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Author Topic: The lesion is getting Larger or Deeper  (Read 1466 times)

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Offline Cinammo

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The lesion is getting Larger or Deeper
« on: April 21, 2006, 03:36:46 PM »
My son received the cortisone shot yesterday and I did ask the question about if his lesion could be getting any larger.  The OS stated that normally it takes quite along time after a person is cleaned out for the lesion to get larger/deeper but because my sons knee has started locking up again just two months after both of his surgeries that means the lesion is getting larger/deeper at a faster rate.  He is talking to his counterpart about my son and what they suggest the next step be.  He also has another apt. with Cole on May 8th.  So we will see.
My 17 year old son had the OATS procedure on November 29th, 2006.  He has two previous scopes on the right knee and one on the left.

Offline brattkids

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Re: The lesion is getting Larger or Deeper
« Reply #1 on: April 24, 2006, 08:59:13 PM »
I'm sorry to hear that your son is having problems again. I dont think that its true for all cases that it takes a while for the lesions to get larger. I had my OATS in September and I already have more damage. I went to the OS on April 20 and got that news.  :'( Locking up is not a good sign. I sure hope you can get some where with your insurance company!!

Your in my thoughts and prayers.
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 blackbeltgirl

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Re: The lesion is getting Larger or Deeper
« Reply #2 on: April 24, 2006, 09:44:33 PM »
In the latest denial letter from my insurance company, they stated that I have a right to receive copies of ALL material used in making their decision.  I just faxed in the request for this information.  I figure, if I know what research they're using to call the procedure experimental, I can better refute it.  To date, I only know what my OS submitted, not what they found in other research forums.  I also have a right to meet with the review panel - and once I review their materials I will.  You may want to check with your insurance company, and see if you can get the same.  It may make it easier for Dr. Cole to counter the arguments used by your insurance company.

In another post you also asked how a plug would stop deterioration.  It depends a bit on the original cause of damage.  If the OS cleans up all the loose edges, and the plug fits in tightly, there isn't a rough surface, and the knee should run smoothly.  If damage is the result of an AVN or OCD, the underlying bone could continue to die, causing new damage to the cartilage. 

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 brattkids

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Re: The lesion is getting Larger or Deeper
« Reply #3 on: April 24, 2006, 11:25:05 PM »
Its horrible that the insurance companies are playing doctor without knowing the situation of each individual patient. I sure wish you both the best of luck.


Jess,

you are very informed and I sure hope you can show your review panel that this is the best proceedure 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 Cinammo

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Re: The lesion is getting Larger or Deeper
« Reply #4 on: April 24, 2006, 11:52:29 PM »
Our insurance company has not informed us that we have the right to review anything they reviewed in making their decision.  Tricare is a government insurance and pretty difficult to work with once they say no.  I don't know if we will have any recourse if they say no after the formal review.  If the answer is no to during the formal review I will ask them to submit to me their documentation on how they determined OATS to be expermental/unproven.  Don't know if they have to comply with that request but all they can say is no, right?  Also what is AVN?
My 17 year old son had the OATS procedure on November 29th, 2006.  He has two previous scopes on the right knee and one on the left.