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Author Topic: ACI Surgery  (Read 9724 times)

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Offline Linda

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ACI Surgery
« on: October 03, 2002, 01:45:34 AM »
Hi,
I have ACI surgery scheduled for Nov. 6 2002. Any helpful hints for rehab? Anyone else that has had this and can tell me about it?
Thanks,
Linda
LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline tazmanian_devil

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Re: ACI Surgery
« Reply #1 on: October 04, 2002, 07:27:39 AM »
Do you mean ACL surgery? That is one of the ligaments right in the center of your knee. Theresa.
L ACL Recon. L lat. meniscus tear 1991, R Dislocated 1996, R ACL partial tear, MCL tear 08/01, R Chondroplasty 2/14/02, R Lateral Release-Medial Reefing-Chondroplasty 12/3/02.

Offline Linda

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Re: ACI Surgery
« Reply #2 on: October 04, 2002, 06:59:30 PM »
This is Autologous Chrondrocyte Implantation (ACI). It is to replace cartilage that is missing in the knee at the end of the thigh bone. The OS removes healthy cartilage cells from an area of the knee that is relatively unscathed. These cells are sent to the Genzyme Tissue Repair Lab and the lab uses proprietary methods to grow new cells from the biopsy. The resulting multiplied cells are then put back in the knee during a second surgery. The rehab then takes 9 - 18 months.  Linda
LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline Heather M.

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Re: ACI Surgery
« Reply #3 on: October 04, 2002, 09:10:21 PM »
Check out the arthritis section below.  Not many have had this surgery, but there are some posts there.

Heather
Scope #1: LR, part. menisectomy w/cyst, chondroplasty
#2-#5: Lysis of adhesions/scar tissue, AIR, patellar tendon debridement, infections, MUA, insufflation
#6: IT band release / Z-Plasty, synovectomy, LOA/AIR, chondroplasty
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Offline Linda

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Re: ACI Surgery
« Reply #4 on: October 04, 2002, 09:29:18 PM »
Hello Heather,

I did wander around yesterday and read just about all the posts on the site. it is very cool that there is a place like this for people to talk about things they are going through! There seem to be many kind helpful people out there.

The only things knee wise that I have been through is a lateral release and a scope for clean up and biopsy. that seems like too much already! Hopefully I can get through this and get back to a more normal life. I do not even want to consider all the things many of you have gone through.

I guess that as long as there are things to try, you can keep looking foreward though.

Thank you for responding.
Linda
LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline gailg3

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Re: ACI Surgery
« Reply #5 on: October 04, 2002, 11:06:14 PM »
Linda, I had my Carticel implant done April 13, 2001.  I had a medial condyle defect on my left knee.  I had minimal pain following the implant surgery believe it or not.  I had major pain in my knee before, so it was a relief to have the surgery.  Yes, the surgery is major and the rehab is tough, but pain wise, it was manageable.  I used a CPM and started PT on day 3 post-op. I iced almost constantly.  I had alot of swelling for a long time.  I still have some swelling if I do too much with my knee.  I'm always aware of my knee and i'm very careful with my knee.  I do have limitations but I'm very glad I had the surgery.  I don't think it'll be the last surgery for me though.  I think it bought me some time until I can have a TKR.  I'm only 26 years old (almost 27) but still way too young.  My advice would be push hard for your ROM but listen to your knee. Don't be too concerned about the protocol except for the ROM part (that's important).  Everthing else will come in time. Listen to your PT and your OS but most important your knee.  I still struggle for strength.  I had to go back to PT for 2 months at 1 year post op b/c i had not gotten my strength back on my own after doing 5 months of formal PT following the surgery.  I went 3 times a week for 3 months and then 2 times a week for 2 months.  I spent 8 weeks totally non weight bearing.  It was supposed to be 6 weeks but I tried partial weight bearing and had pain so we backed off.  Like I said, listen to your knee.  Anyway, if you have any questions you can e-mail me if you want.  I don't check back here too frequently.  Gail
L knee scope Nov 98, L knee LR, Microfracture Aug 99, L knee Carticel biopsy Jan 01, L knee Carticel Implant Apr 01
R knee scope Oct 04 Microfracture

Offline Laura945

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Re: ACI Surgery
« Reply #6 on: October 10, 2002, 10:33:18 PM »
I would strongly suggest getting a second opinion before having the surgery.  I was told by my OS that ACI for the knee doesn't really work.  Because the knee takes more pounding than any other joint in the body, the ACI will eventually shear off.

