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Offline scooter5

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OATS Procedure
« on: June 12, 2005, 01:15:13 PM »
Good morning,
I had the OATS procedure done on my right knee this past Friday.  I am having a hard time lifting my right leg to get in and out of bed.  Is this common?  How long before you feel comfortable getting around yourself?  My doc said 2 to 3 weeks on crutches but everything I am reading seems to say longer recovery.  Looking for some guidance from anyone that has this procedure before.  This is my 5th knee surgery, 1st OATS,  and I do not recall having these problems before.
Thanks.
scooter5  :)

Offline Beauzer

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Re: OATS Procedure
« Reply #1 on: June 12, 2005, 03:16:50 PM »
Hi Scooter,

Welcome to the OATS club! ;)  I had a really tough time at first too.  It was really hard to get my quad to fire and it hurt like heck!  It made it really hard to lift the leg up or get around.  I had a lot of pain for the first few days.  After about 5 days, I could lift my leg and move without too much pain.  I'm almost 7 weeks out and just started some PWB. 

Some OS just keep you NWB for 3 weeks or so and then allow some PWB.  Others feel that any walking before 6 weeks can damage the grafts.  My OS is one of the latter.  Also, my area grafted was fairly large, on the WB surface and was an OCD lesion, so we've been very conservative.  I don't know that there is a right answer.  You may want to share your concerns with your OS.

My OATS was the 8th procedure I've had done on my knee.  It was by far the toughest.  Even now, I don't really have any pain, but transitioning into walking again isn't easy.  I'm sore and the muscles are very weak.  I was told that the knee will be painful as you walk on it again and it takes months before it feels normal again.  You have to be patient.

I've kept a journal of my postop course, listed as OATS under the Post-Op section.  You may want to check it out, it'll give you an idea of how things went.  We also have an ongoing thread (OATS recovery) under this section too.  We're a few weeks further out from surgery, but we're recently post-op too, so we spend a lot of time comparing notes and just generally griping.

Good luck,
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 scooter5

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Re: OATS Procedure
« Reply #2 on: June 12, 2005, 04:02:03 PM »
Danielle,
Thanks for the feedback. I will take a look at your recovery journal.  Good luck on your recovery. 
Thanks,
Scooter

Offline JG

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Re: OATS Procedure
« Reply #3 on: June 13, 2005, 04:21:47 AM »
scooter5,

I also had an OAT procedure using mosaicplasty technique (interlocking grafts versus the traditional side by side) with a total of 18 grafts in two large defects, trochlea and MFC.  I don't recall having problems with lifting my leg, but it took me a 10-14 days to get myself around.  I was locked at in a brace at 10 degrees (when not using my CPM) so I was able to pull up on the brace to place my leg in bed.   I guess if I tried to lift it on it's own, I wouldn't have done that well.  Danielle has posted a few times regarding what is helpful during post-op recovery.  I was NWB for 8 weeks and another 3-4 PWB.  The transition was from both NWB to PWB and PWB to walking was a little rough.  My biggest problem was my foot and calf.  While NWB, I was told under no circumstance to even touch a toe on my operated leg to the ground...not to rest, not to put shoes on, nothing.  It sounds like your graft(s) might not have been placed in a weight bearing part of the femur.  They do allow those who have had troclear graft to weight bear earlier, like a couple weeks.  Most physicians who focus on articular cartilage injuries recommend at least 6 weeks and up to 12 weeks of being NWB if the patient had graft placed in a weight bearing location.

Hang in there.  Keep in mind that the grafts do take time to heal.  There is new evidence that allografts are "weakest" at the 8 week mark.  I'm not sure about autografts.

So what did you have done exactly?

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 scooter5

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Re: OATS Procedure
« Reply #4 on: June 13, 2005, 02:09:36 PM »
Janice,

Thanks for the feedback.  Not exactly sure what was done at this point.  I don't remember talking to the OS after the surgery.  I have had 4 previous surgeries to correct the position of the knee cap and repair any cartilage tears/scar tissue.  For this surgery, the OS took some cartilage from a different part of the knee to plug the existing hole from the previous ops.  I am not sure of the size of the plug yet.  I see the OS this Wednesday.  He had mentioned there would be a 6 inch incision and what the surgery would entail but I didn't think I would have a hard time getting in and out of bed by myself.  The surgery was on 06/10 and I have to say, today is the least amount of pain so far.  I am hoping that continues to improve.

How long has it been since your OATS procedure?

