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Author Topic: MACI using CaReS system (1st in UK apparently) - follow my progress  (Read 10790 times)

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Offline gammyknee

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I've already posted re. this particular system (CaReS). Although MACI has been done in the UK before, what's different about this is the use of a 3D membrane so that the cartilage can fill the depth as well as surface area of the defect - and apparently I'm the first person in the UK to use it.

Cartilage harvest yesterday - general anaesthetic, home in the evening, v. painful yesterday but today I'm using painkillers but not on crutches and although it 'catches' sometimes and can be sore, so far so good. :)      My cartilage cells have goen to Austria and I'm having the implantation in 2 weeks - november 16th. Nervous but want to get it done and hope this system lives up to its promises re. shorter op time and shorter rehab. :-\      Will keep you posted.

Offline kalyjoe

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #1 on: November 01, 2006, 09:36:34 PM »
I decided to move over here so we don't have two conversations going on.   :)

So you will be in the hospital for 4-5 days afterwards?  My OS told me I'd be going home that day.  That is what makes me kind of nervous about it.  The whole open knee procedure and the pain following it.  I hate being in pain.   :'(

I'd like to swim as well, but for me there is no local indoor swimming pool that would work.  So, I'm stuck doing stuff at my gym.  I'm hoping that after the first surgery I can at least continue to do strength training to build up my muscle b/c I know how much it atrophies being NWB for six weeks. 

Have you had any other procedures done to you knee? 

Keep in touch!

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 gammyknee

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #2 on: November 02, 2006, 01:03:37 PM »
Hi Kristi

I find it quite hard to believe that you could be out of hospital the same day as the implantation - if you check other post-op diaries everyone seems to have had a spell in hospital. I know that our procedure has a shorter op and rehab time but still!! The first two days after the op my knee will be immobilised in a brace and the other two days are to move my knee using the CPM. One of the problems with having it done in the UK is that patients don't have access to CPM machines at home so my only chnace to use one will be in hospital - maybe if I had one at home I would go home sooner but I still think my OS would want to monitor my progress in hospital for 4-5 days. After all this is open knee surgery we're talking about - out on the same day as the harvest is standard but the same day as the implantation seems odd.


Offline kalyjoe

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #3 on: November 02, 2006, 05:50:11 PM »
Well, I checked with my doc today because I'm trying to mentally prepare myself for what's to come.  (Not to mention my 2 kids and husband!)  He said that I would indeed go home on the same day.  He said it is an open knee procedure, but it's just a small incision and the other 9 before me have gone home the same day and done fine.  Obviously, I hope for no complications.  I will have the CPM machine at home and be required to use it for six hours a day for the first four weeks and then it's optional for the last few, but of course, encouraged.  I'll also be in a stabilizer when I'm not in the CPM machine for the first four weeks.  That kind of depresses me b/c when I had my microfracture, I was still very mobile and although it was hard, my life didn't change THAT drastically.   I was still planning on going to the gym and doing upper body and also just socializing!   But not sure how'd I get my leg in the car in that immobilizer unless I took it off when I was in the car.  Guess I'll just have to play it by ear.  I hate the thought of being stuck at home and so dependent on people.  But...I'll survive I suppose. 

Guess that's the difference with the US and UK.  We're pretty much treated like cattle here....in and out as fast as possible.   :-\
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 gammyknee

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #4 on: November 05, 2006, 06:13:53 PM »
hi Kristi

I'm sure your OS knows what he/she is doing and if 9 other people have gone home on the same day without problems then I'm sure you'll be OK - let's face it, hospitals are not the most restful of places anyway. I just think it's interesting that there are different approaches. I'll be interested to see if there are differences in the rehab protocol as well, as in theory, I would assume there shouldn't be differences. For example as far as I am aware my leg will only be immobilised in a brace for those first two days (however there is so much info swimming around my head that I could be wrong).

Now 4 days post-harvest and absolutely fine, walking up and down stairs, driving (a 'stick shift' using my bad knee to press clutch), and back in work (I'm a teacher on half-term break and do alot of standing and walking around so if I hadn't been on a break might have had to take 1 or 2 days off work, no more than that). Like you I'm not looking forward to being immobile, not being able to do stuff and relying on my husband - still, have to think of the long-term benefits i suppose.

Offline kalyjoe

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #5 on: November 06, 2006, 09:01:53 PM »
Yes, I find the different protocols interesting too.  Like you said, in theory, it should be the same but in reality it's not.  We'll have to keep comparing notes throughout this whole ordeal.

So...question for you.  I'm planning on going out dancing two days after my first surgery.  Is it possible?  My OS seems to think I'll be normal the next day, but just wondering what you think. Obviously, I'm not going to be able to go crazy or anything, but I hope I'll be able to dance to my favorites.   ;D  How long did you stay on the painkillers?  (In case I want to have a drink..don't want to mix anything.)  I want to live it up while I can.  I'm already bummed I'll be stuck at home for New Years. 

I go this Friday for all my bloodwork and then next Thursday is my first surgery.  I know that is your second one....so we're getting close! 

