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Offline agilitynutt

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OATS help
« on: May 26, 2005, 06:21:04 AM »

I just found this site, doing research on my upcoming OATS procedure.  I am scheduled for an Allograft in a few weeks.  I am not finding too much that makes this look promising.  I am very active in horses as well as dog performance sports.  My OS recommended this procedure because of my activity level. 

I am curious as to how long I should expect to be off work (riding horses and also teaching dog obedience in a warehouse setting).  I have been told that I will be NWB 6-8 weeks, but that is about all I have gotten so far.  In order for me to return to work, I need to be able to walk on concrete for extended periods of time, and need to be able to handle rowdy 100+ pound dogs. 

How bad is the first 2 weeks after surgery?  My understanding is that I will be in the hospital for 2-3 days.  After that I will be on my own for about 2 weeks.  The closer I get to the day of surgery, the more I am starting to stress about this!  Any advice anyone can give would be appreciated!!


Offline Beauzer

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Re: OATS help
« Reply #1 on: May 26, 2005, 12:17:28 PM »

I had OATS 4/25.  Autograft though.  The first 4 days were bad for me.  Loads of pain.  A good bit of mine was from the donor sites though, so I don't know if an allograft would be any different.  After that, the pain went away very quickly.  By about 7 days I was rarely taking any pain medicine and stopped it altogether about a week later.

I was just in the hospital overnight and probably should have stayed longer.  I was pretty much on my own from day 1 since my husband works 2 jobs.  Getting around the first few days were hard.  I was also in a CPM for 2 1/2 weeks.

I also have a job where I stand and walk all day (like 12-14 hours at least).  I'm NWB 6 weeks and then my OS wants me to be PWB for another 4-6 to keep me from just jumping back in and screwing things up.  I actually went back to work at 3 weeks, just desk stuff.  I don't think I could have even done that any earlier due to swelling and pain whenever the leg was down.  It'll be awhile before you're back at work.

I have a few recommendations:
1.  get a wheelchair - makes life much easier - I use mine to cook and clean and whenever we go out
2.  get a backpack - you can carry anything you need if you're by yourself
3.  tupperware, ziplock bags and a thermos - I ate out of these for a long time, as they can easily be carried in #2
4.  cycling or weightlifting gloves - save your hands
5.  learn how to use the crutches before you need them - including stairs if you'll be doing them often
6.  shower chair and handheld shower attachment - gonna be a long time before you can stand up
7.  ice is your friend - find out if your OS will be giving you something to help you ice down - if not, a cryocuff or ice packs are definitely worth the investment

It'll be OK.  My OS tells me not to get too excited because I haven't started walking yet so we don't know how things will be then, but I have no pain for the first time in almost a year.  Pretty exciting for me considering before the OATS I had severe pain 24/7 even when I wasn't on my feet.

If you want a better idea of all the postop stuff, I've been posting a regular diary under the Post Op section, it's under OATS.

Good luck.
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 help
« Reply #2 on: May 27, 2005, 02:00:17 AM »

I had an allograft OATS (aka mosaicplasty)...a very big one.  I had 18 decent sized grafts in two locations, the medial femoral chondyle (MFC) and the trochlea.  My problem was way too big to have an autograft.  Unlike Danielle, I had basically no pain for the first 5 days.  I had a Pain Buster which feeds marcaine directly into the knee for 5 days.  After I removed the line, I expected to have some pain but didn't really.  I'm really good with pain.  I tend to either not have it or not feel it.  I just had a scope and nerve decompression surgery about a week ago and haven't taken anything (to the suprise of my surgeon since my nerve incision is at least 5 inches long and he removed lots of adhesions from the knee).  I did do the overnight, basically a 23 hour stay.  I was pretty much on my own from the time my sister dropped me off.  She hates hospitals, so she dropped me off and picked me up when I was ready.  I did okay on my own.  I agree with Danielle, back/fanny back was important.  I was NWB for 8 weeks with another PWB for 4.  I was ready to ditch them at week 4 or 5.   Unlike Danielle, I wasn't allowed to put any pressure on the joint, not even putting a toe on the floor for those 8 weeks and forget trying to bike.  I didn't do any real PT either until I could PWB.  I'm really glad I waited, the most important thing is for the graft to heal not exercise.  I have a desk job so I went back part time at like 10 days and full time at week 4.  I started by working at home and transitioned to the office.  I didn't use a wheelchair, but agree with Danielle, the crutches can  be a bit much.

I'm confused as to how you are having a scheduled allograft.  Most surgeons use fresh allografts (as opposed to frozen), so you go on a waiting list.  No unlike any other transplant list (heart, kidney, etc.), you wait until you are called.  I was called on a Sunday and was in the OR on a Wednesday.  Unfortunately, someone has to die to donate the allograft so scheduling a fresh allograft is impossible.  Surgeons typically prefer not to use a frozen allograft due to chondrocyte death during the freezing process.  Bascially you need viable chondrocytes for the cartilage part of the graft to survive.  If I were you, I would talk to your surgeon about what he is doing.  There are plenty of articles out there strongly supporting the use of fresh versus frozen.

So where exactly is your problem, medial or lateral?  Most are medial.   How old are you?  This actually matters a bunch.  I had mine at 35 and there was an 18 year old who had 8 or 9 really deep allografts in his MFC.  He was running at 6 months, no problem.  It really took me about 6 months to feel okay with ADLs and 18 months to feel really good or normal.  It's really not like an ACL recon at all, it takes much longer to heal.  Given that you are a dog trainer, I would imagine it be tough to go back before 2-1/2 months especially on concrete flooring.  I'm no longer able to run, but feel pretty good.  I can cycle, walk the dogs lots and over function great.  I can't run primarily because I have an even bigger defects on my lateral femoral chondyle and my lateral tib plateau.  I can say that I no longer have the typical osteoarthritis aches and pain, so it was worth it, but rehab is long.  I plan on having work done on my other problems in the next year or two.

Let me know if you have any questions....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