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Author Topic: ACI Surgery Jan 3 07  (Read 10659 times)

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Offline ivischwartz

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ACI Surgery Jan 3 07
« on: February 10, 2007, 05:42:07 PM »
I just had ACI surgery Jan 3, 2007 in Cincinnati, Ohio. The OS was Angelo Colosimo, and the PT is Troy at Novacare. I had a 2x3 cm chondyle lesion midway between front and back. No other damge. Caused by deep bone bruise on femur during karate training - probably from hyper-extension. I am 40 year old male of medium to medium-high activity level. I am just beginning to get off of CPM, and weight bearing will begin next week. So far, all seems to be going according to plan except for (1) pain at full extension during leg lifts, and (2) slight infection at surgery sight.  More posts to come....

Offline LadeeStingray

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Re: ACI Surgery Jan 3 07
« Reply #1 on: February 11, 2007, 01:22:11 AM »
Hi ivischwartz,

Glad to hear all is going well for you.  Keep us posted on your progress. 

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 bioprof

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Re: ACI Surgery Jan 3 07
« Reply #2 on: February 11, 2007, 02:26:01 PM »
Welcome.  It's good to hear your recovery is going well.  Your comments regarding the cause of your lesion intrigued me, because I also had an incident that caused a deep bruise to the medial part of my knee.  I was playing baseball (fast-pitch hardball) and took a hard foul ball off of my knee while batting .  About 2-3 weeks after that, I started having pain deep in my knee, which eventually led me to my OS and arthroscopic surgery for a slight meniscus tear.  Up to that point, I had no knee problems at all.  During the procedure, the OS found a medial condyle and a trochea lesion which were the real cause of pain; the condyle defect was directly under the site where the baseball hit.  The OS suggested there may be a connection between the lesions and the original injury, but it stated it was unlikely.  After reading your post, I'm not so sure the two incidents are not related.  It would be nice to know, because if the lesions were a result of trauma and not just wear and tear, I would be less worried about my left knee which remains pain free but has gone through all the wear and tear of my surgically repaired right knee.

I wonder if anyone has read anything about the connection between acute trauma (e.g. deep contusions) and cartilage lesions.  If the trauma doesn't directly damage articular cartilage, does the swelling and inflammation from trauma somehow lead to cartilage degradation?  Or does the trauma from an acute injury make an already existing lesion worse?

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: ACI Surgery Jan 3 07
« Reply #3 on: February 16, 2007, 11:02:44 AM »
Into week 6, and all still seems to be going well, albeit slow. I have finished CPM machine and am beginning to transition off of crutches. I moves to one crutch yesterday and will consult with PT this morning about same. The pain I have on weight-bearing is at same location as pain pre-surgery, but based on other posts in this forum, this seems to be relatively normal (?) at this stage. Infection at incision site being treated with oral antibiotics and seems to be resolving.

Bio - regarding your question on specific traumas leading to ACI-need, I can only give you two point of information I have received in this regard. One -my OS indicated his belief that a deep bone bruise can cut off the blood supply to the cartilege, and if this deficency lasts long enough, the cartilege can die and then flake off. The second one comes from my PT who indicated that the OS' interpretation is a respected theory, but the science has not yet determined this connection and the whole area of bone bruises is not yet well understood. So, now you know what I know.

I am not doing much therapy on my own, which means I am only really getting a once-a-week session in. The only significant thing I am doing at this point is continually straightening my knee and gently pushing it to go completely straight. I am anticipating that once I am completely off crutches, I can get back into the gym 3-4 times per week and really begin focusing on the muscle-building portion of rehab, but this still remains aspirational at this point.


Offline bioprof

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Re: ACI Surgery Jan 3 07
« Reply #4 on: February 18, 2007, 10:49:47 PM »
Thanks for passing along the info on bone bruises and cartilage breakdown.  I really want to believe this is what happened to me, but as your PT indicated, we'll have to wait for the science.  BTW, I need to clarify something in my previous post.  I had ACI surgery on my LEFT knee, not the right knee - how could I have possibly forgotten???
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: ACI Surgery Jan 3 07
« Reply #5 on: February 23, 2007, 03:26:39 AM »
Most Important Things I Have Learned From KneeGeeks:
1. There is a way to find other ACI people (seems like no one I see during the day has ever heard of it, nor had I)
2.  Week 8 - it is OK to have pain which feels like a bone bruise in the same place as before surgery - this does not mean you still have a problem.
3.  Using the electric stim machine is extremely helpful - even if you are too lazy to do the proper rehab.
4.  Ups and Downs through the process are normal and to be expected.
5.  The link to the Carticel Rehab Manual

Thanks, KneeGeeks!

Offline ivischwartz

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Re: ACI Surgery Jan 3 07
« Reply #6 on: February 28, 2007, 01:29:29 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 ivischwartz

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Re: ACI Surgery Jan 3 07
« Reply #7 on: June 08, 2007, 12:49:15 PM »
5 months out. Occasional pain at surgery sight, but not often and only when weight is put on leg in particular way. All seems to be gettign better, except.......

