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Author Topic: Carticel????  (Read 2382 times)

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Offline Liz13

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Carticel????
« on: November 08, 2005, 09:48:47 PM »
Hi, everyone I am new to this site, and very excited to here from people, so I can get some help.  I am 22 years old, and at the age of 20 I tore my ACL, and had the replacement done by taking my hamstring to make my ACL.  Currently my ACL is still in tact and strong.  I then a year later I was still having bad problems and lots of pain and stiffness, so the DR. decided to do a lateral release, and a plica removal.  Everything he said went fine, but my knee cap was deteriorating so they took cells so they could do the carticel surgery later in case I need it.  Since that passed surgery in may, i have not gotten rid of my pain, and have tried a cortisone shot which did not work, as well as the synvisc shots which did not seem to work either. I still have tingling, pain, and stiffness in the knee, and at the age of 22 am unable to be very active.  The next step the Dr. says is the carticel.  I just want to know if you all think is would be worth it at my age and I want to know how it worked for you?  I am scared to death about the recovery and it not taking.  I really want to try to get rid of all this pain.  Does the surgery really work in doing that?
July 26 2004- ACL Reconsruction
May 2, 2005- Lateral Release/Plica Removal/1st stage of ACI
Sept 2005- Cortisone Shot
Oct 2005- Synvisc Shots
Jan 2006- Cortisone Shot
March 2006-Cortisone Shot
May 19 2006- ACI Surgery 2nd Stage, with Lateral Release

Offline Angelam

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Re: Carticel????
« Reply #1 on: January 16, 2006, 08:52:42 PM »
 :)I am going threw the same thing you are. and wondering the same information you are. I have to get an oats procedure done before hand and was told that will help. But it is 8 weeks on cruches afterwards. I am 33 and the dr. is trying to avoid knee replacement surgery,because they wear away. my replacing cartliage with my own from another part of my body it will grow back. basicly it is a cartliage transfer. Have you been told about this procedure. There is recovery time ,but if you have a sit down job you can go back to work after a couple of days. Angelam

Offline Liz13

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Re: Carticel????
« Reply #2 on: January 19, 2006, 07:52:54 PM »
Thanks for replying.  I have been wondering if anyone would.  What is the Oats procedure you are talking about?  The cartilage repacement is the one that I would be getting because the back of my knee cap is just basically feathered. The Dr. has said it would be 6-8 weeks no weight bearing, and 3 to 4 months for recovery.  Basically he told me that he has idea if it will work or not.  He says he has seen good outcomes from the surgery though.  I guess I just have to decide if it is worth.  But i guess by not doing anything it will just get worse.
Liz
July 26 2004- ACL Reconsruction
May 2, 2005- Lateral Release/Plica Removal/1st stage of ACI
Sept 2005- Cortisone Shot
Oct 2005- Synvisc Shots
Jan 2006- Cortisone Shot
March 2006-Cortisone Shot
May 19 2006- ACI Surgery 2nd Stage, with Lateral Release

Offline blackbeltgirl

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Re: Carticel????
« Reply #3 on: January 19, 2006, 09:04:20 PM »
Liz -

Make sure you have a really good doctor if you're co nsidering carticel to the back of the patella.  Check the website: carticel.com.  If you go to the patient section, they have a surgeon locator.  They only list surgeons who have comopleted advanced training, although many surgeons offer the procedure after only completing more basic training.

Your other concern will be insurance coverage.  To date, there is only 1 paper supporting carticel to the patella.  Most of the early studies showed a very low success rate to the patella, and it's very difficult to get insurance companies to cover treatment to that area.  Heck, it's hard to get insurance to cover carticel for patients whose cases are textbook perfect.  When you're an "off-label" case the fight gets harder. 

Is it worth it?  If it works, I'd say the answer is yes.  I'm currently goign through the insurance battles for my own treatment.

To learn more about articular cartilage health, and all of the treatment options, go to www.cartilagedoc.org.  Go to the resources section, then select knees.  Towards the bottom of the page you will find about 10 articles on the subject, and you'll learn a lot.

Also, check out the ACI board.  From the main bulletin board page, go down to the arthritis section.  There is a message board geared towards ACI (autologous chondrocyte implantation), and you'll find posts from others who are considering carticel to the patella.

