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Author Topic: Bilateral patellar and trochlear ACI  (Read 29599 times)

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Offline erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #15 on: April 23, 2007, 02:26:54 AM »
Tomorrow is the big day.  I will post an update when able-it's expected I will be able to come home from the hospital on saturday.
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline David3

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Re: Bilateral patellar and trochlear ACI
« Reply #16 on: April 23, 2007, 11:42:05 PM »
Good luck Erinee!  This really is the big one - we're hoping for a jackpot outcome! We'll be thinking of you. Very best wishes.
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 LadeeStingray

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Re: Bilateral patellar and trochlear ACI
« Reply #17 on: April 24, 2007, 02:56:27 AM »

Hope all went well for you today!  Looking forward to hearing about your experince when u feel up to it.

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 erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #18 on: April 30, 2007, 01:37:24 PM »
Just got home from the hospital last night.  The surgery went very well technically, /i have good quad control and am able to passively flex both knees to 75.  Using NMES and TENS a lot.  Will update more soon
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline LadeeStingray

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Re: Bilateral patellar and trochlear ACI
« Reply #19 on: May 01, 2007, 05:09:16 AM »
erinee

Hey glad to hear you are home and all went well.  Up to 75 already, very impressive!  Ill check back for updates from you soon.

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 erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #20 on: May 07, 2007, 01:34:21 AM »
Quick update-
2 weeks post tomorrow.  Things are going well, aside from my feelings of helpless-ness and complete dependence on my amazingly wonderful boyfriend.  He was been the king of Polar-care ice changes, CPM, and commode.  Bless him a million times over.
I have PROM easily to 90-95, probably 100.  MY OS told me it was OK to progress the range faster than the protocol if I felt OK.  I can do a SLR on the right 5x.  Left is weaker, about 3, better with assistance (brace on).  Been using TENS and NMES a lot-basically, if I'm not in the CPM I'm either exercising or sleeping.  I see my doc again onTues-hopefully sutures will come out. 
I'm planning to go back to work (desk) on Wednesday. 
My surgeon has been phenomonal.  I think the fact that I have had good pain control (except the night of post op day 1 when the femoral nerve block wore off, the PCA was d/c'd and my night nurse was an hour late with my meds) has allowed me to do well.  I've been standing very little, only to take a few steps into the bathroom each day.  Other than that I can sliding transfer from w/c to couch.  It has been very challenging, but so far I'm glad I did bilat.  I'm also very glad that it's rare to have is problem bilaterally so hopefully no one else will have to go thru this!
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline TallPaul

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Re: Bilateral patellar and trochlear ACI
« Reply #21 on: May 07, 2007, 01:21:53 PM »
Good for you Erinee being brave enough to go for ACI on both knees at the same time. I'm very glad it's so far so good for you. I'm going to risk disappointing you by saying I don't think you are the first to have bilateral ACI but hopefully I can encourage you more as it appeared to work out very well for your predecessor: check out www.ausport.gov.au/fulltext/2001/acsms/papers/ROBE1.pdf

Best of luck with your recovery. Don't try too much too soon.

Paul
3/96 ACL
9/03 notchplasty
9/06 notchplasty/partial meniscotomy
currently considering MACI

Offline TallPaul

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Re: Bilateral patellar and trochlear ACI
« Reply #22 on: May 07, 2007, 01:23:32 PM »
 ???Just trying to get that hyperlink working properly...

www.ausport.gov.au/fulltext/2001/acsms/papers/ROBE1.pdf
3/96 ACL
9/03 notchplasty
9/06 notchplasty/partial meniscotomy
currently considering MACI

Offline erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #23 on: May 07, 2007, 01:53:20 PM »
Thanks for the link Paul-awesome news.  More specificially, I believe I was the first bilat in the US w/ Carticel-that's all I'm aware of-I wish I wasn't!
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline LadeeStingray

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Re: Bilateral patellar and trochlear ACI
« Reply #24 on: May 07, 2007, 05:05:42 PM »
erinee,

So great to hear that all is going well for you.  Your boyfriend sounds amazing also.  My husband was very helpful to me also after my OATs, but the poor guy was so nervous around me it almost made it worse.  I have bilateral lesions, and there is no way i am brave enough to do both legs at the same time.  Plus right now my left knee doesnt bother me that much (knock on wood).  Still fighting my insurance company.  Went to doctor number 4, and this doctor believes that since my OBI plugs failed that aci may not be my best choice.  So now we are going in for another scope so he can get a good look of my knee and then possibly doing a HemiCAP in two places.  Try to stay positive as hard as that is sometimes!  Going back to work should help you out with that. 