This f'ng limp. Doesn't seem to be due to pain. I am walking on treadmill about a mile every morning, and my legs are just starting to regain significant strength. My insurance money ran out on rehab, so now I am basically adrift. I am starting with personal trainer, and I have Carticel Rehab Protocol brochure which I will follow.

Any comments appreciatied.

Offline LadeeStingray

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Re: ACI Surgery Jan 3 07
« Reply #8 on: June 08, 2007, 03:40:28 PM »
Glad to hear you are doing so well.   As for the limp ....if u figure out how to get rid of that please share with me.  Ive never been able to get rid of mine after surgery.  I can say the good thing is I no longer notice myself that i am limping, someone usually points it out to me.   So for me atleast there is an upside ... one day u wont notice it anymore.

Hang in there !

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 bioprof

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Re: ACI Surgery Jan 3 07
« Reply #9 on: June 09, 2007, 12:07:30 PM »
Your 5 month mark is an important personal milestone, but it's important to keep in mind that in the big ACI picture, each day, each month and even each year is a small step toward recovery.  I'm as "guilty" as any for being impatient, and at times overly pessimistic about my progress.  But after 11 months of ups and downs (read my thread) I've come to the realization (with a little straight talk from ACI'ers here, my OS and PT) that "full" ACI recovery is closer to two years than 1.5 or less.  This is especially true for those 35+ years.  Naturally, the promotional literature (at least for Carticel) emphasizes the remarkble potential of ACI, and downplays the reality - i.e. recovery time, pain, etc.

Your limp (and pain) will likely fade SLOWLY - so slowly that coworkers, friends, family and even you won't mark the milestones.

Here's to recovery - step, by step, by step, by step...

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 Peg Leg

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Re: ACI Surgery Jan 3 07
« Reply #10 on: June 14, 2007, 03:43:27 PM »
ivischwartz,

I had microfracture Oct. 24th, and i still limp! My PT was as frustrated by this as I was.  He had started to wonder if it was a habit, though I continued to complain of pain and muscle weakness, and then I had a scope in Apr. and it showed that my defect was almost double in size!  I kept repeating that the pain I felt was bone pain, now he never questions me!!  I am having ACI 2 weeks from today(yikes!!) :'(.  I am thankful for KG and finding people who have been through some of the same things I have.  People are always interested and sympathetic in what I am experiencing, but they really have NO IDEA what it has been like!  Good luck to you!

Robin
10/06  Miicrofracture Rt knee on mfc
defect was 1.3x2, small defect under patella
04/07 Arthroscopy/Cell harvest for Carticel
06/28/07 Carticel surgery ,Rt. Knee
12/27/07  Scope to debride Patella lesion,Rt. Knee
4/17/08  Fulkerson AMZ, Rt. Knee
6/25/09 ConforMis BiCompartmental Knee Replacement

Offline ivischwartz

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Re: ACI Surgery Jan 3 07
« Reply #11 on: August 29, 2007, 12:22:20 AM »
The latest from ivi:

8 months post op. I think everything is on track. There have been some ups and downs, but progress seems to be trending in positive direction. Leg strength is back. Still limping, but I am attacking that problem in particular fashion. Hope it works. Some pain twinges in the joint once in a while (about once a day) when knee moves in particular way. I am looking at it as I am 1/3 through 24 month rehab, but feel like I am 60% recovered. Just need to stay steady without pushing it. Very hard for me because of type A personality, but trying to keep eye on the long picture.

Offline kevinnjaime

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Re: ACI Surgery Jan 3 07
« Reply #12 on: August 29, 2007, 05:07:03 PM »
Great to hear that you are doing so well.  It helps to hear people that are more far alone that me.  I am six weeks post-op and progressing well but still slow.  It seems too slow for me but I know it is a slow rehab.  Is your limp noticable or is slight?  Just wondering. 

Thanks for all of the posting.
Kevin
05-07 Meniscus tear cut out
07-07 Carticel implantation femoral condyle on left knee
03-09 Reinjured same knee during a car accident

Offline downtownsjb

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Re: ACI Surgery Jan 3 07
« Reply #13 on: August 30, 2007, 07:30:53 PM »
Glad to hear that all is going well!!!   I had my ACI 5 days after you & I still limp too.  Pain sounds about the same too.  I've had several setbacks-I had the knee scoped at 3 months for lost range of motion due to scar tissue & I actually go in tomorrow to have my screws removed since they are backing out BUT I still feel overall that this will all be worth it!

I agree with the 1/3 way thru & 60% recovered.  The rest will come with time!

Offline ivischwartz

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Re: ACI Surgery Jan 3 07
« Reply #14 on: September 15, 2007, 01:47:32 PM »
Checking in -

The degree of my limp changes during the day. Sometimes, it is almost gone, and sometimes it is pronounced. Sometimes, I think it gone, and someone asks, "why are you limping?" I think some of it is real, and some of it is habit.

I need to find some info on whether pain at this 8 1/2 month mark is normal. I guess I should go see my ortho just to assure me I am on course. I will probably do some research and check Carticel site first.