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Author Topic: A.C.I For Gibbon :)  (Read 23737 times)

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Offline bb_forrest

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Re: A.C.I For Gibbon :)
« Reply #15 on: November 14, 2007, 12:10:16 PM »
Interesting to see the different rehabs.

After surgery on Monday I am at home with a leg brace that keeps the leg straight.

Little bit of pain from incision when doing SLR's although there is pain from time to time from the muscles at the top of the leg. I find that some of the leg muscles start to flex from time to time and I have to make an effort to get them to relax, very strange feeling.

The OS has told the physio not to use the CPM machine at this time.

I'm going back to the hospital either tomrrow or friday to get another brace that will bend up to 60 degrees.

Back to see OS on 22nd to find out how the op went as I could have been out of it when he came to see me after the operation (that and the fact that I was in 3 different rooms on the day which is another story, at least the last room was pretty good).

I'm non weight bearing for 3 weeks and then back to physio to get the flextion set to 90 degrees and can start on partial weight bearing.

First day that I can start to put more weight on it rather than taking most of weight on crutches is Xmas day!

Offline casey2291

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Re: A.C.I For Gibbon :)
« Reply #16 on: November 16, 2007, 12:55:31 AM »
hey everyone,
I'm so amazed at how different your protocols seem to be from mine.  I guess they do things differently here in the US.  I have to wear some sort of brace for 3 months.  I was told this info before I even knew that I was having an HTO, so even if I had just an ACI, I would have to wear a brace.  I must say I am jealous of those of you who get to take your brace off and even ditch it all together.  I'm also impressed that you all were able to do a SLR so quickly after your surgery.  I am just a little over 3 weeks out from surgery and just today did my first SLR.  I am also surprised bbforrest that you get to start weight bearing at 3 weeks.  I am NWB for a full six weeks.  How long are the rest of you NWB for?  Sounds like you are all doing great...congrats and keep up the great work!!
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline Gibbon35

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Re: A.C.I For Gibbon :)
« Reply #17 on: November 16, 2007, 09:51:04 AM »
It does seem that protocols differ quite alot, and may not be injury site specific, but more OS specific. I am NWB for the full 6 weeks but have been asked to get 90 degrees flex by week 3........so i am. This is without a CPM. I am literally sliding my ankle up and down the sofa or hanging it over a chair to get a bend. Quite abit of disconfort but worth it as it is already at the 90 degree bend. Hopefully we are not pushing the graft to quickly.......time will tell.

G

Offline bb_forrest

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Re: A.C.I For Gibbon :)
« Reply #18 on: November 16, 2007, 10:59:51 AM »
Actually, I wonder whether the rehab is a combination of procedure and where it is on your knee.

I had a CaReS procedure that apparently speeds up rehab time. I will find out where the op was (rather than saying it was my knee I'll see if I can be more specific). This then mean that we can see what the criteria is.

Got new knee brace last night (in stylish black and gray - would look good with a tux) set to 60 degrees. Am doing leg bends lay on bed or sat on edge of bed and let leg bend slowly. Pain is not from where graft is but is from wound and scar tissue so not too worried about pain, that will pass. I'd say that I can bend to just over 30 degrees at present. SLR's are straightforward. The 1st tidy up op I had on this knee (last June) I could not do a SLR for about 2 weeks after, I literally could not get my ankle off the ground. I will never forget lying in bed at the hospital after that particular op and the physio coming in and saying do a SLR - trying and nothing happening. The thought that went through my head was $%^& - I'm paralysed. This feels so much better than that time!

Going to see OS on 22nd in afternoon to get staples taken out but physio took bandages off last night and put tube grip on. Left bandage above staples but could see most of knee, swelling is going down very quickly.

Feeling very positive, following rehab without being reckless. Hope you are all well.

I will go to partial weight bearing after 3 weeks, I guess taking 90% of my weight on the crutches but this is stuff I'll ask the OS about next week.

You all take care, I'm thinking of you.

Offline djs60

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Re: A.C.I For Gibbon :)
« Reply #19 on: November 16, 2007, 04:40:07 PM »
The site of the ACI makes a big difference.

If the aci is patello/femoral (patella and/or trochlea), then you do not need to be non-wt bearing, because the patellofemoral joint is not a weight bearing joint.  However, if you have some kind of realignment procedure with a patellofemoral ACI (such as TTO or HTO), then you usually have to restrict weight bearing while the bone is healing.

ACI on a femoral condyle does require non-weight bearing status, as it is a weight bearing joint.

That said, there's of course a lot of variability in what different OS think is best.

I had a patellofemoral ACI/TTO, and was told to wear my Bledsoe brace whenever not in the CPM or sleeping.  At my 6 week postop visit, I was told I could discontinue the CPM and the brace.  Truth be told, I did not always wear the brace if I was just sitting on the couch, but I was pretty good about using it when moving around.  As my quad atrophied, the fit was less & less secure...
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 gary55

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Re: A.C.I For Gibbon :)
« Reply #20 on: November 16, 2007, 07:20:47 PM »
Hi guys

I am due to go in for ACI with Tim Briggs at Bushey on 15th December-Just what I wanted for Xmas!

I had a skiing accident about 5 years ago (segund fracture of right knee) and tore ACL in right knee.

Original OS did not do anything after arthroscopy but subsequently after 4 years of slow deterioration I had ACL reconstruction in October 2006. Had difficulty with certain exercises and then I was diagnosed with Osteochondritis Desicans (disease which effects bone under the cartilage). In March 2007 I has arthroscopy and effectively a hole was drilled into damaged area for the grissle and bone to regrow-but didn't work.