Thanks,
Scooter

Offline RichE

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Re: OATS Procedure
« Reply #5 on: June 13, 2005, 07:27:31 PM »
Hi Scooter,

As Danielle has already mentioned there is a thread 'OATS recovery' that I have also been diarising my recovery from an OATS procedure on the 7th of May. We have been sharing hints and tips on how to make the best of the NWB period.  I still have another 5 days till I complete my 6 weeks and Danielle is 10 days advanced of me.

On the point about lifting your leg in and out of bed.  You may already be doing this but from previous experience I find hooking the foot of my good leg under the ankle of the bad one and lifting them both in together is the easiest way in and out of bed, at least until you're ready to try lifting them independently.

Good luck with your visit to the OS

Rich.




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

Offline scooter5

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Re: OATS Procedure
« Reply #6 on: June 13, 2005, 11:50:31 PM »
Rich,
Thanks for the tip.  Sad to say but I have not thought of that.  I was looking forward to the OS on Wednesday but he had to cancel for a surgery.  I'll be going to him Thursday afternoon instead.  Today was a pretty good day pain wise.  I am looking forward to the days ahead.  Good luck with your recovery.
Thanks,
Scooter

Offline SallyW

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Re: OATS Procedure
« Reply #7 on: June 14, 2005, 12:47:54 AM »
I'm following this thread with interest. My doc is scheduling me for OATS - will happen sometime within the next two weeks, as soon as he can get his assisting surgeon lined up. He says he'll do autograft unless he gets in and finds that I have too much damage - in that case, he'll measure me for allograft and do nothing until that tissue becomes available (he says the only way to accurately measure is with an operation - MRIs aren't good enough...interesting).

At any rate, Scooter, you mention 3 weeks NWB? My doc says to plan on 8 weeks (right during my busy season on our farm  :( ). My damage appears to be fairly large, and in an important weight bearing area, so I appreciate his conservative approach. He asked if I wanted to wait, but - there will never be a "good" time to be NWB.

Based on advice in the other thread (thanks RichE and Beauzer), I asked my doc for a prescription for a wheelchair. When I had other major ops, I lived in a tiny apartment (stand in one room and you can reach every other room with barely a hop). Now I live in a large house (no stairs, thankfully), so a chair will help me be a little functional around the house.

I'm getting really nervous about this. It sounds like a bigger deal than the TTTs that I had before (I was only NWB for 3 weeks in one op, 2 weeks in the second). Reading what you guys have survived is giving me hope, though.
« Last Edit: June 14, 2005, 01:18:52 AM by SallyW »
Right knee: LR/TTT 1995 Left knee: LR/TTT 2000, Microfracture & partial meniscus removal 2004, Synvisc 2004, Unloader 2004, OATS 6/20/2005, Synvisc 2006, Debridement 2006

Offline kathleenj

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Re: OATS Procedure
« Reply #8 on: June 14, 2005, 02:06:22 PM »
Hi Scooter,

I've had 2 OATS.  Same spot...1st one failed.  I think it is really important to stress the NWB issue.  My OS wasnt as conservative as many are now and me being the impatient person that I am cheated with the NWB and probably started too soon.  At 8 weeks post op I began having the exact pains as before surgery and we later found out that the plug was not flush and had 'shifted' out of place.  The plug was fine at 1 month out so I am certain that I did too much too soon.  I needed to have the entire thing redone at 6 months.  Stupid me.  If only...

I am now just over 1 year post op the second one and things are ok with that plug.  It is totally incorporated and looks good.  Although, I now have additional lesions on the MFC and Tibia, the only place that looks good is that second plug.  I really took it easy after the second one as I'm sure you can understand having to go thru it twice was not fun.

I know alot of people have been posted about having the OATS...it is a really great procedure but you need to follow the post op protocol to the T.  Its a real test of your patience and commitment.  The NWB time is very difficult but it is crucial as is the months of rehab afterwards.

Good luck to everyone having been thru the OATS.  Maybe someone will learn from my mistake, I would hate to see someone have to go thru it again like I did. 
Hang in there...if you follow your doctors recommendations you will be out doing all the things you love in no time!!!!!!!!
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 scooter5

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Re: OATS Procedure
« Reply #9 on: June 15, 2005, 02:39:47 PM »
KathleenJ, Thanks for the feedback.  I will definately take your advise as I do not want to go through this again for awhile.  I think my wife has had enough of me the last few days.