I had asked my OS specifically about this when I was looking for options for my own knee problems.  I'm 42, and I've already had a patella realignment, a lateral release, and an arthroscopy (to remove cartlidge debris and inflamed tissue), this last back in June.

But Gail is right.  Listen to your PT (they often know about what's going on than the OS), and listen to your knees.  

Offline Linda

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Re: ACI Surgery
« Reply #7 on: October 10, 2002, 10:48:10 PM »
Hi Laura,

Thanks for the input. The three docs I saw tell me that it about the only option I have except for Knee Replacement! I am 38, so that is not an option yet. They tell me that it should last for at least 10 years. they said that even if it only lasts for 5, I have not created any more problems, and have gained a few years of knee use.

It is so tough to know what to do!

My PT sent me to this Doc. She felt that this would be a good option.

It helps to know that others are interested and looking for answers too.

Thanks,
Linda
LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline jimbeaver

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Re: ACI Surgery
« Reply #8 on: October 11, 2002, 11:44:22 AM »
Hi everyone!

Like lbdeharak, Im going for my ACI on my left knee on the 24th Oct. I had the initial harvesting done on the 2nd Oct, which went along well.  Prior to this ACI, I had 2 anthroscopy done at the start of this year.

Having read the postings here, I am beginning to have
apprehensions about going through the final surgery!  :'(
My OS deemed this procedure as the only option barring
a total knee replacement, considering that Im 33 years old
now.  

Presently, my knee will swell and have jabbing pains whenever I over-exert myself at the slightest form of
exercise like swimming, stationary bicycling etc.  Even
walking up & down the stairs will cause throbbing pains.

I didn't really have much of a choice apart from taking up what my OS recommended.  Considering my age, I wanna get back to sports & exercises and also to trek & tour like before.  I just wanna get over this and put it all behind me.

But having read the postings, I have to lower my heightened expectations, and be ready for the worst, in that, it may not cure my knee problem.

My concerns are as follows:
1)  The "trauma" of having to go under the knife for the
     4th time this year.
2)   The rehab period is gonna be tainful, long & tough!
3)   The cost of the entire surgery.
4)   The extended period of absence from work may
      render me a unemployed!

To gailg 3:  How long did it take for you to start walking and resume your activities (like work, school etc) again?

Im praying hard that this shall be the final op needed for
my problematic knee!!

Good luck to all!!


     

Offline PJS

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Re: ACI Surgery
« Reply #9 on: October 11, 2002, 01:22:30 PM »
All,
I had carticel a year ago for a 2.4cm2 lesion in my right knee.  I had no pain prior to the operation and only had the operation on the advice of the OS who convinvced me that I could return to competitive sports and tournaments. One year on I still suffer from an occassional pain over the implant site if I push the knee.  My knee is extremely variable in its feeling. Sometimes no pain for a couple of days, then a twinge whilst walking, sometimes no pain with leg lifts and then sometimes a dull ache.   At this moment in time I am worse off than before the operation and hope that my progression continues over the next 6-12 months to allow me to play football again.   I was also told that it would take 18mths to 2 years, I am now into year 2 and starting to worry that the OS has made we worse off.
It is very difficult to establish what is going on inside the knee and it worries me greatly about the stability of this operation.  The OS Carticel surgeons are great at explaining the 95% success rate, I am begging to believe that they have greatly exaggerated the benefits and success rates of Carticel for their own commercial and selfish reasons.    My advice to anyone would be to think long and hard before undertaking this operartion.
If I could turn back the clock I would say NO, not worth all the rhabilitation pain with the high assocaited risk of failure (I believe this to be 50% and 95%).
It would great to hear how others are coping with their ACI rehabiliation.
???










Offline mj/usa

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Re: ACI Surgery
« Reply #10 on: October 11, 2002, 05:06:37 PM »
Hi!

