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Offline Beauzer

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Re: Major disaster
« Reply #30 on: October 07, 2005, 01:37:54 PM »
OK, OK, I'll answer my own question.

WB = crunching = pain. 
I get it now.  I'll stop being an idiot.
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 blackbeltgirl

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Re: Major disaster
« Reply #31 on: October 07, 2005, 02:19:21 PM »
Danielle -

Don't ya just love it when you rbody communicates that clearly?  I wish my knee had been able to explain that before the damage got so bad.

Have a good weekend!
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 Beauzer

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Re: Major disaster
« Reply #32 on: October 12, 2005, 06:32:12 PM »
Hi all,

I had my postop check today.  So, first off, my plugs (except for a very small area of cartilage tear, not bone, I misunderstood, in my dilaudid-induced haze) were nice and stable at the op and looked fantastic overall.  My problem seems to be the subchondral bone.  There is probably some AVN and I "microfractured" it around the plugs, which is what hurt like the dickens.  He said it's almost like a really bad bone bruise (bone bruise?  this happened just walking around at work, it's not like somebody smashed a football helmet into my knee ;D - I am in Pittsburgh after all, poor Ben...but he'll be back before I am)

My OS is encouraged by the rapid decrease in the pain, but nearly smacked me when I admitted to walking on it some.  I'm still not allowed to drive (unless I absolutely have to, like next week when my hubby is away, I was able to bargain that one, at least).  I don't have to use the brace anymore, which is great as it was very uncomfortable.  I'm still NWB.  Follow up and likely repeat MRI in 3 weeks, yadda yadda.  I forgot to ask if I could start the stationary bike again.  I guess I'll just try it with no resistence and see what happens.

I started back to work today, out of sheer boredom.  I only spent 8 days trapped in the house and was absolutely climbing the walls.  I can't really do much though.  Fortunately the division secretary found out I was gone and fed my poor fish (no floaters today,  :P).  Gee what a difference the workouts (and losing 30 pounds since my OATS) have made in crutching around.  I actually feel OK today (although my knee is hurting from having it down all day - is it time to go home yet?)

Anyhoo, I'm rambling...

Danielle
« Last Edit: October 12, 2005, 06:35:13 PM by Beauzer »
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: Major disaster
« Reply #33 on: October 12, 2005, 07:24:04 PM »
Danielle,

Glad to hear that the plugs are ok. That is definately good news. 

You mentioned AVN or problems with the subchondral bone, possibly a bone bruise?  Gosh, that seems so vague.  I wish there was a way to tell for sure.  It seems like AVN is something that is hard to determine for sure.  I've had one of my second, or was it third, opinions mention AVN but nothing mentioned as far as how to deal with it.  Did your OS say what they would do if it was AVN?  Will the NWB time help the AVN or is that just for the fracture?  It is all very confusing to me.  One doctor thought that maybe the reason all the cartilage was falling off my bones was because of AVN.  He explained it to my husband and compared it to a stroke of sorts.  Saying that over time the bone slowly dies and the cartilage begins to deteriorate.   Have you gotten any specific explanation of AVN or how to treat it?

Sorry to bombard you with questions but I figured you may have some answers since we both seem to be dealing with somewhat similar issues.  Thought I would get your insight.

Anyway, glad you are feeling a bit better.  Hang in there!
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: Major disaster
« Reply #34 on: October 12, 2005, 08:12:09 PM »
The problem is, the AVN diagnosis can be rather vague.  I aked my OS today, "is this AVN?"  I don't know.  "How can you tell?"  You can't, for sure.  "will the NWB make it go away if it is AVN?"  I don't know.  "What does this mean for me in the long term?"  I don't know.  And this guy's been in the biz for over 20 years.  Gee that makes me feel better :-\

From what I've read (which is quite a bit, the past few months) AVN is tricky to diagnose and trickier to treat.  If caught early and in younger patients (whatever that means), NWB may be successful in making it go away.  Or you can try drilling into the area to stimulate bone growth (and clean out the dead stuff).  Or you can do an OATS (wait, isn't that how all this started?)  Or you can do a TKR.  Actually, all the surgical options don't work as well in folks with AVN, because it tends to progress, so what to do?  As the orthopedic establishment hasn't found a good answer yet, I CERTAINLY don't know.  Nobody really seems to know for sure what causes it in most people either.

I have a few things that seem to be related to increased AVN (according to some folks), multiple traumas to the same area, use of one of those heater probe thingys (on my MCL and joint capsule - twice) and possibly even OATS (which is why they don't drill out the holes for plug placement anymore).

I can't see how this is a bone bruise as I haven't done anything other than swim and stand all day at work.  No trauma or anything.  I was just walking down the hall when the crap hit the fan last week.  Dunno.

I'm still hanging in,
Danielel
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: Major disaster
« Reply #35 on: October 12, 2005, 08:34:18 PM »
Thats what I thought!!  I seem to get the same answers... I dont know, I dont know, I dont know.  The best is "time will tell"  It's really not comforting at all. 

Anyway, thanks for your thoughts.  I was hoping you may have more info than me but it seems that we've been told the same things.

Take care. 
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: Major disaster
« Reply #36 on: October 28, 2005, 01:38:39 PM »
I'm just sitting here at work going nuts, so I thought I would update this a bit.

My launch date from crutches is 11/9.  I bumped into my OS today.  I was all set to beg to get off the crutches a few days early.  I just found out that I got accepted to a workshop next weekend, which is a really big deal (impossible to get into, all expenses paid, major implications for future job search, yadda, yadda...) and basically decided that I was going to go and participate in it come hell or high water.  I asked if I could dispense with the crutches a bit early.  He just said "either your knee will be OK or it won't.  Try it and see, I don't have anything else to tell you."  Gee that makes me feel better...

