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How long did you wait for an osteochondral Allograft?

1 month or less
4 (57.1%)
3 months or less
0 (0%)
6 months or less
0 (0%)
6 months to a year
0 (0%)
More than a year
3 (42.9%)

Total Members Voted: 7


Author Topic: Allograft waiting list  (Read 10902 times)

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Offline blackbeltgirl

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Re: Allograft waiting list
« Reply #30 on: January 25, 2006, 02:30:58 PM »
I haven't got links, BUT

microfracture is generally goot for up to 2-3 sq. cm
ACI is FDA approved up to 10 sq cm, femoral condoyles and trochlea only.  (My OS has done ACI on lesions up to 36 sq cm, however, one of the reasons I've chosen him)
autograft OATS is good for up to 2-3 sq cm, after that it's allograft
and for allografts, depending on technique and surgeon, they've done entire femoral condoyles

NOW - what's been done successfully by a handful of surgeons, and what the standards are, is also different.  Obviously my surgeon has done ACI well beyond the FDA requirements.  I've seen studies that list 20 sq cm as the max for ACI.   But I've read so many articles in the last year that I couldn't find sources for most of this info if I had the entire morning to dedicate to the effort.

Did that help?  Or was it just more confusing?
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 hopalongcasualty

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Re: Allograft waiting list
« Reply #31 on: January 25, 2006, 05:21:26 PM »
That was helpful, I have spent many evenings with google searching for this stuff.  This must be one of this secrets held close to the vest by the Illuminati (DaVinci Code Refernece).

I would think that there should be a .gov resource where this kind of info would be available.  Instead all i keep finding are books to purchase, what is the fun in that?

Thanks again.  We should keep putting our heads together and compile a database of FREE references that we could start posting.  Just a thought.  ;)
R Knee
83-LCL,ACL&Medial Meniscus tear
86-Debridment
87-TTT Houser Manuver
89-TTT Maquet Procedure*
92-Meniscus Tear
04-Supartz Injections
05-Contusion
L Knee
05-tibia & patella dislocation w/MCL tear & large lateral condyle defect
2-15-06 Lateral condyle osteochondral Allograft ::)

Offline hopalongcasualty

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Re: Allograft waiting list
« Reply #32 on: January 25, 2006, 05:28:54 PM »
I also know that the phrase "it depends" is very important when dealing with surgeries.

Some people heal better than others, weight is also a factor, varus/valgus angle and all that kind of crap. 
Some would never try the BIG ACI procedures because they are afraid it will fail and the patient will sue. 

I would prefer a Vangard surgeon who will try something if I am a good candidate.  (I have read many posts where young folks had a unicompartment failure but ended up with TKR, because PKR is "experimental")  I want (hope) a chance, and apparently so do you. ;D

Phil
R Knee
83-LCL,ACL&Medial Meniscus tear
86-Debridment
87-TTT Houser Manuver
89-TTT Maquet Procedure*
92-Meniscus Tear
04-Supartz Injections
05-Contusion
L Knee
05-tibia & patella dislocation w/MCL tear & large lateral condyle defect
2-15-06 Lateral condyle osteochondral Allograft ::)

Offline blackbeltgirl

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Re: Allograft waiting list
« Reply #33 on: January 25, 2006, 06:46:57 PM »
I agree.  It's important for people to educate themselves, so they don't go into surgery either under-informed, or with insane expectations.  YOu see it all the time here - people who had surgery and "Are never the same again".  Many have recovered to the point where they haven't had to change their lifestyle, but every now and then it still hurts.  But they're disappointed, because the knee isn't perfect.  Or people find out they have some arthritis, in addition to the torn meniscus, and want to know how to get rid of it.  Some of them are younger and should be trying to resolve the issue, some only have random bad days or weeks, but haven't had to make major lifestyle changes, and some are in their 40s, 50s or older, and want to be able to conitnue playing aggressive sports several times a week.  And while I respect that need, if your body is 50 years old, you may just have to switch sports and get over it.  I didn't mean to rant, just that people expect to be 100% immediately after surgery, and many middle aged folks seem to think doctors should be able to give them 20 year old knees in their 50 year old bodies.  Education can prevent those crazy expectations, and the disappointment that's bound to follow when the expectations can't be met.