If you can wait, they are starting clinical trials on the 2nd generation sometime in 2006.  It will be arthroscopic, with a much easier recovery period.  If you find a participating surgeon you may be able to enroll in the study.  If you're cartilage has not yet worn down to bone (and if the cartilage is feathered it may not be down to the bone surface yet) you may be able to wait and see if the studies support carticel II for the patella, improving the odds of getting insurance coverage.

To learn more about OATS, go to the board for cartilage plug transfer.  Depending on the size of your legion, they either take a plug of cartilage from your own knee, or from a cadaver, to fill your hole.  Not sure if they can do that on the patella though.

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 TinaRich

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Re: Carticel????
« Reply #4 on: January 19, 2006, 11:26:47 PM »
HI liz,
I to have been told i need a ACI or total knee replacement but because iam only 40 years old my OS will not do the TKR. But Jess is right about the insurance battle iam fightin my insurance cause one of my lesion is under the kneecap too. If u go to the arthititis department and read under cartilege plugs you will see what OATS is and in the same department read under bone marrow U will learn about microfacture. These are just some thing i did not know about and rdy to talk to dr about either one of them or if he thinks my lesion are to big for them. Feb 7th will be seeing my 4rd OS to help with overturning my insuracne denial, even looking at going to the unversity of maryland to see one of their specialist, doing anything i can  to make insurance see the pain is here and real.

So as should u do it? I say yes if the insurance will cover it and even look in to other treatments..

Good luck and best wish in what ever you decided

Tina
10/04 L knee, LR
09/05 L knee, partial medial lateral menisectomy, Chondroplastyof the trochlea and medial femoral condyle the posterior surface of the patella, Microfracture Technique of the lateral femoral condyle, Carticel biopsy
ACI?
2/28/06 Microfracture surgery

Offline Liz13

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Re: Carticel????
« Reply #5 on: January 22, 2006, 12:16:56 AM »
Thanks for all the wonderful responses.  It really helped a lot, and I am looking into everything you guys told me.  Right now I am leaning more towards the surgery I guess because I know it will only get worse without surgery.  It really is a tough decision though.  Thanks again for all your help.

Liz
July 26 2004- ACL Reconsruction
May 2, 2005- Lateral Release/Plica Removal/1st stage of ACI
Sept 2005- Cortisone Shot
Oct 2005- Synvisc Shots
Jan 2006- Cortisone Shot
March 2006-Cortisone Shot
May 19 2006- ACI Surgery 2nd Stage, with Lateral Release

Offline Liz13

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Re: Carticel????
« Reply #6 on: April 30, 2006, 07:49:41 AM »
Well my ACI surgery is scheduled May 19th.  Just a couple of weeks. My insurance will be covering it, and we had no problems with them thank goodness.  The surgery will be to replace the cartilage on the back of my knee cap.  I am ready for it, but really really nervous.  It's hard not to think about it.  If anyone has any tips for before or after surgery please let me know.  Or even to let me know the truth about what I should expect after surgery that would be great.  Positives from the surgery too would be great, just so I can try to stay positive. Thanks

Liz
July 26 2004- ACL Reconsruction
May 2, 2005- Lateral Release/Plica Removal/1st stage of ACI
Sept 2005- Cortisone Shot
Oct 2005- Synvisc Shots
Jan 2006- Cortisone Shot
March 2006-Cortisone Shot
May 19 2006- ACI Surgery 2nd Stage, with Lateral Release

Offline ozzie

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  • ACI & Fulkerson 6/25/13, ACI & Fulkerson 12/26/13
Re: Carticel????
« Reply #7 on: April 15, 2013, 06:15:56 PM »
April, 2013-This is an old post  but I want to add what I have learned about Carticel/ACI surgery and insurance coverage.... I am a patient of Dr. Gillogly's in Atlanta and he is about to publish a study re:ACI surgery of the patella.  The study had an 82% success rate-Gillogly's success rate was 84%.
ACI patella and trochlea & Fulkerson on Dec. 26, 2013-Dr. Scott Gillogly
ACI patella surgery and Fulkerson with Dr. Gillogly June 25, 2013
Extensive cartilage damage in both knees due to misalignment of patellas















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