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Author Topic: OATS in PATELLO FEMORAL, will I run again?  (Read 8132 times)

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S_501

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OATS in PATELLO FEMORAL, will I run again?
« on: January 25, 2007, 02:38:33 AM »
Hi there everybody,
I'm new to the site and threading in general.
I'm on a waiting list for an OATS underneath the patella and on my throclea lateral side. It's chronic injury due to overuse and chondromalacia. I've been a lifetime long distance jogger, age 36, live in CA.

PLEASE PLEASE PLEASE I'm freakin' out about whether I'll EVER return EVEN to MODEST running!!!
I'd like to hear your experiences with OATS under patella+throclea specifically.....!!

I know all the tech, logistics, procedure, op, rehab protocols etc.......I'm having hard time understanding if people DO GO BACK TO RUNNING!!
Doc says I have 8o% success rate, right now I can't even walk to the market.

He also says, "you'll go back to do everything that people your age do", whatever that means.
Problem is, I've always done more that what people my age averagely do.

Thanks guys, whoever......... :'(
« Last Edit: January 25, 2007, 07:33:25 PM by S_501 »

Offline sgt-semper-fi

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #1 on: January 26, 2007, 05:09:21 AM »
S_501,

Hi there!  I just had my OATS procedure two weeks ago (see my post).  Like you, I was an active person with running and biking.  Also, as a Marine my career is probably over and that's the hardest thing to swallow.  My surgeon did an excellent job and had a fellowship with Dr. Cole from Chicago and his attending did a fellowship with Dr. Bugbee.  He stated that my high impact sports days are over unless I wanted a TKR by age 30.  So, after my rehab I am trading my mountain bike in for a road bike and will take up swimming.

I understand this is not what you wish to hear, by I plan on proving my surgeon wrong in order to continue serving in the USMC.  However, I mostly look forward to walking without a limp and having no more chronic pain.

As for the CPM machine, your doctor should prescribe one prior to surgery.  A medical supply company normally fills these prescriptions and will deliver a unit to your residence.

If you have anymore questions, feel free to ask and I can help you to the best of my ability. 
05 - R knee scope/manipulation
07 - R knee OATS (open & fresh plugs)
07 - R knee Retinaculum repair

S_501

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Re: OATS in PATELLO FEMORAL, will I run again? + death row
« Reply #2 on: January 26, 2007, 07:11:29 AM »
Hey Sgt,
thanks for your sharing your story, I appreciate it. I read your previous post also.
I don't have dislocation history like you, but I did have a plica taken care thru scope back in 95. Back then I was running after 20 days!!!! ...good were the times.
This new problem kinda originated in running and first symptoms were my sneakers wearing down to the inner shoe pad (literally!) on the outer side of my left knee. It felt like I was walking or running with my left knee/leg pulling outward. Never with pain though, until Nov 05.

Injury was sudden catching when running, still with no pain. Within a week my walking felt stiffer and I experienced pain when striding forward.
Now after the scope and while waiting for the oats....I can totally weight bear only if standing. Squatting is ok with moderation. I limp and need to get around with a crutch. I try not to have the kneecap move into the trochlea when trying to walk. I'm basically "dragging" my leg after my body, and that's my walking.

Yet at this point I don't know the SIZE of the patches that will be filled with the allograft so I don't know how bad I am.
I read a lot of posts on this site of people who know their lesion size, and also I seem to understand this:
-you have better prognosis if the lesion size is small, but I don't know HOW SMALL is small..?
-if you'll have oats in more than one compartment you're basically screwed, so unicompartment is good (there's 3 compartments in the knee: 1 patello+femoral -- 2 medial -- 3, lateral)

I know I'll get a lateral release and that worries me, although Bugbee says that restoring cartilage is useless if there's malalignment.

Like for you, Dr. Bugbee said my options were allograft or the partial patella rplcmt. I understand though that these docs do not offer oats to everybody. For some people there's only TKR so we should feel lucky that we qualify!
I know for sure Bugbee is up there with the best OS for oats so that reassures me, although we kinda yelled a bit on my visits.

Still, running is half of who I am and right now I fell like I'm on death row. Good for you that you can compromise with yourself so well...I am not that type.
Best of luck!

S_501

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #3 on: January 26, 2007, 07:30:06 AM »
Sgt,
I forgot to extremely thank you for the info on CPM machine. I actually will try and call the doc's nurse to see if she can confirm what you said....if it comes thru as a "prescription" then it's great!
I was already worried and thinking that maybe I had to go out and "rent" one on my own, that'd be very uncool.

S

Offline sgt-semper-fi

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #4 on: January 26, 2007, 03:43:03 PM »
S_501,

Have you had an MRI to see how big the defect is?  The MRI will give you a general idea of how big it is. 

Also, as you stated that OATS is available to certain people.  It took my doc almost a year to decide on what to do.  I really need a TKR, but I am too young for that and yourself as well. 