OK, totally off the soap box now.  But maybe you can tell me why, procedures that are approved by the FDA for years, are still considered experimental by insurance companies.  I SO don't get that!
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 hopalongcasualty

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Re: Allograft waiting list
« Reply #34 on: January 25, 2006, 07:50:26 PM »
MONEY!

I am hoping for a 47year old's knees in my 37year old body.  Instead I have as much difficulty as my 63yr old mother (needs 2 TKR).  Granted her's is wear and mine was from tear ;D.

Yeah those folks with occasional aches and pains from weather change or they over did it on the soft ball field.  GMAB  :-X(give me a break)

Folks have got to learn, you will never be PERFECT again, although good with occasional flair ups is great. 

I would like to be able to go up a few flights of stairs, walk arround the mall or simply be able to enjoy the beach without popping, snapping, twinge, stab, burn and aching.  If I have set for more than a hour, I have to wait a few minutes to start walking for all of the theatricks to cease and the joints to function.  OH I am on the Soap Box now, you want it back? LOL.

Phil   
R Knee
83-LCL,ACL&Medial Meniscus tear
86-Debridment
87-TTT Houser Manuver
89-TTT Maquet Procedure*
92-Meniscus Tear
04-Supartz Injections
05-Contusion
L Knee
05-tibia & patella dislocation w/MCL tear & large lateral condyle defect
2-15-06 Lateral condyle osteochondral Allograft ::)

Offline stgiles16

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Re: Allograft waiting list
« Reply #35 on: January 25, 2006, 08:26:40 PM »
Hopalong, my dream is to just make the pain low enough to be able to ignore it again. I dont expect 100%, I would be thrilled if I could get 60%. I think that I am about to truly try an experimental new PKR that is currently in clinical trials. If the finances work out, I am going to become a lab rat. My 70 yr old mom can out walk me while shopping. That is depressing because I love to shop. I dont even mind the cracks and pops, I just want to be able to walk for more than 10 mins and not have to take narcotics.

Jess, I am right up there on that soap box with you. Arthritis is a natural part of aging and when 50 -60 yr old folks get on here complaing because their knee hurts if it rains, I just want to scream. I am only 42 and my knee hurts if I BREATHE. They want to play tennis, golf, rodeo, ect and I just want to WALK.  To me, it is like comparing apples to oranges. There is no similarity.

off the box now.
hope you both have a good day.
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 JG

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Re: Allograft waiting list
« Reply #36 on: January 26, 2006, 11:59:08 PM »
Phil,

Go to page 9 of this document.  It outlines all the procedures and the lesions size that they are effective for.  I posted earlier in this thread.

http://www.cartilagedoc.org/downloads/sek/g4368.pdf#search='chondral%20defect%20and%20treatment%20options'

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

Offline kittykat

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Re: Allograft waiting list
« Reply #37 on: January 27, 2006, 01:03:41 AM »
Hi everyone!
I posted earlier in this thread about my allograft and got some responses but it has taken me a while to have a chance to respond.  Yes, I admit my defect was alot smaller (2.0 by 2.5 cm) isolated and tramatic in nature but I can say that I am 100% glad I made the decision to go with the allograft.  I mentioned the recovery was easier than expected and you asked what I meant by that.  What I meant was that it was much easier than recovery from my ACL reconstruction.  After my ACL it was like someone else had taken control of my leg.  It was not that way this time.  ALthough, I must admit that I had really worked on my quad strenght pre op and had a much more aggressive PT program with the allograft.  I guess I also need to tell you I was 42 years old when I had my ACL done and 45 years old when I had my allograft.  I would say I am in average shape for my age and goal was to walk without pain and the nasty limp I had develped.

