transplants once . Just browsing through the literature you can see for yourself that it at least reduces the pain of the underlying injury.Speaking of my own experience I had an Allograft on nov.4th here in the U.K, 10 weeks post op now starting to walk around without crutches , slight swelling , lots of physio so things are looking rosey.
We dont have the same system of insurance here in the U.K , but i think the private insurance companies wouldnt  pay up for the same reasons .
However my health authority came up with the money to my surprise .
I would consider approaching your insurers with the angle of the long term cost they would incurr as regards to treating the knee problem e.g increasing osteoarthritis and ultimately Knee replacement.
The Allograft would at least delay  the knee replacement by 5 years or so .
Good luck hope this helps
Rick Allison.
Left Lateral meniscal allograft.
& Chondroplastys

Offline adrian

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Re: meniscal allograft success? advice?
« Reply #3 on: January 16, 2003, 03:51:40 PM »
Dear Rick,

I am considering a meniscus allograft (I live in Gloucestershire, Male aged 37) after a having a partial meniscestomy on the lateral side of my left knee. Could you give me more details of your circumstances and who did it as I am finding it difficult to come up with much info on this this.
Thanks
Adrian
Lateral Menisectomy - Bucket Handle Tear 2002

Offline Keffy

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Re: meniscal allograft success? advice?
« Reply #4 on: February 13, 2004, 09:38:56 AM »
Dear Adrian ,
           How much of your lateral meniscus did you lose and what type of tear did you have? I have got 50% left from a horizontal split tear and have been thinking about the allograft surgery , but no surgeons seem to talk about it as an option. I don't know what to do.






Offline adrian

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Re: meniscal allograft success? advice?
« Reply #5 on: February 15, 2004, 08:20:11 PM »
I've had 70-80% removed,but I think that considering an aalograft depends on a number of factors including pain, lifestyle and whether any arthritis is developing, probably best measured by an MRI scan.
Regards

Adrian.
Lateral Menisectomy - Bucket Handle Tear 2002

Offline surgeryXseven

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Re: Be carefull
« Reply #6 on: February 25, 2004, 07:28:04 AM »
I had a meniscal allograft and high tibeal osteotomy at Rush Pres in Chicago.  I drove six hours from home.
The Doc told me no one did it in my area (not true I later found out a doc had been doing it eight years).
The Doc removed all my remaining medical meniscus and then when the donor meniscus was thawed (during the same time I was on the table, to save his valuable time) it was discoved it was for the wrong leg (left versus right).  I can still remember him telling them "Turn off the Video" (I was awake, then they put me fully under when the massive screw up was discovered).  I ended up with no transplant and lost all my remaining meniscus. Except my knee, all the cuts, prep work, removing of my remaining meniscus, drilling for new menicus was all done.  Lots of scars and now scar tissue.  Had to do the whole eight weeks non-weight bearing and seven months of rehab for the HTO (high tibeal osteotomy).   The doctor didn't even come in to visit me the next day in the hospital, untill I insisted.  No nurses on the floor were even notified that the operation was screwed up, and questioned my being upset? Six hour drive back home also, in the back of a Suburban.  Stay away from physicians with MBA's behing their name, for this guy could have referred me to someone he knew eight miles from my house, but he made me come to Chicago for the business.  In it for the $$$$.  Promised me soccer with my kids, some running, sport activities, etc.,   My  next step, knee replacement.      Also, in his pre op notes he wrote "informed patient and his wife of the possibility of receiving the wrong meniscus, even with this, they agreed to proceed"   Be careful!  I was on the table six hours....  Oh yes, the video of the surgery was lost too?    :-/
Get Third Opinion's, Watch Internet listings for Clinics and Docs. A Red Flag!  Docs high on search engine's are advertising $$!  Stay away from MBA's, you want a knee done right not your checkbook!!

Offline colemanjsz

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Re: meniscal allograft success? advice?
« Reply #7 on: March 23, 2004, 07:08:40 PM »
Watch out for the insurance companies.  
Blue Cross Blue Shield of Georgia did me the same way.  My Dr.  wanted to do an meniscal allograft and an osteochondral allograft together with an ACL reconstruct.  They flagged the meniscal and osteochondral as experimental.  My appeal was denied even on an independent review.  The reviewer rejected the the procedures based on one article review.  My doctor and I had sent 8 articles in support of the procedures and they were never mentioned as even being read by the reviewer.  I asked the company what they recommended and they said to listen to my doctor, but they wouldn't pay for it.  

Presently, I am awaiting the opportunity to change insurance companies during my employers open enrollment to go with a company that will approve the procedure.  I hope you have better luck than I did.  I have been waiting since July of last year.      

Offline surgeryXseven

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Re: meniscal allograft success? advice?
« Reply #8 on: March 23, 2004, 09:37:05 PM »
I even offerred to pay the physician CASH out of my own pocket, a Dr. Brian Cole of Chicago, but after he made all the incisions and removed my remaining meniscus, then he discovered the the wrong meniscus was shipped for the operation.  Make sure your doctor measures twice and cuts once, at least carpenters do it.
Get Third Opinion's, Watch Internet listings for Clinics and Docs. A Red Flag!  Docs high on search engine's are advertising $$!  Stay away from MBA's, you want a knee done right not your checkbook!!















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