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Author Topic: 4 weeks down the long ACI road  (Read 17293 times)

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Offline kalyjoe

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Re: 4 weeks down the long ACI road
« Reply #45 on: March 14, 2007, 08:39:53 PM »
I am so sorry to hear about your setback.   :'(  I think all of us on here can appreciate your frustration and disappointment at something like this.  Hopefully it's just something you'll have to rest for a bit and now you know what NOT to do.  I know for me, the thought of doing the eliptical seriously makes me cringe and although my OS has said I could do it, I won't.  You've just confirmed that I am right to ignore that advice.  I agree the OS doesn't always know what is best for us from a PT point of view and it is hard to know who to listen to all the time. I think the best indicator is our knee.   

I don't think your last six months of hard work were for naught.  I know right now things look bad but try to hang in there and don't give up.  You've always seemed to have such a good attitude on here and I'm sure that will work in your benefit.  I'll be sending you good vibes and positive thoughts.   :)

Keep us posted. 

Kristi
2 x 1.2 cm defect of right medial femoral condyle
Microfracture, right knee, October 18, 2004.
MACI using CaReS, same knee, November 30, 2006

Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #46 on: March 15, 2007, 12:44:29 AM »
Thanks for your words of encouragement Kristi - keep those vibes coming.  Two days ago, I seriously began regretting not going for the "hardware" option.  At least I wouldn't have to worry so much about whether those damn cartilage cells were growing or not!  Today, after heat, ice, massage, ultrasound and ICF at PT, my knee is starting to feel a bit better - ibuprofen and ice at home are also helping.  I hope everyone reading this takes your advice seriously and weighs the advice of their PT or OS against their own good judgement.

Mike
« Last Edit: March 15, 2007, 12:46:22 AM by bioprof »
8/05 - Cortisone injection, L. knee
10/05 - Meniscus repair, microfracture, L. knee
7/06 - Arthroscopy, Carticel biopsy, L. knee
8/06 - ACI, L. knee
5/07 - L. knee arthroscopy; post-ACI "clean up"

Offline kalyjoe

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Re: 4 weeks down the long ACI road
« Reply #47 on: March 19, 2007, 11:50:31 AM »
I think you really have the added benefit of having a good PT who seems to be committed to your recovery and knows what he's doing.  You've definitely got that in your favor.  I hope things are feeling a bit better and you're able to get back to where you were.  Don't give up...hang in there.   :)

Kristi
2 x 1.2 cm defect of right medial femoral condyle
Microfracture, right knee, October 18, 2004.
MACI using CaReS, same knee, November 30, 2006

Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #48 on: April 03, 2007, 06:55:37 PM »
I'm sorry to report it's a sad, sad day for me...I found out yesterday that an MRI revealed that at least one of the two carticel grafts performed on my left knee has failed.  I have been experiencing increasing pain, stiffness and muscle weakness for about 7 weeks - particularly after my elliptical fiasco that I reported on this forum.  Needless to say, I'm devasted.  It now appears that all the pain, and hard rehab work I've gone through has been for naught.  I'll know more this Friday when I meet with my OS to discuss the MRI and my options. 

Those of you who have followed my experience through this thread will recall that I had some "unusual" experiences soon after my surgery that caused me concern.  I'm now wondering if these issues may have contributed to the failure.  I've scheduled an appointment with another OS for a second opinion.  I'll keep you posted.

Mike
8/05 - Cortisone injection, L. knee
10/05 - Meniscus repair, microfracture, L. knee
7/06 - Arthroscopy, Carticel biopsy, L. knee
8/06 - ACI, L. knee
5/07 - L. knee arthroscopy; post-ACI "clean up"

Offline kalyjoe

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Re: 4 weeks down the long ACI road
« Reply #49 on: April 03, 2007, 07:50:25 PM »
I'm so sorry.   :'(  This is certainly not what I hoped to hear from you.  You  may never know exactly what caused this failure.  It is so frustrating to not have a sure cure for this problem!   Good luck at your appointment on Friday and let us know what the OS says.

Hang in there. 

