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Author Topic: 4 weeks down the long ACI road  (Read 17291 times)

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Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #30 on: January 27, 2007, 02:06:43 AM »
Hey Don.  It's good to know that your rehab is going reasonably well.   Sorry to hear that you had to have another surgery, but it sounds like it was well worth it.

I do get some pain, and an occasional pop in the area of my condyle repair.  My PT and I seem to think (and are hoping!) it's either an inflammed tendon, ligament or some scar tissue causing the problem.  Not sure what "positive flex" is????.   I'm thinking leg extensions when you refer to "leg lifts."  Is this right?  Are you doing weighted extensions?  I'm doing extension with 4 lbs mostly pain free. For what it's worth here's my basic PT regime:

- stationary bike (12 min, low resistance)
- step ups (forward, lateral, and diagonal; 2 sets, 30 reps )
- step downs (1 set, 20 reps)
- lunges (forward, lateral; 2 sets, 15 reps)
- leg press (30 lbs, 2 sets, 15 reps)
- wall squats (2 sets, 20 reps)
- 1-leg ply ball throw (2 sets, 20 reps)
- weighted walks (forward/backward, lateral; 4 reps each)
- 1-leg balance on disk (10 reps)
- theraband lateral "monster walks" (2)
- weighted leg extensions (4 lbs, 2 sets, 30 reps)
- weighted standing hamstring curls (4 lbs 2 sets, 30 reps)
-  ice (well deserved, 10 mins)

I was prescribed a portable muscle stim unit (Ortho DX) that I use once/day at home.  It gives simultaneous electrical current through the repair area and neuromuscular stimulation to my quads.  This is a very cool device that really makes a difference.  Immediately after a treatment, my knee just feels better, and it really does seem to awaken my much atrophied quads.

Take care.  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 DJF

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Re: 4 weeks down the long ACI road
« Reply #31 on: January 29, 2007, 02:48:16 PM »
Hi Mike,

Looks like you are about 6 weeks ahead of me. 

Positive flex?  What I mean is that I cannot extend my leg.  My extention is at +4 degrees or so.  This is causing me to limp more than I should.

You are doing a lot more exercises than I am.  I cannot do squats yet at all.

I did bend to 135 degrees of flex on Friday.  It hurt the area around my TTT and I have been having a lot of shin pain. around the screws.  I am also having buring pain around the screws.  The PT says its just nerve damage and will go away.

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 LadeeStingray

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Re: 4 weeks down the long ACI road
« Reply #32 on: January 29, 2007, 06:16:07 PM »
Hi all

Wish i would have found this site back when i had my OATs procedure would have answered alot of my questions.   So now here i sit waiting for my ACI surgery (never got to return to work after my OATs 06/06)  I thought the first 24 hours after my OATs was terrible ... i can only imagine what this one is gonna feel like.  They are planning on doing three different areas  MFC, trochlea, and patella.    Of course my OATS went great .... its the area around those plugs thats gone now.  Of course with me its never a simple fix.   So please ... keep the posts coming ... this is helping my anxiety about this surgery. 
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 ivischwartz

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Re: 4 weeks down the long ACI road
« Reply #33 on: February 25, 2007, 01:45:53 AM »
Bio-P:

Would you tell me a little more about the stages of progress you went through. Of particular interest is the history of your gait as well as the continued pain you have in your implant area. These are the two things that worry me the most at this point, so any comparisons are helpful.

Offline Rod G

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Re: 4 weeks down the long ACI road
« Reply #34 on: February 25, 2007, 02:08:31 PM »
Hi,

I just wanted to reinforce BarryB's post and confirm that the recovery from a maci/aci operation is a lot longer than what the literature states from carticel.  I couldn't imagine doing sport at 12 months post op.  I'm currently 14 months and it has certainly been a challenge.  My OS has confirmed that 75-80% of the graft has taken and i now only have a 2cm2 hole in my cartilage as oposed to 9cm2.

How does my knee feel?  It feels a lot stronger but it is very deceptive as i think the cartilage isn't mature enough to handle that much exercise.  I can gently kick whilst i am swimming and that's about it at this stage.  I'm hoping to get further improvement in the next six to eight months.

Oh btw don't worry about the pain it is fairly normal and there were many times i thought i'd damaged the implant.

Regards

Rod

Offline DJF

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Re: 4 weeks down the long ACI road
« Reply #35 on: February 26, 2007, 12:00:36 AM »
ACI guys

I am now 5 months post op.  I have good days and bad days.  I still walk with a limp.  On bad days I have a fair amount of pain right on the damaged area (Trochlea).  On good days, I can walk almost normal. 

How are you guys doing in comparison?
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 #36 on: February 26, 2007, 01:54:19 PM »
ivi-

I had two lesions/defects; MFC and trochea - each about 2 cm x 2 cm.  As you may know the recovery schedule is based in large part on the number and severity of lesions.   I was NWB with crutches for 12 weeks, and gradually went to FWB after about 2 additional weeks on 1 crutch.  My biggest pain issue was and continues to be the MFC repair site.  My knee can get sore all over after PT, but the MFC area can get sore after a few hours of normal activity.  With that said, I'm experiencing less pain/soreness at 6 mon than I did at 4 mon.  I've  been seeing my OS every 2-3 mon.  I'll see him again next week and will give an update.

I was walking with a noticeable limp and pain for at least 1 mon after going FWB.  As Rod has stated, the goal of a painfree, normal feeling knee is probably longer than many of us expected - but the "fine print" for ACI does state that full recovery and cartilage stability can range between 12 - 24 mon (months sounds better than 1-2 years, doesn't it?).

