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Author Topic: ACI Surgery on 6/28/07 on MFC  (Read 23252 times)

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Offline David3

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #30 on: September 13, 2007, 05:30:21 PM »
Good progress Peg! Must be exciting to be increasing your activity level. Keep working those quads!

You asked earlier about whether you should try and ween yourself off crutches or continue to use them. You are way ahead of me on this, so I don't have much personal experience to offer yet. However, when I saw Dr Minas last week for my 6-week follow-up, he gave me some advice about walking and WB. He said my knee would be more painful towards the end of the day because early stage cartilage is not able to retain water the way mature cartilage holds water in its matrix. That means that the water in your developing cartilage gradually gets squeezed out during the day, making the developing cartilage a poorer shock absorber late in the day.

His advice was: "Progress WB as per protocol. If, at any stage, it is painful to walk, especially late in the day, use your crutches more. Don't push the pain. If you are limping - especially if people say "David - you seem to be limping", that's a sign you need to be putting more weight on your crutches. Don't try and get by with a limp".

Hope that helps - sounds like you are doing well! 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 Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #31 on: September 27, 2007, 03:35:41 AM »
13 week update.....

It has been a frustrating couple of weeks of going back and forth between crutches and no crutches, but it has now been 3 days since I used them!!  I am walking better this afternoon than I have since I began wt.-bearing.  Of course, the way it has been going, tomorrow could be different!!  I had therapy yesterday and i got to 150 degrees but I still have a 6 degree extensor lag.  I  was able to do some wall squats...that was exciting!!  I'm going to get that quad fired up yet!! ;)   

Anyway, today I saw my OS and he wasn't too concerned about the walking issues.  He said if I was having issues with the ACI, that there would be a lot more swelling than I have.  He did say that I have patella femoral issues and this was having a negative affect on my quad muscles.  I am to focus even more on building them up and hopefully that will help to straighten it all out.  If it doesn't help, then we have another problem to deal with.  Not exactly what I wanted to hear!!  He also said I might have synovitis which couild be causing the tightness I feel behind the knee and would make full extension more difficult to achieve.  So basically, take 2 aspirin and see me in 3 months!!  What an emotional ride this is!!!

Peg Leg
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 kevinnjaime

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #32 on: September 28, 2007, 08:35:25 PM »
Hey Pegleg,

Great to hear that your PT is going well.  With the walking issue does your OS have you using any kind of brace?  When I got my brace it made a world of difference, it supported my knee side to side and allowed me to walk without the crutches for longer distances.  Now my OS stated that I could walk for a couple miles a day if I feel up to it.  Have you been doing leg extensions at home?  Doing them at home really helped me progress alot quicker even without any weight on my leg.  Just a idea.  Good luck.

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 Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #33 on: October 12, 2007, 01:43:55 AM »
It has been 15 weeks since the reunion and I am still waiting on the desert!!  Seriously though, I guess all considering, I am doing ok.  The walking has been a bit better yesterday and today, though there is still a nagging pain in my knee and a really good limp.  I am also having discomfort on the lateral side of the knee, probably due to IT Band tightness.  At therapy yesterday, I got to 152 degrees!!  So, at least there is no problem there!  My extensor lag dropped to 5 degrees, so there was a bit of improvement (the first in a while).  I have met with two reps about unloading braces and I am going to decide tomorrow.  Both of them show up for an appointment with a middle aged woman and bring braces that fall off my chicken leg!!!  I did have good results with one of them; I was able to walk without pain or a limp!!  Can't wait to try one that really fits!!

I have continued with knee extensions, SLR's, quad sets, leg presses at 40 lbs., wall squats to 90 degrees, 2" Step-ups, biking with a bit more resistance about 20 minutes a day, and swimming 40 laps a day with some kicking and lots of arms. I am going to start using fins in the pool to help with resistance, and I pool walk.  My PT told me to take a day off every now and then ;D!!  With all of this, my quad is still resisting my efforts.  It is firing, but there has been no obvious increase in muscle; therefore the chicken leg effect.  We have been trying to drop to every other week in therapy, but with continued pain and lack of improvement, we are still at 1x per week for now.

Take Care Everybody!!  Peg Leg
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

jonhark

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #34 on: October 12, 2007, 02:07:09 AM »
PegLeg,

I think everyone has different experiences with the surgery and their OS's protocol.

My defect is on the patella, so I'm sure our protocol will be different.

I had my 8 week check-up and my OS basically said no squats (even 1/4), leg presses, step ups, stairs, or pool work for six months. The idea is to keep the patellofemoral forces to a minimum.

My rehab protocol will consist of light biking, leg raises, and terminal knee extensions for six months.