Kristi
2 x 1.2 cm defect of right medial femoral condyle
Microfracture, right knee, October 18, 2004.
MACI using CaReS, same knee, November 30, 2006

Offline David3

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Re: 4 weeks down the long ACI road
« Reply #50 on: April 03, 2007, 08:10:19 PM »
Mike, 

I'm so sorry. I was certainly concerned for you when I heard of your set back in mid-March since your symptoms of a sudden increase in pain occurring a couple of days after an increase in activity seemed identical to my case, albeit that mine was a failed microfracture. Please keep us posted on what options lie ahead for you.

Stay determined that you're going to beat this.

David
2006: Left Knee (LK) microfracture (MFC, LFC, Trochlear), failed at 6 months
7/07: ACI/TTO of LK (MFC, LFC, trochlea, patella)
2014: Considering ACI treatment on RK.

Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #51 on: April 08, 2007, 04:02:32 AM »
Thanks David and Kristi for your words of support.  They really were helpful.  I met with my OS on Friday and there is still some room for hope - hope that all is not lost.  After reviewing my MRI films, he doesn't think the graft completely failed.  In fact, he said that besides a slight irregularity in one part of it, that it looked fairly normal for 7 months out.  Best case scenario is that the edge of the graft has some bone hypertrophy that needs to be "ground down."  Slightly less desireable is that the edge of the graft has lifted and created a rough edge which is causing the pain.  I won't burden you with all the other possibilities - suffice it to say that they are ordered in decreasing degrees of desirable outcomes.  The next step is to go in with a scope and see what's going on.  That's scheduled to happen on 4/30/07.  If it's just hypertrophy or a loose flap, then it will be taken care of during the procedure.

While I'm still very nervous and naturally expecting the worse, I do have a bit more hope.  I'll keep you posted.

Mike
8/05 - Cortisone injection, L. knee
10/05 - Meniscus repair, microfracture, L. knee
7/06 - Arthroscopy, Carticel biopsy, L. knee
8/06 - ACI, L. knee
5/07 - L. knee arthroscopy; post-ACI "clean up"

Offline LadeeStingray

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Re: 4 weeks down the long ACI road
« Reply #52 on: April 08, 2007, 06:57:49 AM »
Mike,

So sorry to hear about your set back.  Ill be thinking of you on the 30th with fingers crossed.

Ladee
10/05 Rt medial meniscal tear repair 1/06 synvisc injections
3/06 cortisone injection   6/06 open OATs MFC
9/06 drained/cortisone  11/06 biopsy for ACI surgery
6/07 scoped again....failed OBI plugs
awaiting approval for HemiCAP

Offline DJF

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Re: 4 weeks down the long ACI road
« Reply #53 on: April 11, 2007, 02:44:45 AM »
Damn Mike.  That is very bad news.  Were you feeling okay prior to the stairmaster work?  My pt has very strict orderd:

1 - No stairmasters
2 - If it hurts at all under the patella, quit.

I may have missed it. but what machines were you using?

I can't imagine how you feel, but hang in there.

Don
50 y/o male
Houston TX 

4 surgeries
Manual manipulation Dec 2006
Carticel implant with TTT October 2006
Carticel Harvest August 2006
The following done October 2005:
Chondromalacia Grade III to IV
Scope with chondromalacia
plus lateral release
plus plica resection

Offline DJF

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Re: 4 weeks down the long ACI road
« Reply #54 on: April 11, 2007, 02:58:25 AM »
My routine at this point.  I am 6 months post op Trochlea repair and TTT.

10 minuteson a stationary bike
3 sets of 10 reps two legged on a palatte machine
3 sets of 10 reps with the bad leg on the pallate machine using 1/2 of the weight of the two legged version
3 sets of 10 reps leg curls two legged using 30lbs
3 sets of 10 reps leg curls using my bad leg and 15 lbs

I then move to a BioDex machine
http://www.lifetecinc.com/products/product.php?id=1179

We set the machine to move from about 65 degrees to 0 degrees.  (knee bent some to stright out)

The machine will put as much resistance as I put preasure on it.  I can watch a graph of the resistance and try to make the lines stay in a certain strength measurement.

The Biodex is the only machine that has been able to make my quads sore and not hurt my knee.  I wanted to get one for myself, but the $40,000 price tag made is a little expensive.

Still, I am sore for about 3 days after my 1.5 hour workout.

I still get sore late in the day especially if I walk alot.

I get sore if I sit at my desk all day also.

+++++++++++++++


Mike,  Keep us posted on what is happending with you. 

