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Author Topic: ACI autologous chondrocyte surgery in two days time...+ Diary of future progress  (Read 1715 times)

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Offline daverozee

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It all started last November, almost a year ago when I decided that enough was enough and I'd speak to the doctor about how much my knees hurt. Only now do I realise that the pain was secondary to my actual knee function. Locking, collapsing and inability to move around without whinging had become the norm.
Cut to meeting Mr Kevin Chea at The Springfield Hospital in Chelmsford and his suggestion that an arthroscopy on both kness should be all i need. Left knee, no problem. Everything doing pretty good following trimmed cartilage tear and general clean up. Then it was the turn of my right knee. Not so good. Some kind of impact injury has led to an ulcer having eaten away the cartilage  right behind my kneecap. Cut to today, biopsy of cartilage has been growing in some Scandinavian lab and having lost the required 30 pounds, I am all revved up and ready to go.
I have been grateful to everyone on kneegeeks who has posted their experiences and they have helped me prepare bit menatlly and physically for what is to come.
In return and to hopefully help others, I will try and keep this posting going so that we can help move this surgery away from being classified as experimental by the N.I.C.E. (The National Institute for Clinical Excellence).
One word of warning. Be 100% sure that your insurance company is clear as to what procedure you are having. ACI is 'autologous chondrocyte implantation', also originally known as ACT (autologous chondrocyte transplantation). Anything else is NOT the same thing.
I am with Universal Provident and they gave full approval for surgery having been given the recognised OPCS codes of W8500 & W3100. (If you require hospital treatment and decide to pay directly to be treated privately (because you do not have private medical insurance or are not covered in this instance by your insurance) you have the option of taking an active role in choosing a suitable hospital and determining the fee you will pay. Alternatively you can let your consultant or specialist make these decisions and arrangements for you.
If you decide to play an active role you will do so in partnership with your consultant or specialist. Once they have decided on the treatment or procedure you need, ask them to give you the OPCS code for the treatment, as well as describing it verbally. OPCS codes are set by the Government's Office of Population Censuses and Surveys as standard descriptions which identify all medical procedures. The codes are used to generate a range of medical statistics. They also allow non-medical personnel to give an accurate description to a hospital of a medical procedure, without needing to get involved in any medical language). Problem was W8500 is for the arthroscopy & W3100 is for Osteochrondral Grafting. It took me some research, a week after the arthoscopy, I received a call from my insurers saying that they'd been given incorrect OPCS codes and my claim was null & void. 7,500 of bills to date would be unpaid by them and the decsion to have the ACI would be one of finance not necessity. A total bill of 15,000 looks likely.
Meanwhile, My Kevin Chea was kind enough to call them directly and explain that OPCS coding is coming and all 'other' insurers have agreed to use W8500 & W3100 in the meantime. I've been luck as they have now agreed to settle ALL bills, albeit as a "goodwill gesture". As I said, be careful as it could prove expensive...
Enough of that, I'll be back on this weekend and let you know how it is going...
 

Offline daverozee

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Here I sit, 5 days post operative and I have to say it really wasn't too bad. I remeber reading another guys ACT posting and screaming about the pain he was in. Take no notice of him. It really isn't too bad at all, plus they give you morphine on a self-activated drip that really helps you sleep it off...
It was explained to me that my approach to my recovery is 99% of the deal, the surgery is 1%, so I guess the work starts now?
Meanwhile, my leg is in a rigid splint for 10 days, so it comes off next Monday along with the STAPLES (yuk). It is such that I can put very minimal weight on my foot at the moment and will have to build up to full weight-bearing in 8 weeks time. That is also when I can drive again. Great.
Crutches are a bit of a pain, but getting to be part of it. Can feel my muscles wasting away, so keen to get on with the rehab. Its times like this when you find yourself wishing the days away, so time to concentrate on the good stuff meanwhile...

Offline blackbeltgirl

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Dave -

Are you in the US?  Were you in the hospital overnight?  I need to pick my insurance plan for next year, and I may be having ACI.  Just trying to figure out if it's in-patient or out-patient surgery.  And that seems to depend a lot on the country, patient, doctor, etc.

Glad the pain isn't too bad.  My experience with most things - surgical or otherwise - is that it's what I do, and my attitude, that makes the difference.  I'm sure this is no different.  So positive thoughts, and high expectations, and lots of hard work, and I'm sure in a year you'll be telling us about the amazing return to normal life your knee has experienced.

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 daverozee

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2 weeks to the day that I was operated on and I have to say "go for it". This whole thing really isn't too bad at all. My kneww function is coming back at an ever increasing rate, I have 90 degree movement and can stand with some weight bearing no problem. I did wake up in the night and take a pain killer as it was aching enough to keep me up, bu ll in all, this has been nothing like the horror stories I have read on this site.
Assuming all goes well with the implant itself (and I don't see why not) all I can say is, if you have the condition that requires ACI, get it done!
Good luck...

Offline daverozee

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Dave -

Are you in the US? Were you in the hospital overnight? I need to pick my insurance plan for next year, and I may be having ACI. Just trying to figure out if it's in-patient or out-patient surgery. And that seems to depend a lot on the country, patient, doctor, etc.

Glad the pain isn't too bad. My experience with most things - surgical or otherwise - is that it's what I do, and my attitude, that makes the difference. I'm sure this is no different. So positive thoughts, and high expectations, and lots of hard work, and I'm sure in a year you'll be telling us about the amazing return to normal life your knee has experienced.

Jess

Jess
No, I am in the UK. I was inhospital from Thursday, when the procedure took place, and went home on Sunday. Th enature of teh op is such that it is definately not an outpatient procedure as they currently do it as an arthropy (open knee surgery) as opposed to an arthroscopy (keyhole).
The pain hasn't really been an issue. You're right about how you approach it can make a difference and it is simply a case of if it hurts, don't do it.
I think alot will depend on where your injury is. I was lucky in that my damage was right behind the kneecap and anywhere else means that you'll need to be non-weight bearing for longer.
I'll let you know how it goes...