Maybe try bringing the intensity level of your rehab down to see if there is an improvement in symptoms....

I've noticed my quad muscle tends to stop firing with knee pain no matter how much rehab I do. Your opposing leg will alway overpower it. The theory my OS offers is to get out of pain first then attempt to get the muscles firing and go from there.

Easier said than done, I'm sure....as I'll be eager to accelarate my rehab at 15 weeks.



Offline Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #35 on: October 14, 2007, 06:23:11 PM »
Thanks, Jon, for your input!   Since my defect is medial, my protocol is different from yours and my PT is very good about following it.  I was mistaken when I spoke of wall squats, I am only doing 45 degrees.  Anyhow, I have backed off some, mainly due to a very bad cold, and because I am trying out this new brace.  It definitely helps in that I can get into full extension without pain (something I can't do on my own), but it rubs my periosteum incision very badly.  I have until Tuesday to try it out, so we will see how we are getting along then!  I am seriously considering trying the Don Joy, also.  Enjoy the rest of this beautiful weekend!

Take Care,

Peg Leg
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 kevinnjaime

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #36 on: October 30, 2007, 05:55:50 PM »
Hey pegleg,

I was just wondering if you made your decesion on what brace to use and how everything is going with the strength in your leg.

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 Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #37 on: October 31, 2007, 02:08:34 AM »
Hey Kevin,

It's good to hear from you! Europe! Wow, I am envious!!
As for my knee, things are still dragging;  I tried an unloading brace, but it only helped temporarily.  It did relieve the aching I was having at night, though.  I am now trying a patellofemoral brace, since taping my kneecap was also helping.  I am not crazy about this brace because it really cuts into my leg.  I still bear the imprint of it almost 2 hours after removing it!!  I am waiting on the rep. to give me his opinion on what we could do next.  My quads are still not building up at all!!  I still have a 5 degree extensor lag, but with help from the brace, I am walking better.  I attended a football game Sat. night and had to walk about 6 blocks; The trip in was ok, the trip out was horrible. I was limping badly and in pain; so walking is still not good for me.  I can say that I have no pain in my graft site, it is all patella pain, so that is good news for the ACI surgery!! I'm really wondering how much the grade 3 defect under the patella is causing my trouble.
Are you still wearing your brace?  How long do you anticipate having to wear it?  When is your trip?  Have a blast, Kevin!!

Peg Leg
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 kevinnjaime

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #38 on: November 01, 2007, 04:32:46 PM »
Yes I still wear my brace when I leave the house but if Im just at home I don't wear it.  I dont really need it for short walks.  I will probably wear the brace for as long as I have to wear it and when I return back to work I will probably wear it under my uniform just for the support (just in case). 
I cant wait I leave in one week.  The only thing Im not looking foward to is the flight over.  We have to make a connecting flight on the way over and also on the way home.  A total of about 10 hours in the air.  I guess its not that bad with all of the history Im going to experience.  Well got to go I have a lot of packing to do and a lot of errands I have to run.  Stay stong and keep working on the quad.  I felt soooooooo much better once I got my quad strength back.  Good luck and Ill talk to ya later.

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 Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #39 on: November 14, 2007, 03:27:45 AM »
Hey Everybody,

I am and have been experiencing a deep ache in my knee joint at night for some time now.  I was wondering if this is from the ACI or maybe from my chondromalacia.  Does anyone else feel this?

I am the proud owner of a DonJoy unloading custom brace; I am really hoping this is the answer to my walking troubles.  Though, truth be known, I met my out of pocket max. and could get this $1600 Baby for nothing!!haha!  But, I'm still hoping that it brings me some relief and help.  I know the kneecap is not tracking properly, but a patella brace and/or taping does not help for very long, either. So, that brings me back to unloading the joint.  I definitely feel more comfortable with the support it gives my leg what with the weak quads and all.

At Pt last week, I still had the 5 degree extensor lag (in spite of lots of hard work!!) and Jason seemed to think my tibia was rotating inward.  Not exactly sure what this means, but it doesn't sound great.  Erinee, are you out there?!!  Maybe you can shed some light on this for me!