Best Wishes
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 erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #25 on: May 19, 2007, 09:01:34 PM »
Almost 4 weeks post-and going a little nuts!  Not being accustomed to ever having to ask for help, asking for help for everything is driving me a bit batty.  My ROM is still about 90-100-my OS told me to hold there at least until I see him again this Wed.  Still bilat PWB-so still in the w/c.  The incisions are healing beautifully, and
I seem to have good patellar mobility so that is encouraging.  Strength continues to improve and I can now do 4 unassisted SLR on the L and 6-7 on the R.  Only able to tolerate about 5-6 hours at work-then my back and butt start killing me from the w/c and legs out in full extension!  Polar Care going for the 6 hrs CPM and overnight still.
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #26 on: May 25, 2007, 11:27:08 PM »
Update from MD appt which was on Wed-
everything looks really good, my patellar mobility is good, the swelling is minimal all things considered, and my quads are coming back well.  On X ray there's still a bit of lucency at the osteotomy so I'm to be very cautious on the L knee.  At 6 weeks post op I'll be allowed out of the w/c  ;D and WBAT on the R knee, still PWB on the L.  I'll be permitted to open the brace to 90 on the right and 30 on the left.  I get to also get rid of the CPM if I wish.  He gave me clearance to go as tolerated w/ the CPM, and last night I was at 115.  Able to complete SLR independently on both sides, alhtough the left is much harder.  Today I'm having a bit of a setback pain-wise-I had been doing well with Vicodin Q6 hrs, but for some reason tonight my L really started to hurt in the CPM, so I'm taking a break  and took an oxycontin, which I hadn't needed since I came home from the hospital.  I understand that there will be some bad days, but I'd been doing so well it hit hard.  Tomorrow will be a better day.
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline djs60

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Re: Bilateral patellar and trochlear ACI
« Reply #27 on: May 27, 2007, 08:39:33 PM »
Hi Erinee,
Sounds like you are really doing well overall.  It's interesting to me that our surgeons seem to have some differences in their protocols.  I am not allowed to go beyond 40 degrees in my CPM machine.  Perhaps not surprisingly, I can't get much beyond 90 degrees of flexion, although this has been improving with the help of my PT.  She's hoping to get me on a stationary bike in the next week or so.  I don't really have any pain to speak of now, although it was pretty uncomfortable at my last PT session when the therapist was trying to get more motion in the knee.

I don't have my 1st postop visit until the week after next, which will be just short of the 6 weeks postop mark.

Keep us posted on your progress,

djs60
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 erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #28 on: May 27, 2007, 09:13:19 PM »
Hi Erinee,
Sounds like you are really doing well overall.  It's interesting to me that our surgeons seem to have some differences in their protocols.  I am not allowed to go beyond 40 degrees in my CPM machine.  Perhaps not surprisingly, I can't get much beyond 90 degrees of flexion, although this has been improving with the help of my PT.  She's hoping to get me on a stationary bike in the next week or so.  I don't really have any pain to speak of now, although it was pretty uncomfortable at my last PT session when the therapist was trying to get more motion in the knee.

I don't have my 1st postop visit until the week after next, which will be just short of the 6 weeks postop mark.

Keep us posted on your progress,

djs60
Hi there!
Yes, there will always be some differenes, also dependent upon the exact locations of the lesions, and different surgeons experiences.  Although I am allowed more passive motion than you, I'm still not allowed any active or active assisted motion-so no bike for me til probably week 8.  My MD believes that passive range is fine, but that active can put too much strain on both the graft due to the patella femoral contact forces, and the osteotomy from the pull of the quad.  It makes sense to me as a PT, so I'm good with it.  I'm actually allowed in the pool soon, but I have to wear the braces until I'm in the water...which provides a bit of a logistical nightmare.
My pain from the other day has gone-I think I had gotten a bit of scar tissue caught in the joint space.  Back to 115 in the CPM today. 
And djs-you'll get the range, never fear. ;)
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.

Offline erinee

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Re: Bilateral patellar and trochlear ACI
« Reply #29 on: June 10, 2007, 06:37:32 PM »
7 weeks post -op tomorrow....
Just this past week I have been allowed WBAT on the right side, and after a few days of feeling unsteady what a difference it makes!  I still use the w/c to motor around the house a bit, as it's impossible to hold/carry anything w/ crutches as you all know.  But I finally moved back into my bedroom after being in the guest room since sx, was able to stop the Cryo-cuff at night, and am allowed AAROM full on the right, so only the CPM on the left now!  And what a difference-I can get in and out of it by myself, get up and go to the bathroom-the beginning of freedom! ;D
I feel really steady on the right-I'm hoping when I see OS on the 20th he'll allow me to d/c that brace-it's open to 90 now anyways.  The X-ray will determine if I'm allowed to increase WB'ing on the left-the left was the side where the anchors had to be used for the periosteal graft, and the osteotomy had a bit of lucency since the beginning, so we're being much more conservative on that side, right now I'm still PWB on the left.
This week at work I began sitting in my office chair instead of the wheelchair-had a bit of edema so promptly purchased some compression stockings which seem to be helping.  Already had the boxes under my desk to prop the legs up on!
Got to get in the pool yesterday-and how awesome was that!  Jeff had to basically lift me to the pool deck so I could take off my braces there and just walk my hands down the steps to get in the water, but it was awesome!  I practiced some gait, some exercises and had a blast.
I am allowed to drive now so took a test drive this morning-felt weird, but OK.
Onward!  Hopefully soon I'll be allowed some active motion on the left and be able to get on the stationary bike...(PROM on the left is at 125 on the CPM, AAROM on the right about 130)  Strength is coming along well, can do 3 sets of 1 now of full unassisted SLR.
37 year old physical therapist, Left lateral release '92, bilateral debridement and scope '04, bilateral patellar cartliage defects, denied ACI repeatedly by insurance.  Scope and debridement 12/06 L knee.Bilat patellar ACI with Fulkerson 4/23/07.















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