SallyW - Good Luck with your upcomining procedure.  It will go fine.  I will admit that the NWB time has been a pain however, think of it as a vacation from doing the hard work that you do all day long.

I am at day five and have very little if any pain.  I am more uncomfortable if anything.  I go to the OS tomorrow so we will see how things went.  For some strange reason, I am looking forward to the ride to the OS office.  Probably because it is my first time out of the house since the surgery.

Good luck to all on your revoveries and have a great day.

Scooter

Offline Beauzer

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Re: OATS Procedure
« Reply #10 on: June 15, 2005, 07:21:31 PM »
Scooter,

Glad to hear that things are finally settling down.  Don't feel strange about being excited about getting out of the house.  I didn't go anywhere for about a week and my first trip (to the grocery) was about as exciting as a major vacation! ;D  My husband was laughing at me.

Are you doing any PT stuff (SLR, quad sets, etc.?)  My OS thinks it's really important to not let the quad get too atrophied.  I started with some simple PT stuff right away (had home PT actually) and think that it has helped with the transition to PWB now.  Even though my quad is still weak, I can't imagine how bad it would be if I hadn't done anything at all. 

Everybody is different, though.  Rich hasn't been doing as much PT as I have (about an hour a day of home exercises, PT 2X/week and swimming 2X/week).  It'll be interesting to see if our PWB goes differently.  I have a job where I stand for 12+ hours a day, though, so my OS wants to make sure I'm nice and strong before I get back to it.

Good luck and remember, ice is your friend.
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 scooter5

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Re: OATS Procedure
« Reply #11 on: June 15, 2005, 11:37:51 PM »
Hi Danielle,

I have not started any PT yet.  I am assuming I'll find out on Thursday when I go to the doctors.  I think he may have put the imobilizer to high on my leg.  I think that is why I am having a hard time moving it right now.

After my last surgery, my leg cramped up after removing the imobilizer.  I am hoping that doesn't happen this time.  There was more pain from that than the actual surgery.   :'(

My wife hopes this is the last surgery for a while because I am driving her crazy.  Can't say I can blame her as this was the second surgery in 6 months and she has been with me for all 5 of my surgeries.  She said I owe her a vacation.

I hope your recovery is going well. 
Talk to you soon,
Scooter

Offline scooter5

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Re: OATS Procedure
« Reply #12 on: June 16, 2005, 08:24:21 PM »
Well, I went to the OS today and found out he ended up doing three plugs rather than the one he planned for.  He had to remove quite a bit of cartilage across the entire knee and then did the three plugs.  I have a nice 6 inch incision down the middle of my knee.  It actually looks rather good.  I also found out that this was the first time he did this precedure specifically on the knee.  All of the other times he did it was on the femur.

I questioned why the short time of NWB and he stated since it was on the knee and not the femur, I would not need to be NWB for as long.

No PT set up yet.  The imobilzer was removed and then placed back on before I left.  I need to wear the imobilzer when I get up and try to walk around however, it can be removed if I am just sitting around.  Let me tell you, it feels great to have it off and let the air get to it.

I go back to the OS next week and have the staples/stitches removed.  I have been given the clearance to start bending the knee.  I am sure I'll find out about PT next week.

Danielle: You were right, ice is your friend during the recovery.

Talk to everyone soon,
Scooter :)

Offline JG

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Re: OATS Procedure
« Reply #13 on: June 17, 2005, 02:47:26 AM »
scooter5,

The knee joint consists of the femur, tibia and patella.  There is no knee bone.  It's highly unlikely that he did the tibia because that is very very rare with plugs. If he didn't do the femur, that leaves the patella.  Another unusual surgery.  I had plugs in the medial femoral chondyle and trochlear (femur part where the patella slides), both part of the knee.  When I talk about my surgery, I talk about a knee surgery not a femur surgery.  It sounds like you had it done to the trochlea.  Typically that requires an immobilizer in a more straight positiion. 

Just curious about the knee bone....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 scooter5

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Re: OATS Procedure
« Reply #14 on: June 17, 2005, 04:09:37 PM »
Hi Janice,
Sorry I wasn't more specific, the plugs were done on the patella.  He did mention that this was a very unusual surgery and the first that he had done like this.  The OS had to remove quite a bit of arthritic cartilage from the patella before doing the plugs.  That was the reason for the three plugs.  His original plan was one plug.  The imobilizer needs to be used when I get up and move about otherwise it can come off when I am sitting around.
Thanks,
Scooter