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Author Topic: Need Advice Fast -- Should I have OATS?  (Read 3429 times)

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Offline mjg407

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Need Advice Fast -- Should I have OATS?
« on: November 15, 2005, 09:11:22 PM »
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« Last Edit: December 02, 2005, 12:41:43 AM by mjg407 »

Offline blackbeltgirl

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Re: Need Advice Fast -- Should I have OATS?
« Reply #1 on: November 15, 2005, 09:45:26 PM »
Mike -

I haven't had OATS, and I'm not even eligible for it, so I can't provide specific advice on that front.  I'm actually facing similar decisions about ACI - do I take the risk now, or risk not having this option later.  If you can have autograft OATS (meaning they use your own cartilage to plug the hole, vs. a cadaver graft) the whole isn't too big, and you should have good options.  Go check out some of the articles on cartilagedoc.org (go to resources, knees) to learn more about articular cartilage health, restoration/replacement options, and expected outcomes. 

After you read some of the literature, call or e-mail your OS with a list of questions.  And frankly, if you want more time to think about it, take the time.  YOu can always schedule your surgery for January or later (unless you're trying to work around a potential change in insurance policies) to give yourself more time to think about it.  Yes, the lesion will grow over time, but a few months won't be that big a difference.

best of luck-
Jess
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)

kelsaygh

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Re: Need Advice Fast -- Should I have OATS?
« Reply #2 on: November 15, 2005, 10:51:54 PM »
You didn't mention the possibility of having an allograft (cadaver donation), and you might want to ask about that if you don't have enough of your own cartilage for an autograft (using your own tissue).  How difficult the recovery is depends upon, in part, where the location of your defect is.  Weight bearing surface requires a lot more "crutch time" than non-weight bearing.  Also, many docs will only do the OATS procedure with another procedure called a TTT or distal realignment or Fulkerson to "unload" the area at the same time.  You don't mention how old you are--that might have a bearing on your decision too.  These are all questions to ask your OS, and when you have the answers, you can do research and TAKE YOuR TIME before you make a final decision.  You also may have to deal with your insurance company as some are better than others at covering this procedure.  I am 4 weeks out from an OATS w/ TTT, and so far (crossing my fingers!) the recovery has not been nearly as arduous as I was lead to believe.  But I have a looong way to go.  I picked now because I will hopefully be good to go walking by my vacation in March, and ready for hiking by Summer.  Lots of info and support on these boards, and everyone will tell you not to  allow yourself to be rushed into anything! 

kelsaygh

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Re: Need Advice Fast -- Should I have OATS?
« Reply #3 on: November 15, 2005, 10:55:10 PM »
OOPs--you did say you were 28, sorry I missed that!  You are young enough to have really excellent odds for a good result, and for the insurance company to look favorably upon the surgery too :)

pipervlh

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Re: Need Advice Fast -- Should I have OATS?
« Reply #4 on: November 15, 2005, 10:58:21 PM »
Mike -
I was in a very similar situation.  Was told that I needed OATS, but at the time my pain was "manageable", the popping was irritating, etc.  After doing some research (most of it on this website), I decided that the situation was only going to get worse.  I didn't want to wait so long that then I would need a more extensive/expensive solution (like a PKR).   So, I made the decision and had the autograft (2 plugs transferred) in September.  I'm still in the recovery stage, just starting with the walking after 6 weeks of NWB.

The last 6 weeks were tough and I wasn't sure I made the right decision.  BUT!!!  Already I can tell the difference.  Simply stated:  my knee doesn't hurt.  I know that I'll have good and bad days for awhile to come, but right now I am happy with the decision.

You said you have been diagnosed with OCD.  That would seem to be a degenerative condition and soon (relatively) you wouldn't be eligible for OATS if the cartilage starts wearing away.  Will OATS delay any of this?  If so, then another reason to consider surgery now.