Rod, I'm curious about the remaining "hole" in your cartilage.  Does your OS expect this to fill in, or is it something that will be "addressed" later?

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 ivischwartz

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Re: 4 weeks down the long ACI road
« Reply #37 on: February 28, 2007, 01:28:49 AM »
I am just starting FWB and at this point, it feels like it did just before surgery except with severely weakened muscles. Feels fine, feels fine, and then WHAM - shooting pain. I am at 8 weeks and will just keep on trucking trying to be smart. I was prepareed for the 18-24 months, but I guess it did not register that this meant 18-24 months of pain. Not sure what I thought this meant - Duh.

Offline bioprof

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Re: 4 weeks down the long ACI road
« Reply #38 on: March 05, 2007, 01:18:59 PM »
Just a quick update following my 6 mon post-op visit with my OS....

He was generally pleased with my progress - but did note that we really needed to get my much atrophied quads back into shape soon.  In his PT order, he recommended that I stop all step over/down routines because he thought thye may be aggravating the trochela repair - especially with my weakened quads not providing the stabilization needed to hold everything in place.  He ordered elliptical/stairmaster work instead - suggesting that it would emphasize quad strengthening without the impact of step downs.   Interestingly, my PT doesn't have an elliptical or a stairmaster, but I'm lucky to have access to them where I work.

Did a lot of walking at a very big dog show and a nature hike on snow-covered trails this weekend - all preceded by 3 consecutive days of PT - and yes my knee is sore as hell!

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 #39 on: March 06, 2007, 07:19:28 PM »
Glad to hear you're progressing well.  Are you doing any sort of strength training for your quad? 

Hope you're knee is feeling better now!!   :)

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 #40 on: March 07, 2007, 12:13:44 AM »
Thanks Kristi.  I did 12 minutes each on the elliptical and stairmaster today.  The first 5 minutes were pretty tough with a lot of soreness - after that things felt a bit better.  As I sit here, my quads, etc are fatigued and I have some soreness in the joint, but it in a weird way my knee feels better, sort of like muscles feel after a heavy workout.  I believe that this new set of exercises with the machines is going to really help with strengthening.  I must admit that I've lost some enthusiasm for my PT's facility - given that it only has one cardio machine - a treadmill.  I'm also a bit disappointed that my PT didn't use better judgement by avoiding step down/over exercises, which my OS said were not appropriate at this stage.

I'm curious to know about the facilities that others here are using.  What type of machine equipment have they been using that has been beneficial in their rehab and when did they start using it?

Mike
« Last Edit: March 07, 2007, 12:19:58 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 #41 on: March 07, 2007, 02:52:12 PM »
My PT facility is pretty sad;  it really has no machines at all.  When I had my microfracture the one I went to for that was much nicer with every cario and stregth training machine imaginable and what seemed to be a very knowledgable staff.  But due to insurance changes, I couldn't go there for this one.  ::) For me personally, I go to my gym to do my PT.  I'm using the bike and have been given the okay for the eliptical, but still have that fear of my knee "giving" so I haven't tried it yet.  I also walk on the treadmill and do a lot of strength training work like squats, lunges, leg press, leg curl,  and the cable machine.  My quads are almost back to normal and I really attribute that to my knee's improvement.  It makes sense that you need those muscles to support your knee, yk? 

My PT also had me do step up/downs, but I quit doing them because they did cause so much discomfort in the implant site and I really don't think that at this stage it's a smart thing to be doing.  The pain I felt doing those were much different than the pain of pushing yourself in PT.  I know we've addressed this before, but it is discouraging that there are so few experienced PT's out there for this type of surgery.  It really makes me lack confidence in them and I really feel all alone in my recovery.

Well, good luck to you and keep us updated!  Glad to see you are moving forward!  :)

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 #42 on: March 08, 2007, 01:04:31 AM »
Hey Kristi,

Thanks for the info on your PT.  Just for clarification...are you doing all your rehab on your own?  Do you consult at all with a PT or only with your OS?

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 #43 on: March 09, 2007, 09:44:52 PM »
I see a PT once a week and then workout the rest of the week on my own, but I'm thinking of discontinuing even the one visit because she really has nothing more to offer.  I'm walking pretty normal now and basically working on continuing to build my quad muscle.  That's stuff I can do by myself.  I won't do any more than my OS told me to do and I don't go back to him now until May...my six month followup.   And since my PT facility has little to offer in the form of strength training...it seems okay to move on.   :)

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 #44 on: March 14, 2007, 07:42:15 PM »
I'm sorry to report that I had a significant setback this past week.  This has to do with my earlier post about my surgeon recommending elliptical work.  I did about 20 minutes (2 sets of 10 min) last week - I was tired and a bit sore right after, but nothing major.  The days following, however, is when things went downhilll fast.  I've had a LOT of pain throughout my knee - including at the implant site and aroung the patella.  It's been so bad the last few days that I've been walking with a noticeable limp.  Though my PT today said he thinks the pain is mostly due to tendonitis and bursitis, I'm very discouraged, concerned and frustrated.  It's seems like 6 months of hard work have gone for naught.  I'm hoping things calm down in a few days - but I've also learned an important lesson:  Surgeons are good at surgery, but lousy at PT.  I've since heard this from several, including my own PT who told my surgeon to "stay away" from his patient's PT.
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"















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