As far as Bugbee goes, he is one of the best and has the clinical background to handle these types of injuries.  However, he doesn't walk in your shoes and you both must work together and have a trust with one another.  If he doesn't know about all of your problems (big or small) then he will just proceed with his prognosis.  Always sound off when you have questions or concerns about anything.  Its his job to take care of you and ensure that he succeeds in your surgery and recovery.

Keep your head up and if you rehab properly then you may be able to run further and faster than before!  My true passion was mountain biking and I felt as it was my true calling in life to be one of the best.  I would give anything to hit the trails again and I will give every effort to do so. 

On a side note, start therapy now so you can strengthen your leg as much as possible prior to surgery.  This will help you maintain some muscular strength because you will lose most of it after this surgery.  You will be NWB for a minimum of six weeks and then another 4-6 to get of the crutches. 

Take care!

05 - R knee scope/manipulation
07 - R knee OATS (open & fresh plugs)
07 - R knee Retinaculum repair

S_501

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #5 on: February 02, 2007, 08:03:18 AM »
Hey there Sgt,
I saw your post. No I don't know how big my defects are, the doc's nurse said she will call me back with that info in a few days but I might call her next week myself 'cause I'm too impatient and I will not be polite!
And yes, I do  have an idea of the possible size from the MRI although not in numbers. i hear people here talking about cm/mm but I don't know!! I have pictures of scope that show bare patches in lat trochlea + lateral facet of patella. Now I don't know how many cm a lateral facet of a patella can be!! I can only hope is not too bad.

The text that came with my initial MRI and CT (this is before the arthroscopy, when I first got injured) scan talked about lesions but they only gave measurements of the osteophyte in which these lesions resolved. Then, after the scope, my doc said he was oging to size it up and get it ready for the allograft list. That measurement is what I'm trying to get info about.

How are you doing instead, besides giving me bad news about sports...? I was actually following your advice about keeping my quad as strong as possible. I still do my old PT exercises at home while waiting for the op: leg lifts on abench, abs, leg lifts from standing up. Sooo as long as I don't walk forward my knee seems to tolerate weight normally, I know my joint space is good.
Keep me posted once in a while, if you wanna rant or smthn', THANKS!!


Oh ye all PATELLA + TROCHLEA ALLOGRAFT people....please let know how was for you...
S501

Offline LadeeStingray

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #6 on: February 03, 2007, 02:14:52 AM »
Hey 501

When is your sugery?  I know u posted it somewhere.  I assume u are having an open OATs procedure.  My areas were different but im sure the post op pain will be similar. After the initial pain when i woke up it was easily controlled.  I still hurt but i could get out of bed and move around.  The one thing i can warn u about is when u start partial weight bearing the sensation in your knee is weird.  For me it was like having a wedge in the middle of the joint.  It didnt hurt just took some getting used to.  Of course now i dont notice it at all.  Have u found anything out about your CPM machine yet?  Just got my final bill for mine today from the second surgery.  With my insurance CPM is considered a DME and i had to pay a portion of the "rental fee" 

Look me up anytime u wanna chat

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

S_501

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #7 on: February 04, 2007, 09:15:01 AM »
Ladee,
I have no idea when my surgery will be, meaning I've been on the waiting list for fresh allograft for just about 3 months and you know, a knee my size has to turn up. They said max 6 months wait, although there're days when I lose my mind. This is considering that I've been using one crutch to get around for more than a year and my neighbors kinda look at me and say, "how come you're still on crutches...?" Hate that. I punch the wall coupla times a week. I know, I'm such a baby but running is important to me and it'll be a catastrophe if I can't return to it.
You describing the rehab pain, you know, that's the least I'm worried about. If they tell me I have to wait whatever long and be in pain that's just fine. I'm just terrified about the end results, I'm only 36 and it's kinda untimely for me to stop running.
About the Cpm, my OS just said he has his own protocol and he prescribes a at-home PTherapist for those initial 3 weeks, then I'll go on my own to PT. Yeah, the cpm sounds pretty expensive to me, although the PTherapist might be worse!!!!
I'm trying to keep my leg muscles toned by doing a 3h exercise plan on my own at home (endless leg lifts on a bench and from standing, some abs too why not...) mostly because I get horrible headaches if I don't work out at all and don't get anything done in the day. I mean, I just cannot be a couch potato and all this waiting is killing me!!
I work from home, so that's good. As far as chatting, I already kinda spend too long on the internet since I found this site, it's probably best that I don't...
Looking forward to hear how you're doing though!

Offline LadeeStingray

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #8 on: February 04, 2007, 10:17:28 PM »
501

Im sure u will have no problems returning to the activities u want.  I missed the "allo"graph part, but im with ya now .... i had 1 auto and 2 synthetic.  The waiting is terrible.  Ive been unable to return to work for 7 months now.  My "cells" are ready for the surgery if i could just get my doctor to make up his mind what he is gonna do. 

