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Author Topic: unilateral patellar and trochlear ACI - 4/27/07  (Read 25453 times)

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Offline djs60

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Re: unilateral patellar and trochlear ACI
« Reply #15 on: July 12, 2007, 11:10:37 PM »
11 week update:  I saw my OS today, and he seemed very pleased with my progress to date.  He gave me the OK to increase my time on the stationary bike, and told me I could get on my road bike for short rides, as long as I avoid hills.  I'm happy about this, as I am vacation the next 2 weeks, and want to be able to push the pedals a bit!

I don't see him again until the 6 month post op visit, at which point he is planning an MRI to check on graft fill. 

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 David3

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Re: unilateral patellar and trochlear ACI
« Reply #16 on: July 13, 2007, 12:33:02 AM »
That's fabulous djs. I had never imagined that progress could be so fast that you could be walking OK and having a very light session on your roadbike only 11 weeks after ACI / TTO. It almost sounds as though life is bearable! Have others experienced recoveries so fast?

I'm heading for the same in 12 days time: ACI / TTO. I'll be ecstatic if I can walk half-normally at 3 months. Hearing your progress is really encouraging. Keep us posted.

David
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 erinee

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Re: unilateral patellar and trochlear ACI
« Reply #17 on: July 14, 2007, 12:50:54 PM »
Awesome news!  You're much braver than me, my road bike will continue to hang on the wall for quite some time yet-where I live drivers seem to take aim at cyclists.
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 #18 on: August 31, 2007, 06:07:26 PM »
I'm 18 weeks postop today , and I am pretty happy with my progress.

this week i started to ride my bike to work (a bit under 10 miles), and that's gone OK.  There are a couple of little hills, so I put the bike in the lowest gear & go up slowly, so as to not stress that cartilage too much.  No discomfort or increased swelling after, so seems OK.

My quad muscle still has quite a way to go.  When my PT measured my quads last week, the difference between the 2 legs had actually increased, although it was because my good leg had gained more than the bad one.  It really is amazing how long it takes to get back the muscle mass I lost pretty quickly...

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 #19 on: September 08, 2007, 07:56:06 PM »
Absolutely-I am still struggling with that as well.  I am now on a muscle building MISSION!!!  (It includes lots of food, too  ;))
Great news about the bike-I'm leaving my road bike hanging on the wall a while longer.  Where I live, getting hit by a car is pretty common for cyclists, and I can't imagine crashing at this point...so be careful!!!
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 #20 on: September 17, 2007, 12:20:03 AM »
I seem to have hit a little bump in the road.

For the last 2 days, my knee is definitely more swollen, and kind of sore, too, which really hasn't been the case for a couple of months.

I'm scratching my head to try to figure out why.

I had been increasing my activity, although I haven't done anything in the last few days that seems unusual to me.

The weather has been unsettled - have others noted effects of the weather on their ACI knees in the 4 to 5 month post-op period (or other times)?

Anyway, I guess i will just dial back on my activity for a while & hope this all settles down.

There are bound to be some bumps along the way, I guess  ???
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 David3

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Re: unilateral patellar and trochlear ACI
« Reply #21 on: September 18, 2007, 11:43:18 PM »
I don't have personal experience to offer you DJS since I'm not as far along as you are (I'm only 8 weeks post-op). However, I seem to recall that others on this site (Nick Knack?) had a reoccurrence of pain as late as 9 months post-op, only for it to subside and have good progress continue. I guess there's alot of remodelling and change going on as the grafts develop, so I get the impression that a few bumps along the way may not be unusual.

I'd be interested to hear what your OS or his PA have to say.
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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #22 on: September 19, 2007, 01:57:31 AM »
David,

I did speak to the OS's RN yesterday.  He thought it might be related to my progressing with activity too quickly, but also mentioned the possibility of graft overgrowth (I don't have any catching, but do have some clicking).

As of today, the knee is slightly better than it was when I posted 48 hours ago, but still much more swollen than it has been.