Just a few thoughts. Let us know what you decide to do.
Vicki

Offline mjg407

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Re: Need Advice Fast -- Should I have OATS?
« Reply #5 on: November 16, 2005, 03:16:21 PM »
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« Last Edit: December 02, 2005, 12:40:28 AM by mjg407 »

Offline blackbeltgirl

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Re: Need Advice Fast -- Should I have OATS?
« Reply #6 on: November 16, 2005, 04:26:22 PM »
A lot of people with OCD have microfracture instead of OATS.  Actually, a lot of insurance companies require that you try microfracture first, and if that doesn't work, then they will pay for OATS.  If you do a search on OCD, you will find a number of folks on the boards who are dealing with it. 

I understand your timing issues.  But unless you have a physical career, either way you'd be back at work, at least part time, in about a month.  A lot of people seem to go back part time at first, just to have enough time to do physio.  You might as well check with your insurance company to see if this is even a realistic plan of action for you.  I;d hate for you to commit, only to find out last minute that insurance won't pay.

Good luck.
Jess
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 brattkids

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Re: Need Advice Fast -- Should I have OATS?
« Reply #7 on: November 16, 2005, 07:18:41 PM »
I have had the synthetic OATS grafts and they failed in my case. I had them placed on both the medial and lateral femoral chondyles. My OS is working with the company and it seem now that the more they are put into circulation the more thay are failing in the knee. They have had great success in the shoulder- NO GOOD FOR US- but the knee just doesnt hold up.

Paulette
4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop

Offline Beauzer

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Re: Need Advice Fast -- Should I have OATS?
« Reply #8 on: November 16, 2005, 09:16:11 PM »
I had OATS on 4/25 for an OCD lesion of my MFC, but I also have arthritis in that area too and had a microfracture there in 1999 (no OCD at the time).  They used two 9mm plugs from my lateral trochlear groove.  I did very well at first.  It really was amazing.  I had absolutely no pain for the first time in years.

However, 9/30 I got a stress fracture around the area where the plugs are.  I have what looks like AVN around the plugs.  So I spent another 6 weeks NWB.  It seems to be doing better and we're hoping that everything will be OK, but due to everything else that's wrong with my knee, I'll probably need a TKR in the next 5-10 years.  OCD is bad.  Unfortunately the procedures, like microfracture and OATS (and even TKR) used to treat it have a higher failure rate in folks with OCD.

If the OCD lesion is deep or big, it's probably not a good idea to ignore it.  Believe me, I know it's hard, when you're young and active to think about doing something to prevent problems in the future.  Arthritis is no small thing and you'll get it if you are missing part of your articular cartilage.  I can tell you from experience, as my OCD lesion is related to a cartilage tear I got when I tore my ACL in 1998.  I'm only 31 now, am active, have a job where I stand all day, and my knee is a disaster.

You also need to check with your insurance company beforehand.  Mine precertified me for the OATS with no problem and then decided afterward that it was experimental and is refusing to pay for it. 

If you have any questions about OCD, OATS procedure or recovery, what happens to you knee if you ignore problems, etc. just IM me, I have lots of experience, good and bad.

Good luck, there is no easy answer.
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 brattkids

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Re: Need Advice Fast -- Should I have OATS?
« Reply #9 on: November 17, 2005, 02:25:55 PM »
Danielle,

I am also fighting with my insurance company about my OATS. I was also pre-approved. I dont understand how they can do that. They tell you yes they will cover the surgery and then bammmm a $15,000 bill comes in the mail!!

Hope you get things covered!!!

Paulette
4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop

Offline stgiles16

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Re: Need Advice Fast -- Should I have OATS?
« Reply #10 on: November 17, 2005, 09:19:00 PM »
If you will look closely at your policy, you will notice that the sneaky insurance companies put in there that just because they precertify you for a surgery, it does not mean that they will pay for it. I have had my insurance tell me that over the phone before surgeries.
They are a sneaky nasty bunch.

missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012

Offline mjg407

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Re: Need Advice Fast -- Should I have OATS?
« Reply #11 on: November 21, 2005, 07:07:46 PM »
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« Last Edit: December 02, 2005, 12:41:10 AM by mjg407 »















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