We also opted for no brace with WB.  He doesn't think that the postop brace will really help.  What I really need at this point is an unloader brace.  But since my unloader stretched out my MCL plication (which fortunately, scarred down to an acceptable level of instability from my big arthrotomy for my OATS) we're both a bit reticent to use it again (OK, scared as hell would be a more apt description).

I've decided that I'll try some PWB between now and next Thursday.  He said it didn't really matter if I did some PWB or just stayed completely NWB from a healing standpoint.  I just think it'll be easier to survive two full days on my feet if I wasn't NWB right up until that day.  So I guess we'll just have to wait and see.

Darn knees!
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 blackbeltgirl

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Re: Major disaster
« Reply #37 on: October 28, 2005, 01:40:59 PM »
Danielle -

Congrats on getting into your workshop.  Just remember that you may not abosrb as much new stuff if you end up doped up on painkillers.  Bring the crutches with you, even if you decide to just use 1, or some other compromise. 

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 Beauzer

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Re: Major disaster
« Reply #38 on: October 28, 2005, 03:36:42 PM »
I'd already thought about that.  I'm driving, so taking the crutches isn't a big deal.  Unfortunately, the majority of the workshop consists of standing and practicing skills requiring the use of both hands for two full days.  I'm not sure how well I'm gonna do, but we'll see.
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: Major disaster
« Reply #39 on: October 28, 2005, 04:34:37 PM »
Danielle,

I am in nursing school and on crutches I have found very inventive ways to be able to use my hands and still crutch. I put the crutches under the arms and pull them back and forth with my body while still being able to use my hands. It took a couple days to get it down but it has helped me greatly in getting around and doing my school work.   Just a suggestion hope you do well and I will have my fingers crossed for you!!!

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: Major disaster
« Reply #40 on: November 01, 2005, 04:48:49 PM »
Just a quick update. 

Overall things seem to be going OK.  I've been doing the PWB thing since Friday.  I can even go short distances (like around the house) without crutches.  But I can't make it very far.  I also limp/waddle when I walk without the crutches.  Not very attractive.  Walking is somewhat uncomfortable, although PWB is painless.  I imagine it will take a few weeks until I can tell how this is going to go.   

Actually, I can't get too ahead of myself.  I was PWB for 2 weeks after 6 weeks NWB after my OATS and getting FWB was difficult.  This time around, I make big strides on a daily basis.  I started back on the exercise bike this weekend too (carefully, with no resistence at all).  I can't wait to get back into the pool.

On a down note, I'm getting a lot of patellofemoral maltracking which hurts.  I think it's due to my quad being so weak since I wasn't allowed to do any rehab.  This has me worried as I'm being "released back into the wild" after my appointment next week.  (Well, I can probably beg out of the OR for a few more weeks, but I'm back on call, so if anything comes in afterhours, I'm SOL).

I'm going nuts and getting anxious about getting back to my life.
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: Major disaster
« Reply #41 on: November 07, 2005, 06:05:13 PM »
OK, so now I'm confused.  ???   I just bumped into my OS in the hall and he yelled at me for being off crutches.  I pointed out that I asked him two weeks ago if I could get off a few days early because of the workshop this past weekend.  He said "yeah, but that was just supposed to be for the workshop".  Huh?  First off, that's not what he said.  Anyway, that doesn't make sense.  It's OK to walk and stand for two days, but not after that? 

So, it wasn't easy to go from being NWB to standing for two days.  Saturday my knee hurt a good bit, but I stood for 3 hours and then drove 6 hours home.  So, duh, it's gonna hurt.  It's OK now.  I told him that.  He still wasn't very happy.  I tried to remind him that I sort of expect it to hurt a bit when I walk on it, since I've been NWB for a long time.  I'm going to try to get a repeat MRI before my appointment on Thursday.  I also promised that I wasn't really back to normal activities and was trying to stay off it as much as possible. 

So...  Not really sure why he's mad, when he told me I could do it.  Anyway, we'll see how everything looks.
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: Major disaster
« Reply #42 on: November 10, 2005, 05:00:53 PM »
I just got back from my OS appointment.

Overall, my MRI looks better than it did 6 weeks ago, with much less marrow edema on the MFC.  My x-ray, though definitely looks suspicious for AVN, so that's probably what the inciting event for the stress fracture was.  Also, my MCL (which was loose again, tightened up after the OATS arthrotomy to an acceptable level) is now loosening up again, probably from the inactivity and such, so I'm back in a hinged brace, likely indefinitely.  So...I can walk and swim and cycle again.  I'm OK to do short procedures, but need to try to stay off of my feet as much as possible for another month.  Guardedly good news, I guess.  It just doesn't really feel like it.

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: Major disaster
« Reply #43 on: November 11, 2005, 07:24:15 PM »
Danielle,

I am glad to hear that your MRI looked well. I sure hope your progressing well!! I have my fingers crossed for you

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 shade

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Re: Major disaster
« Reply #44 on: November 11, 2005, 08:27:53 PM »


Wishing you continued progress.  Glad that the MRI looked okay.  Sorry about the MCL getting loose again.

Good luck,

Shade
July '05 (RK) - LR/debridement
Mar '06 (RK) - Open LR + Allograft w/OBI TruFit Plug + Fulkerson TTT
 Feb '07 (LK) - LR + Fulkerson TTT