Take Care=======Peg Leg
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 and4400

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #40 on: November 20, 2007, 09:52:19 PM »
Peg Leg, How's it going I been  real lazy about posting but just wanted to say that I still have alot of aching in my knee too. The worst is on cold rainy days and night when I'm trying to sleep. I should say that I just went back to work last week after 13 months out so I'm walking alot more now. My leg hasn't really felt great ever yet so I'm  crossing my fingers that this will work. It's been alittle over four months since surgery so hopefully its gonna get better. How are you getting along with everything like walking, pain, swelling? since your surgery was two weeks before me. Andy
osteochondritis dissecans  RT. knee
Debridement Oct 06
Bone grafts 3x3cm defect MFC(harvest ACI)Dec 06
Scope Apr 07
ACI done July 07
Scope May 08,Scope Dec09
surgery #8 Oats(MFC) Open wedge HTO July 10'

Offline Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #41 on: November 21, 2007, 01:05:36 AM »
Hi Andy, it's good to hear from you!  I am doing ok considering everything!  To answer your questions, my walking is alright with the brace, though I still limp when I get tired.  My PT feels that my hip dips down on the right side, I think I am anticipating the pain from the patella. So, we are working on strengthening the hip. I have some swelling, but not a lot.  When I wake up every am, my foot and ankle are a bit swollen and I have some pitting of the skin. I still have some pain and the aching that I have mentioned.  The pain is not bad usually, but every once in a while it spikes up to where i take something like Tylenol or Tramadol.

I went to PT today and I still have the 5 degree extensor lag, in spite of all the hard work I have done ::) ::); very discouraging. Jason says my hamstring is doing all the work that my quad should be doing.  He also said that I had lost some ROM on the end range due to a tight patella tendon.  He worked on that and it is very unhappy right now :'(!  He also said that he was going to email my Dr. and let him know what's going on or not as the case seems to be with me!  I guess we'll just have to wait and see what's next?????

Take Care,

Peg Leg
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

jonhark

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #42 on: November 24, 2007, 03:38:35 AM »
Hey Peg Leg,
I've been watching your postings with interest as I had ACI on my patella about 14 weeks ago. Until a week ago i was still getting some discomfort with walking. My knee cap also felt like it was popping in and out, especially when I would lay on my stomach in bed. In the last week i no longer have any pain with walking nor does my knee pop.In fact, I was in Vegas all this week and walking all around the city with no problems.  It leads me to believe tracking of the knee is hugely important with the patella. There was probably some scar tissue stuck in the joint space that has broken up. I'm not pushing the ROM or working to free up my patella tendon. I've noticed this does irritate the graft. My plan is to really get after that around 6 months when the graft should be of a putty material. Anyways, as you know defects with the patella are really helped big time with a TTT. I had horrible malalignment and couldn't even spin a bike at light gears before my TTT in January. Now with the ACI in August my knee is finally starting to feel like it did 5 years ago. Another thing to inquire about is an X-Ray that looks down upon your patella in the groove with the knee bent. It is a good visual for showing the problem. Best of luck and we'll keep pulling for you.

Offline Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #43 on: November 25, 2007, 06:05:37 PM »
Jon,

Thanks a bunch for your words of encouragement; I appreciate it a lot!! ;D I'm glad that you are feeling so much better and were able to walk a lot in Vegas.  Were you lucky there as well?!!!

When I had my surgery in June, my Dr. said that I had no alignment problems at all, so a TTT was not warranted.  Since the quads have gone on strike, my patella has become more of an issue and I wonder how much the grade 3 patella defect is the culprit.  I am having more stiffness and general pain in the knee and I am tired of sitting here and obsessing about it so I think it is time to visit the Doc.! I will keep you posted!!

Peg Leg
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 Peg Leg

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Re: ACI Surgery on 6/28/07 on MFC
« Reply #44 on: December 02, 2007, 01:21:55 AM »
Alrighty Boys and Girls, time for an update!!

I FINALLY have a bit of really good news!!!!! At PT on Thur., my extensor lag was only 3; yea!!!!!!  The first improvement in 13 weeks!! My PT asked me what I had done differently and the answer was nothing.  I have been very consistent and persistant in my exercises and swimming.  I think it just took all that work to get the quad to wake up.  Before I raised the leg, Jason asked me to contract the quad like usual, and this time, there was visible movement! We were so surprised and shocked by this turn of events, that the extension was almost anti-climatic!!

The disturbing news is that my OS is apparently awol.  He has not answered either of our emails and it has now been 11 days since the first was sent to him.  I called his office and was only able to move my appt. to Dec. 12th, up 1 week, because he is not in the office much this month.  I sure wish my knee problems could take a vacation!! So, even though there has been some improvement, I still have some swelling, stiffness, aching, catching and clicking around the patella. Things that I will feel better discussing with my missing OS, considering that I am at 22 weeks.  We did regain the ROM this week with a great effort on Jason's part.  I tell him often, now, that I am shopping for a new PT because every week gets more and more painful!! :o   I guess with progress, I just need to suck it up and be a big girl!!

That's all for now; I'll keep you posted!

Peg Leg
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















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