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 cadenz2

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #6 on: November 06, 2006, 11:59:23 PM »
How big is the incision for MACI?

I've heard they can do it via an arthroscope or an open incision.

Offline kalyjoe

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #7 on: November 07, 2006, 12:38:13 PM »
At least what I'm having done, the incision is very small.  About 2 inches he said.  For MACI using the CaReS system, I don't think it's possible to do it with the scope b/c they have to be able to fit the harvested cartilage into the defect just right and it's too difficult to manipulate with the scope.

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 gammyknee

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #8 on: November 07, 2006, 08:06:08 PM »
Agreed. As far as I'm aware it's about 2 inches and although the desired development is, I'm sure, to be able to do it with a scope, it's not possible at the moment.

Kristi, as far as your night of dancing is concerned I say 'Go for It'. If it's painful you'll just have to sit out a few dances but I'm sure you'll be OK. Besides which I don't think there'll be much dancing for quite a while after the implantation so seize the moment. I also think you should have a drink if you want as well - I did take some painkillers for a few days after the harvest (Diclofenac) but it didn't stop me from having a few drinks - as I said, seize the moment!!

I meant to say that my OS gave me a copy of the rehab protocol from Arthro-Kinetics and it says that in weeks 7-12 although full range of motion is allowed the patient should still only be partial weight-bearing up to 30kg and at week 13 there is unrestricted movement and therapeutic (???) weight-bearing and muscle training. It also says that low impact activities (biking/swimming) can only be started after 3 months and high impact after 12 months!!! Am I right in assuming that I'll be on crutches for 12 weeks and not able to do much for 3 months - if so not only will I be going mad but I don't think my school will let me return to work (health & safety).

Offline kiwi girl

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #9 on: November 07, 2006, 08:49:27 PM »
Hi Gammyknee,
I was wondering where in the UK are you having your surgery? Who's your surgeon? and are your having it done through NHS?
I have an appointment at the end of the month to discuss the options to repair a large femoral defect and am trying to get as much info on all the different options, so I can ask intellegent questions!
Thank you and Good Luck!!
kiwi girl

Offline gammyknee

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #10 on: November 07, 2006, 10:46:51 PM »
Hi Kiwigirl

I live in South Wales and am having my operation done in a very small hospital. It's the Neath-Port Talbot hospital and is part of the Bro Morgannwg Trust (the main hospital for this trust is the Princess of Wales Hospital in Bridgend). My surgeon is Amit Chandretreya (he's a really nice man who has worked really hard to make this a reality for me). Yes, I am having it done on the NHS - he had to work quite hard via various funding committees to get the money but managed to do it. There was the possibility of me having to go to Stanmore but thankfully I can stay closer to home. Initially he was going to do the standard ACI but as time went on while he was trying to get funding he investigated other options and quite late on, he discovered and got approval to use the 3D CaReS system. Hope this helps - if you want anymore info let me know.

The link for info on this system is on another post I started "ACI using CaReS - shorter op and rehab"

(By the way I have a lateral femoral defect)

Offline kalyjoe

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #11 on: November 09, 2006, 03:52:56 PM »
I'm with you on the depressing rehab protocol.  I'm not looking forward to being so limited for such a long period of time, but I guess if it works it will be worth it.  I waited a year to do high impact activities after my microfracture and 18 months before I ran hard, and yet...here I am back where I started.  I'm trying to stay positive that the CaReS will be the solution, even if I have to restrain myself from being so active for a few years.   

From what I understand....I'll be NWB for six weeks, then PWB for 3-4 weeks.  I go tomorrow for another pre-op appointment, so I'll ask my OS how the other patients have done in their rehab and fill you in on what he says. 

Yes, I'm going for the night of dancing.  I need to live it up while I can!   ;D
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 kalyjoe

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #12 on: November 15, 2006, 02:53:22 PM »
Good luck tomorrow!  I know you have your second surgery tomorrow....so I'll be anxious to hear from you when you get back! 

Take care and lots of well wishes!!!   :)
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 gammyknee

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #13 on: November 15, 2006, 03:01:06 PM »
Day before the implantation. Obviously want my knee sorted out but am getting very nervous. Worried about the pain immediately after the procedure and the length of the rehab  :(. The CaReS MACI system is supposed to have a shorter op and rehab but I'm still not sure exactly what to expect - the impression from the rehab protocol is that I will only be partial weight-bearing for 12 weeks and this doesn't seem particularly short to me.

Anyway, got to keep thinking positive and the reality is that things could be a hell of a lot worse than having a gammy knee that someone is going to try to sort out tomorrow.

Kristi - really weird, just as I was writing this post and wondering how you were feeling about your procedure, you posted your message. Spooky. Thanks for the message of suppport - good luck with your harvest and hope you enjoy your night of dancing  :)  !!

Offline cadenz2

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Re: MACI using CaReS system (1st in UK apparently) - follow my progress
« Reply #14 on: November 15, 2006, 07:59:04 PM »
I hope the procedure goes well and has a great outcome for you.















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