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Author Topic: unilateral patellar and trochlear ACI - 4/27/07  (Read 25452 times)

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Offline djs60

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unilateral patellar and trochlear ACI - 4/27/07
« on: April 30, 2007, 07:41:39 PM »
Like Erinee, I am just home from the hospital from my ACI, but unlike her, I only had one side done :)

All in all, I was pretty happy with the way things went.  I had an epidural rather than general, as they wanted the epidural for postop pain control  It was kind of interesting, because at one point I was pretty awake, so following the conversation in the OR.  I asked a few questions, and don't remember too much after that, so maybe the surgeon didn't want the patient to be too lively.

My post op pain control went well, although I did have one bad patch in the PACU where the epidural catheter was somehow positioned such that it was working well on my right side but not on my left (bad because it was my left leg that was operated on!).  Fortunately they were able to correct that quickly.

My post op dx was a little different than the preop in that the surgeon told me I  had essentially no cartilage on my patellar (it has appeared not that bad arthoscopically).  On the plus side, my lateral femoral condyle - which he thought had a crack in it - looked fine when he got in the joint.  The surgeon told me he was glad he had ordered extra cells, as he used them all.  The surgeon told he he felt the procedure had gone perfectly, which makes me feel good (I'm actually supposed to get a DVD of the surgery, as it was broadcast as part of a Continuing Medical Education course).  In addition to the trochlear and patellar ACI, I had a tibial tubercle osteotomy.

My post op pain hasn't been bad, so now it's on to rehab!  As a matter of fact, I'm going to get back in that CPM machine right now...
« Last Edit: October 24, 2008, 12:51:20 PM by 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 LadeeStingray

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Re: unilateral patellar and trochlear ACI
« Reply #1 on: May 01, 2007, 05:12:53 AM »
djs,

Glad to hear things went well for you also!  Have fun in the CPM, I actually didnt mind it so much after my surgery.  Keep us posted on your rehab adventure!

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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #2 on: May 03, 2007, 01:27:32 PM »
I have a ? about pain.

When I'm horizontal, I'm not having much pain at all.  However, when I get vertical, like when I go to the bathroom, I get pretty bad pain.  I think the pain is mostly in my tibia area, I guess where I have screws from the osteotomy.  Last night, I was _really_ bad when I got up to pee, and remained pretty bad for a while even when I got back to bed.

Have others had this experience?  How long did it take to improve?

thanks,
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 LadeeStingray

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Re: unilateral patellar and trochlear ACI
« Reply #3 on: May 05, 2007, 02:51:14 AM »
My leg always hurt/throbbed more when i was standing.  Not sure if its because of the weight of the leg when u are up or the increased blood flow.  Our surgeries were different, but after a week or two it didnt bother me so much.
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 Rod G

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Re: unilateral patellar and trochlear ACI
« Reply #4 on: May 05, 2007, 07:29:20 AM »
Hi,

Don't worry about it as it happened to me as well.  The pain will stop after
awhile.

Regards

Rod

Offline djs60

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Re: unilateral patellar and trochlear ACI
« Reply #5 on: May 05, 2007, 06:37:46 PM »
Thanks, Ladee & Rod.

It's gotten a bit better since I posted that question, so things seem to be going in the right direction.

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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #6 on: May 11, 2007, 02:40:26 PM »
Well I am now 2 weeks out from my aci and TTT. 

I am now at the point where I don't have much pain.  Using very little pain medicine. 

I am slated to start PT next Wed, so I am looking forward to that.

The knee is still a bit swollen, but a lot better than it was.  Here's a photo from the other day:

http://new.photos.yahoo.com/djs092360/photo/294928804375471947/0

djs60

« Last Edit: May 15, 2007, 09:59:17 PM by 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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #7 on: May 18, 2007, 09:58:01 PM »
Today is three weeks since my trochlear and patellar ACI & TTT.

Overall, I think things are coming along pretty well.

I had my second PT session today, and the therapist was able to flex my knee to 75 degrees (I have full extension).  She also commented that my patella was easy to move around, which I guess implies no problems with scar tissue at this point.

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 LadeeStingray

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Re: unilateral patellar and trochlear ACI
« Reply #8 on: May 18, 2007, 10:09:23 PM »
djs60,

Hey sounds like things are going great so far.  I looked at the pic u posted .... just looks painful!   Insurance is still fighting me.... new doc is going to do a scope next month to get a good look at my knee and see if maybe i qualify for a clinical trial.  I am now looking into a HemiCAP.... but the insurance doesnt seem to like that idea either.

Take care  looking forward to hearing how you 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 erinee

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Re: unilateral patellar and trochlear ACI
« Reply #9 on: May 19, 2007, 08:57:28 PM »
Hey there!
Sounds like you are doing great.  Funny-the same thing with me-per scope looked like a trochlear lesion, but when they opened it was fine. I will be 4 weeks post on Monday, so we're pretty close in timeframe.  I believe that pain w/ dependent position is from the blood rush esp. to the osteotomy-like you, mine subsided quite a bit after the first week.  I am still taking Vicodin every 6 hours. 
Keep up the great work!
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: unilateral patellar and trochlear ACI
« Reply #10 on: May 21, 2007, 11:27:23 PM »
Hi erinee,

I'm glad to hear things are going well for you, too.

Ladee,

Hope the scope goes well for you - I'm sure you are frustrated with everything you've been through recently.

djs
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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #11 on: June 06, 2007, 11:07:04 PM »
I saw my OS today for my 6 week followup, and got a very positive report.

He told me my xrays showed very good healing of the osteotomy site.  He told be I could discontinue my brace, discontinue the CPM machine, and use a crutch or cane as  tolerated.  He wants me to continue with the stationary bike (I only this week got enough flexion back to get around on the pedals).

Overall, I'm feeling good about my progress to date.  I'm back to work on Monday.

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: unilateral patellar and trochlear ACI
« Reply #12 on: June 07, 2007, 02:31:33 AM »
Congratulations!!   ;DAwesome news.
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: unilateral patellar and trochlear ACI
« Reply #13 on: June 26, 2007, 02:53:44 PM »
update at 8.5 weeks postop:

- I'm walking much more normally in the last week.  I now have a slight limp as opposed to a big one, and I can walk faster.  I've walked as much as a bit over a mile without difficulty, but am reminding myself to go slow and not get carried away

- I can ride my stationary bike without pain (do have some stiffness, as the knee is still pretty swollen).  I'm up to 10 minutes once or twice a day, but my PT doesn't think I should try to increase the duration until I see my OS in mid-July

- I'm hoping I can get on my road bike by the end of the summer.

- I really don't have any significant pain, although I did not have significant pain pre-op either.

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 rob8647932

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Re: unilateral patellar and trochlear ACI
« Reply #14 on: June 26, 2007, 03:20:04 PM »
Can I ask who performed your surgery?

Thanks
Left knee - 1997 debridement, 1999 trochlea paste graft / microfracture), 2002 IAGH injections, 2005 plica and synovium removal, 2009 Regenexx injections
Right knee - 1997 debridement, 2000 trochlea paste graft, 2004 IAGH injections, 2008 Regenexx injections















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