Don
50 y/o male
Houston TX 

4 surgeries
Manual manipulation Dec 2006
Carticel implant with TTT October 2006
Carticel Harvest August 2006
The following done October 2005:
Chondromalacia Grade III to IV
Scope with chondromalacia
plus lateral release
plus plica resection

Offline djs60

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Re: 4 weeks down the long ACI road
« Reply #55 on: April 11, 2007, 05:50:32 PM »
Mike,

I hope it's just a bit of bone that is causing the irregular appearance.

Best of luck on 4/30!

Dan
3/06 left knee arthroscopy - grade IV lateral trochlea defect
chondroplasy & removal of loose bodies
1/07 left knee arthroscopy/cartilage biopsy
4/27/07 left knee trochlea & patella ACI with TTO

Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #56 on: April 12, 2007, 12:33:42 AM »
Thanks all for the words of support.

Yes, Don, I was feeling a helluva lot better and making farily good, albeit slow, progress before the *&%#$ elliptical machine.  You can go back and read my post about that fateful day - but basically my knee quickly went down hill to the point that I had to revert back to doing PT stuff that I was doing at the start.


I saw another OS today for a second opinion.  Not surprisingly, he knows my current OS and even called him for more information about my case prior to my visit.  My OS was very supportive of me in getting another point of view.  The second OS took a look at the MRI and agreed that both grafts have filled in, though he agreed with my OS that it did appear that there was some irregularity near the edge of the MFC graft.  He also recommended taking a "second look through the scope."  It turns out this new OS has actually done more ACI's than my current OS, averaging abut 15 - 20/year.  He said more than a few of his patients have limped through the 6-9 month post-op mark and still recovered fully. That was encouraging to hear.  I really liked him and his office staff (significantly more organized and professional than my current OS's office).  I do have a sense of regret in not finding him from the start.

All said, I'm a bit more optimistic than a few days ago.  My surgery's been rescheduled for 5/9/07.   I'm in the ironic position of hoping for bone hypertrophy - only in the surreal world of ACI...

Mike

« Last Edit: April 12, 2007, 12:40:03 AM by bioprof »
8/05 - Cortisone injection, L. knee
10/05 - Meniscus repair, microfracture, L. knee
7/06 - Arthroscopy, Carticel biopsy, L. knee
8/06 - ACI, L. knee
5/07 - L. knee arthroscopy; post-ACI "clean up"

Offline DJF

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Re: 4 weeks down the long ACI road
« Reply #57 on: April 14, 2007, 01:44:16 AM »
That's good new Mike.  I sorta wish my OS would go in a take a look also.  I have a sever catch in the joint when I do my leg extensions.  It's like popping your knuckle really hard over and over.  Thing is my surgion has already tried to smooth everything out.

Keep us posted on your findings and we'll keep our fingers crossed.

Where are you that you find a doc that does so many Carticel implants?

My surgion has only done about 9 before mine.  He is in a practice that does quite a few though.

Later
Don in Houston
50 y/o male
Houston TX 

4 surgeries
Manual manipulation Dec 2006
Carticel implant with TTT October 2006
Carticel Harvest August 2006
The following done October 2005:
Chondromalacia Grade III to IV
Scope with chondromalacia
plus lateral release
plus plica resection

Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #58 on: April 14, 2007, 12:50:17 PM »
Hi Don. My PT never seemed to be concerned about the popping during leg extensions, passing it off as irregular patella tracking due to my weakened quads.  Of course, your popping may be in a different place.  I'm in Michigan.  The second OS's name is Joeseph Guettler out of Performance Orthopedics.
8/05 - Cortisone injection, L. knee
10/05 - Meniscus repair, microfracture, L. knee
7/06 - Arthroscopy, Carticel biopsy, L. knee
8/06 - ACI, L. knee
5/07 - L. knee arthroscopy; post-ACI "clean up"

Offline DJF

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Re: 4 weeks down the long ACI road
« Reply #59 on: April 14, 2007, 06:24:41 PM »
So Mike,  You still have the cracking doing leg extensions?  Does it hurt?
50 y/o male
Houston TX 

4 surgeries
Manual manipulation Dec 2006
Carticel implant with TTT October 2006
Carticel Harvest August 2006
The following done October 2005:
Chondromalacia Grade III to IV
Scope with chondromalacia
plus lateral release
plus plica resection















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