Before I had my O.A.T.S. operation 4 weeks ago, my surgeon mentioned that one of my options would be ACI.  WE discussed all the pros and cons and in the end he strongly discouraged ACI, because he said that the success rates are over-inflated, and that he has seen  implants that keep growing and growing and causing trouble because of that.  I felt caught between a rock and a hard place; no decision like this is easy to make and I am sure that we all hope we have made or make the right one.  In my case, I did opt for the oats because my defect is on the smaller side.  Only time will tell if I did make the right choice, but so far everything seems to be ok.
I wish you luck with the ACI, or whatever other choice you might make.
MJ

plica excision 05/01,  followed by OATS 09/02

Offline Linda

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Re: ACI Surgery
« Reply #11 on: October 11, 2002, 08:14:34 PM »
I am not a candidate for OATS since my defect is so large. I had just about decided that I would live with this awhile and see how things went, but then last weekend when i walked my dog, just that little bit of walking caused terrible swelling and pain. i am still working on getting the swelling to a more reasonable point.

I did talk to my OS again, and he gave me a very long list of names of people that have had the ACI surgery. I called many of them. All but one was very happy with the results. The unhappy one admitted to not following the rehab protocol. I do feel a little better now.

i also got a list of names from a different OS. That list did not have as many positive results. Not sure if the surgeon was the cause? There were many flap problems.

A question for everyone. My OS said that while this is a good site for info, to remember that people that are successful in their treatments go on with their lives and quit posting. Do any of you think that there is truth in that?

I hope everyone is doing well. i sure am torn about the November 6 date.

Linda

LR and Chondrplasty 1/22/02, Clean-up, Chondroplasty and biopsy 6/4/02, AC Implant 11/6/02, Micro fracture and adhesion clean up 8/12/03

Offline gailg3

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Re: ACI Surgery
« Reply #12 on: October 12, 2002, 06:03:43 AM »
To Jim, Linda and everyone else,  I agree that people who are doing well move on, as I have.  I only resently started checking back to this site b/c I wanted to tell people I was doing well actually.  While it is a long hard road and there is not guarantee, and I don't expect this to be a long term fix for my knee b/c I am so young, for now, my knee feels good.  
To Jim, I actually took 5 months off work, b/c I could.  I could've gone back sooner.  I was walking after 8 weeks.  I had pain when I tried at 6 weeks so I waited until 8 weeks.
To Linda as far as the flap problems, my OS modified the operation technique and only uses one long insicion instead of two as suggested.  He gets the flap from the top of the medial condyle of the femur instead of the shin b/c the quality of the periosteum is better.  It is thicker and holds up better.  
So I'm happy I had the operation overall.  Everyone has to make their own decision though.  Gail
L knee scope Nov 98, L knee LR, Microfracture Aug 99, L knee Carticel biopsy Jan 01, L knee Carticel Implant Apr 01
R knee scope Oct 04 Microfracture

Offline noddy

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Re: ACI Surgery
« Reply #13 on: October 13, 2002, 02:27:35 PM »
Linda

I am 9 1/2 weeks post op from ACI.  My only other option to this surgery is a TKR.  My OS was very realistic when suggesting this surgery for me. He said that at worst, I would be no worse off than I am now and at best I will get some relief from the constant pain I have when walking.  I am only 47 so it was worth a go.  I am going back to work tomorrow and am unsure how I will fair.

The rehab is long and time consuming.  I go to physio 3 times a week and to the pool as much as I can in between.  You must follow the OS's instructions to the letter to get the best results.

I don't regret having the surgery and hope it can save me from a TKR at a young age.

Offline jimbeaver

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Re: ACI Surgery
« Reply #14 on: October 13, 2002, 08:48:42 PM »
Dear all,

Thanks vm for your replies and kind advice!

I reside in Singapore and I believe I'm one of a few here who has this problem.  They have taken out a portion of
my cartilage and have sent in over to Australia for harvesting and processing.  My op for the implant will be
3 weeks after the harvesting.

I have decided to go ahead with it.  I have another session with my OS prior to the next op and I do have several questions for him,  having garnered some pointers through the postings here.
As mentioned in my earlier posting, I have lowered my
heightened expectations for this surgery.  I trusted my
OS entirely, and I take it that he will help me cure my
problematic knee.  But Im not so sure anymore, since this
is a very experimental surgery here.  

Having read the replies of gailg3 & noddy, I have turned positive again...but I know it's gonna be a long, hard, not to mention a painful road ahead.

Hope to hear from you guys on your progress, and I shall
definitely share my experience here too, since I will have plenty of time on hand during the rehab.   :-/

Wishing all of you a speedy recovery ahead!















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