As you may have noticed from other posts, it seems every OS has a different idea on how long you should be non weight bearing after allograft.  I was totally non weight bearing for only three weeks and then toe touch weight being for 2 weeks.  Everything went fine and continues to go good.  I had a small set back about 5 months post op when I started having medial pain again.  The concern was that I had fractured my graft.  MY OS explained that at the point in time when the bone in becoming yours it gets weak and I remember reading this.  The good news is the MRI showed no sign of fracture just alot of tissue swelling.  The MRI could not assess the cartilage.   I agreed to take it easy for 2 to 3 months and wear a un loading brace bascially around the clock.  We are also in the process of doing a course of supartz (some literature supports it can protect cartilage).

The good news is that the pain in much better.  I am anxious to lose the brace to see it the pain returns.  If so, the plan is a scope to check it out as I might have a cartilage flap based on my physical exam.  If so, it should be easy to clear/clean it up.

Even with all this, it is much improved and I still think it was a success.

Missy, your clinical trial decision really interests me although our situations are somewhat different.  I look forward to your posts.

Kittykat

Offline hopalongcasualty

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Re: Allograft waiting list
« Reply #38 on: January 27, 2006, 02:38:45 AM »
JG - thanks I found it.  Just glad it wasn't a snake or I would have been bitten. 
R Knee
83-LCL,ACL&Medial Meniscus tear
86-Debridment
87-TTT Houser Manuver
89-TTT Maquet Procedure*
92-Meniscus Tear
04-Supartz Injections
05-Contusion
L Knee
05-tibia & patella dislocation w/MCL tear & large lateral condyle defect
2-15-06 Lateral condyle osteochondral Allograft ::)

Offline stgiles16

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Re: Allograft waiting list
« Reply #39 on: January 27, 2006, 04:38:17 AM »
Kitkat, I think that our situations sound very similar. I started on this rollercoaster with a defect on my medial femoral chondyle (trauma induced) from a car accident. If I can just get rid of this medial knee pain, I will stop complaining LOL. I would love to hear more about your recovery. Allograft is my other choice if I dont do the PKR.

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 kittykat

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Re: Allograft waiting list
« Reply #40 on: February 01, 2006, 12:40:50 AM »
Missy,
Not sure exactly what to tell you about my rehab so I guess I will just start typing...  Had surgery, had a femoral pain pump which was the best.  It delivered a base line amount and I could give myself additional doses as needed.  I basically had no pain unitl they took it out.  From talking the the nurses at the hospital, it sometimes works really well and some times it does not.  It seems that the catheter placement is critical and it must be very close the the nerve that supplies the knee.  I could move my leg but had zero pain.  I guess I was one of the lucky ones.  The doc said that if you can keep the pain under control for the first 24 hours it should not be unbearable and he was correct. 

I spent one night in the hospital.  I was started on my CPM pretty much immediately post op.  Had good range of motion to 90 degrees within 24 hours.  Took my CPM home and spent 8 to 10 hours or more in it for 2 weeks.

Started PT 5 days after surgery even while NWB to maintain my muscle strength.  OS insisted that I go to the PT program that he uses for all this patients which was a sports medicine focused program.  Once I started weight bearing, I went 3 times per week and they kicked my butt.  I had to on occassion remind my therapist that although all his other patients planned to return to competative sports in the near future, I did not.  I was a real love/hate relationship.  I must say I believe it really made the difference.  Released for PT after 7 weeks.  Still actively doing my exercises at home.  If I only had a dollar for each straight leg lift that I have done.

I was released to do basically anything I wanted at 4 months except run or ski.  Once I started having pain, we went to nothing strenuous.  Having been wearing a doy joy custom unloader while awake since Thankgiving time.  It is not to bad.  My biggest issue is always having one pant leg that is hiked up after sitting. 

Just let me know what other questions you have.  Hope this helped.  So have you made a final decision?? 

Kittykat

Offline stgiles16

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Re: Allograft waiting list
« Reply #41 on: February 01, 2006, 02:39:42 AM »
Thanks Kittykat, I have made my decision. I am going forward with the surgery on feb 15th. I am not getting alot of support at home but I have to do what is best for me. My OS has not mentioned the CPM yet and I hope that he doesnt. I hate those things. I had one after one of my surgeries (dont remember which one).
I hope that your medial pain gets better.
good luck
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