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Offline Cindy Bailey

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osteochondral graft
« on: October 26, 2005, 03:35:46 PM »
I just saw a new OS who gave me the option to have an osteochondral graft. Can someone here explain what it is and a little bit about the recovery from it.

Offline blackbeltgirl

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Re: osteochondral graft
« Reply #1 on: October 26, 2005, 04:28:54 PM »
I haven't had it, but basically they take a plug of articular cartilage from one spot and use it to fill your hole.  For smaller lesions, they use your own cartilage - harvesting it from a non-weight bearing area of the knee.  For larger lesions they use a cadaver donor to supply the "replacement cartilage".  Several people have post-op diaries on the procedure.  Not sure if those are in the OATS section or the post-op diary section.  But you can do a search and find them.

Good luck.
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)

shadehawk

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Re: osteochondral graft
« Reply #2 on: October 26, 2005, 07:07:32 PM »
Hi,

Here are some articles on FindArticles.com that may help with your research.

http://www.findarticles.com/p/search?qt=osteochondral+graft&qf=free&tb=art&x=26&y=9

Good luck,

Shade

Offline Beauzer

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Re: osteochondral graft
« Reply #3 on: October 26, 2005, 09:24:29 PM »
Hi,

I had an OATS to my MFC on 4/25/05.  They took two plugs of articular cartilage and underlying bone from a NWB surface of my knee and plugged a big OCD hole. 

Postop protocols vary somewhat.  But mine was fairly typical early on, I think.  I was NWB for 6 weeks and PWB for a few more.  I was back to work (standing 12+ hrs a day) on 7/1/05.  I kept a postop diary (under the postop section) and we had an extensive thread under this section called postop OATS (or something close to that).  Those would give you a good idea of the day to day stuff we went through.

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

pipervlh

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Re: osteochondral graft
« Reply #4 on: October 27, 2005, 01:34:38 AM »
Hi Cindy.  I had the cartilage plug transfer (OATS) about 4 weeks ago on my left knee.  You've got a lot of information on this bulletin board and also on the kneegeeks website (click on the link above to do some research).
Some things that might help you....


Prior to the surgery:
Get your house set up.  Figure out how you are going to get around (i.e. on crutches).  Have places to sit that are convenient when your other leg gets tired of hopping/standing.  I have a stool near my front door, in the bathroom, in the kitchen.  If you have a chair on wheels (like an office chair) that works well too! 
Think about where you are going to be "situated" for awhile.  I have stayed mostly on my couch since it is close to everything (door, bathroom, kitchen).
Figure out your transportation needs:  to work, to Dr appts, to PT appts
Figure out your shopping/food needs.


Surgery:
Make sure you know how to use crutches BEFORE the surgery!  The nurses should show you when you are prepping for surgery.
Have someone there to pay attention to any instructions (you will forget).  Also, they can get your prescription medicines.
Your leg will be seriously wrapped in an ace bandaage from your ankle to your thigh.
Talk to your surgeon about pain control.  Are they going to "pack" pain gel (sorry, I don't know what it is called) in your knee?  That was really good and took hours before it wear off.
I had 2 grafts, about 2 inches long, about the size of pencils.  Graft was taken from my outer-knee (lateral) and placed on the weight-bearing side (medial).  I had 4 incisions.  3 of them were across the middle of the knee.  One was above the knee area. 


After Surgery:

ICE! ICE! ICE! I have one of those cryo-ice machines.  I liked it best because it would stay cold for hours without having to get more ice.  I kept it on probably 23 hours a day for the first 2-3 days.  Pain was minimal while using it.
For me, the pain pills were not good.  I felt "loopy" and dizzy most of the time.  Decided that was not good while using crutches.  So I took only 1/2 a pill at night to let me sleep.
Consider having a few extra first aid supplies handy:  rubbing alcohol, extra dressings, bandages, ace wraps. 
Follow Dr's instructions!  If he/she wants you to do leg strengthening exercises, ROM exercises, etc. then you must do!  IT will help eventually. 
NWB for 8 weeks are my instructions.  PWB for 4 weeks after that.  And then?....?
I"m currently getting PT 2x a week, that will continue for a few more weeks (at least).


I hope this helps.  Let us know what you decide to do.
Vicki











Offline SallyW

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Re: osteochondral graft
« Reply #5 on: October 30, 2005, 12:40:02 AM »
Cindy,

You'll find that with OATS, like many ops, the post op period will vary, depending on the exact procedure your surgeon uses...I had a one cm plug placed in my medial condyle area...it was an open procedure - about a 4 inch, curving incision on the medial side of my knee. I only had a big, padded bandage around my knee - reminded me of the knee pads that volleyball players use! - That was for the first 8 days post op, until the stitches came out. I had minimal swelling after the operation, some discoloration, but really nothing like what I expected (based on my other major ops). They sent me home with a portable pain pump - a little device the size of a lemon that was attached to my knee, sent a constant, small amount of local anesthetic into the surgery site for the first three days. Theoretically, it eliminates the need for narcotic drugs after something major like OATS. I dunno - the first few days were miserable - I used my limit of narcotics plus the pump - and still hurt! But you might still ask about it.
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 Cindy Bailey

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Re: osteochondral graft
« Reply #6 on: October 30, 2005, 02:46:59 AM »
Thanks everyone for your advice and input. It sounds like a long drawn out process of which I'm not sure I want to put myself through. I read that if your knee has arthritis in it that you can't have the oats procedure done. I know that mine is pretty bad, so I'm wondering if my original OS was right about a PKR instead. ::) I will have to think this over and check with another doctor to find out what my best option is.

Offline JG

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Re: osteochondral graft
« Reply #7 on: October 30, 2005, 09:52:59 PM »
Cindy,

I have severe arthritis and had a mosaicplasty/OATS using allografts to my trochlea and medial femoral chondyle using a total of 18 fairly large grafts.  My arthritis is considered grade IV in all three compartments so it's pretty bad.  The only thing I have going for me is that I don't have any joint space narrowing and I have 100% of my medial meniscus and about 60% of my lateral meniscus.  I would certainly understand if you don't want any procedure that has a long recovery period because mine took about 2 years before I felt really good.  You are correct that most surgeons don't recommend this procedure when the knee is just degenerating, but some will if you are young.  I'm relatively young and have a history of healing well so it was well worth if for me.  Having said that, I'm still regularly attending rehab (on my own dime) which has been critical to my success and have been very patient with letting the knee heal. 

Good luck,

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