We agreed that I'd get back to him next week if things don't settle down with decreased activity.  If things don't improve, he suggested moving up my MRI, which was to be done "routinely" at the end of October, when I will be 6 months post op.

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 #23 on: September 24, 2007, 01:43:08 AM »
So how goes it?
My clicking which was associated with the overgrowth has subsided considerably, but is still present.  That would be my guess to what you've felt, although strictly a guess.
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 #24 on: September 24, 2007, 05:31:15 PM »
Erinee,

Well, after a week of kind of taking it easy, things are not really different.  Still significantly more swelling than I had 2 weeks ago, along with stiffness and slight discomfort.  I do have a slight "clunk" as well sometimes when I'm moving the knee.

I called the OS's office this am to see about moving up my MRI, which was originally schedule as "routine" for the end of Oct.

I wonder about overgrowth, since I think I'm in the right time frame for that.  I don't really have much pain, which I imagine I might have with graft failure.  On the other hand, I didn't really have much pain preop, either  ???

So, I'm kind of worried.

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 #25 on: September 24, 2007, 11:18:30 PM »
The MRI will put you at ease, my money is on overgrowth-which, all considered, isn't too bad. 
i'm hoping they can move it up for you!
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: unilateral patellar and trochlear ACI
« Reply #26 on: September 25, 2007, 01:50:54 AM »
I hope your concerns get resolved quickly DJS and hope an MRI and a discussion with your OS can shed some light on what's going on. Does your OS order a gadolinium-contrast MRI (seem to remember Erin had one of these with her OS?) and does that provide better imaging of immature cartilage?

I'm not sure how relevant it is, but when my microfracture failed at 5-1/2 months, I went from my knee feeling pretty good to having fairly sharp pain, all within a week. I'm guessing that failure of the early-stage cartilage left me with a debrided, completely open lesion, hence the pain being worse than pre-op. I'm sure ACI is different in some respects, but I would have guessed that even partial failure of an ACI graft would also leave you in some pain??  ... which you don't seem to be experiencing. I'm keeping fingers crossed for you.

David

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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #27 on: September 25, 2007, 05:03:37 PM »
Hi David,

I spoke to the OS's RN this am, and I'm scheduled for my MRI this Sunday am.

It is being done with gadolinium and after exercise (I don't know, but I'm imagining they'll have me ride a stationary bike for 10 minutes or so).

I'll post an update when I hear about the MRI result.

Ironically, I think the knee is a little less swollen today, but it still is not nearly as good as it was 2.5 weeks ago.  At that point, my mind was more on my weak quad, as the knee felt pretty normal.

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 David3

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Re: unilateral patellar and trochlear ACI
« Reply #28 on: September 25, 2007, 09:36:42 PM »
Great that this got scheduled so soon DJS. Hope to hear from you next week.

May I ask what your activity level was at 12 weeks? Also recently (about 5 months?). Since I'm following in your footsteps to some extent, I'm just wondering how well you could walk / cycle / other at each of these stages, and at what rate you have been advised to increase activity. 
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 djs60

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Re: unilateral patellar and trochlear ACI
« Reply #29 on: September 28, 2007, 10:54:34 PM »
Hi David,

At 12 weeks, I was walking up to a couple of miles without much difficulty.  Could ride a stationary bike for 20 minutes at moderate resistance.  I started to ride a real bike on a flat rail trail for 30 to 40 minutes.  No problems.

At about 16 weeks, I tried advancing my biking to riding from my house to work, which is about 9.5 miles with a few small hills.  I now think that was too much, as I developed a significant increase in swelling of the knee at 18 weeks, along with stiffness & some discomfort.

My PT told me on Wed that she thinks my current problems are from trying to do too much too soon.

I'm at 5 months post op today.

As above, I'm scheduled for an MRI of the knee this weekend, so I'll post when I have a report.

I do note less swelling this week with less activity.

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