At home therapy sounds interesting. And i know all to well how u feel about "punching walls"  I may have not been a runner, but i am a nurse and i cant work on the floor 8 hours a day until they fix my leg.  So if my end result isnt what i want... i have to find a new profession and i worked so hard to get where i am i dont want to do that.
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

S_501

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #9 on: February 05, 2007, 09:13:17 AM »
Ladee,
you know you really make me feel so guilty because my "consequences" are really "frivolous" compared to yours...so would you really need to change profession for that? that is horrible!! I hope you have people around who're able to support you in any way that you deserve :) I'm sure you wrote about it somewhere but how exactly this knee problem happen to you, is it chronic or traumatic?
And what do you mean that your doc needs "to make up his mind"? if the cells are ready, then they're ready right? you know, somebody suggested ACI surgery is better vs allograft for large areas to patch up in trochlea + patella.
Do you know the tech indications  for either? what I know is that with ACI is hard to restore the natural biomechanics of the knee because of the unpredictable area it creates but I might get confused.....

 :(

Offline LadeeStingray

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #10 on: February 05, 2007, 04:56:14 PM »
501
Hey there .. sorry was not my intention to make you feel guilty.  Im hopin that this surgery will allow me to return to being a floor nurse, but if not im sure ill find something else i can do that doesnt require me to be on my feet for long periods.  My family is very supportive of me.   As for my injury i just got out of bed one more and the knee buckled.  MRI showed torn cartilage... had surgery for that ... found a small "pothole" in MFC.   My local ortho sent me to Pittsburgh to have that repaired with OATs and that went well but i continued to have pain.  They went back in to do and OATs on the patella and thats when they saw that the area surrounding my previous OATS has also crumbled away.  My doctor has never done ACI on 3 areas at once, he is consulting with other doctors to see if he feels comfortable doing the surgery.  If not i will be sent to my 3rd doctor for my 4th surgery on this knee, so until he calls me back i dont know when the surgery will be or who will do it.   Im not sure of the tech indications all i know is they told me that my lesions are too large for an OATs procedure and they are trying to save the knee so i dont have to have a TKR at the age of 31.   
Have a great day !
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

S_501

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #11 on: February 06, 2007, 02:30:00 AM »
You know, I did a lot of research on my own when I experienced first syptoms myself...your case sounds really strange (not that I would be qualified in any way to give a statement like that!!!), meaning, I was actually running and probably superpushing my body when my knee buckled and started catching, and it was obvious that it was overuse combined with patella maltracking over the years, but you...getting out of bed just one day...?

Did they tell explain to you why the area around your initial oats crumbled? That's the part that puzzles me. I guess what I'm asking is whether it was your not-compliance with rehab that caused further degeneration "around" the area (not even the oats itself) or there is something else happening with the bone in "all" of your knee. I don't mean to scare you, God forgive!

I'm sure you've picked your OS with care being already in the healthcare world, but are you seeing knee specialists? May I ask who your docs are?
My docs are: Dr. Bert Mandelbaum who simply referred to Dr. William Bugbee. They're both from CA and Dr. Bugbee's specialization is fresh oats. Bugbee did the scope + microfracturing initially, which he predicted would fail.
Now I'll go in with him in fact for oats, God knows when.
S501

Offline LadeeStingray

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #12 on: February 06, 2007, 02:46:43 AM »
501
Its ok .. my case is strange.. it fits me well.  Now i was very active in sports thru my teens and early 20s.  They feel this played a part in it.  I was a softball and volleyball player.  After a couple surgeries on my left knee at age 25 i decided to save what was left of the knee and i switched to bowling.  So the day it buckled was probably the tear... the "pothole" was found in that surgery.

They have no explanation as to why the area around the plugs crumbled.  Trust me when it came to rehab i did as i was told and nothing more. It was only 4 months between the OATs and the second surgery and in that amount of time is when the trochlear lesion showed up also.

I started out with a local ortho doc here in WV. He then sent me to Dr Rytel in Pittsburgh. And now im facing possibly having to go to Boston for the next surgery.  Fingers crossed here

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

S_501

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #13 on: February 06, 2007, 08:38:09 AM »
Ladee,
good good, I'm glad you're ok and here's why. You know when I got my first MRI before even the scope in 05 the radiologist stated I had 2 osteochondromas on my knee. Now I bet you know what THAT is! Those things can turn into malignant! I freaked out, I spent probably the worst 48hrs of my entire life. It turns out they were simply giant osteophytes because of the bone reaction to loss of cartilage, whew...

Before this current problem I had my first arthroscopy in 95, like you. Just a plica and was running again after 20 days. So....I guess, like you, it kinda caught up with me later because I kept doing sports.

Well, let me know when you do go to Boston and how it all turns out. I haven't heard of Dr. Rytel before but I read on this site that a certain famous Dr. Tom Minas operates over in Boston. You might wanna check him out too.
Take care! _Saida501

Offline LadeeStingray

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Re: OATS in PATELLO FEMORAL, will I run again?
« Reply #14 on: February 09, 2007, 03:47:06 AM »
Hey 501

Talked to my doc in Pittsburgh today,  he decided my case is too complicated for him to attempt.  Now i have to wait to get an appointment set up in Boston, if i can get my insurance at approve it.  So still a long road ahead.

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















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