The pain feels like bone on bone and is accentuated when I walk up stairs or worse still if I walk up a slope playing golf (my only sport over recent few years)

So now I am awaiting stage 2 of ACI and I have to say I found all of the various comments helpful.

Where is physio Fred based? I am in Aylesbury.

I should mention I am 55 (nearly 56) which is at upper age for this type of op.

I used to play lots of sport and in recent years and until just over a year ago plenty of cardiovascular exercise along with golf. Looking forward to post op recovery soon.

Offline Gibbon35

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Re: A.C.I For Gibbon :)
« Reply #21 on: November 16, 2007, 08:39:10 PM »
Interesting stuff there. I do find it quite strange that i have been told that i can literally bend the knee as much as i can after only 14 days. Truth be told im a holding back on this abit, as research has pointed to slow is better. The knee feels fine although a little stiff to be honest. The thing that gets to me is the not knowing.........if i feel a slight pain or twinge i immediately think of the worst. I spoke to Fred the physio and Tim about how easy it is to distrupt the graft or patch, and the response was quite interseting. Apparently they are quite secure and it would take quite abit of force directly on teh graft or a twisting mostion with wieight to break it. How true this is im not to sure about......but im not taking any chances :D

Fred is based at the Clinic in Park Street London. Same place as Mr Briggs the OS. I hope the surgery doesnt put you off xmas Gary.......take it as an opportunity to relax and eat lots of choccie :D

G

Offline charlesc

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Re: A.C.I For Gibbon :)
« Reply #22 on: November 16, 2007, 11:21:43 PM »
Tim also told me that it would be quite difficult to damage the graft too badly, but i agree - I'm not taking any chances with this, I've been given until after christmas off work, and can start working from home after that (quite generous and surprising of my employer - city bosses aren't renowned for being generous with time off).

I also find the difference in the non-WB and WB timings interesting - I believe it is a combination of the position of the defect (seems sensible to vary procedure according to this) and consistency of the cartilage in the treated defect. I have a rehab protocol from the Chester clinic (do most of the football teams around there) even though i'm being treated at The Clinic in London, and it talks about the consistency of the new cartilage being: like water @ week 1, like yoghurt @ 3 months, like dough @ 6 months, like cheese @ 9 months, like rubber @ 12 months. I presume that this is a similar timeline for all patients, so am surprised to see so much variation between protocols for similar defects...

Staples out on Monday, bring it on...
« Last Edit: November 16, 2007, 11:31:25 PM by charlesc »

Offline casey2291

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Re: A.C.I For Gibbon :)
« Reply #23 on: November 17, 2007, 12:33:20 AM »
charles...neat info about the consistency of the cartilage at each stage of the recovery.   thanks for sharing!
LOA #2 and hardware removal 12/15/08-new cartilage from ACI looks "GOOD"
LOA on left knee 3/18/07
ACI and HTO on left knee 10/22/07
scope of right knee on 6/21/07
microfracture left knee 3/18/05

Offline gary55

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Re: A.C.I For Gibbon :)
« Reply #24 on: November 17, 2007, 11:13:48 AM »
This info is fascinating to a new kid on the block and I am beginning to have more confidence in the post op recovery period.

When I first read about this ACI op it appeared that some odd machinery was needed and a long recocery cycle, bit it appears thing are moving on for most of you at a good pace.

I guess the twisting motion and shift of weight onto each leg could slow down playing golf too sonn- particularly if new cartillage is like yoghurt etc.

I will refrain from responding too often until I have had op and then maybe I can compare recovery stages.

Good luck to you all

G

Offline bb_forrest

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Re: A.C.I For Gibbon :)
« Reply #25 on: November 17, 2007, 11:20:00 AM »
Gary,

I play golf and my OS told me that I was not allowed to play golf for a year due to the twisting motion.

I suggest you ask your OS but I will not be playing next year at all.

Offline gary55

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Re: A.C.I For Gibbon :)
« Reply #26 on: November 17, 2007, 06:41:31 PM »
bb

Glad to hear I am not the only golf bandito up to no good.

I will make a point of asking OS how long before I can play. Looks like I will have to wait awhile before I turn pro!

It's taken me over 20 years to get to 16 h/cap.

G


Offline bb_forrest

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Re: A.C.I For Gibbon :)
« Reply #27 on: November 17, 2007, 08:24:13 PM »
Hhmmm,

I ain't playing you as I'll have to give you too many shots (I'd be Cat 1 if I had 2 legs).

To be honest though it never bothered me that much walking up slopes or stairs and I played at a hilly course.

Downhill and down stairs were a completely different matter however, serious pain.

The OS thinks the pain was due to where the knee was not secure and that the op will stop the pain, I hope so.

Then again as I told people when they saw me walking and saying that there doesn't appear to be anything wrong - If we were crossing the road and a car comes there will only be one of us who gets to the other side - it won't be me.

I'm handing in my resignation at the club I play at and will look around for another one to play at. I want a tougher course to play. Not as tough as Seascale which is the toughest course I've ever played (hope to break 85 there at some point).

Good luck with the op, if you are where we all seem to be within 2 weeks of op then Xmas will not be that bad, just don't drink as much!

Cheers

Ian (nickname was my Quake name back in the 90's)

Offline charlesc

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Re: A.C.I For Gibbon :)
« Reply #28 on: November 19, 2007, 04:46:16 PM »
Just back from Fred the physio - 14 staples out, feels so good. First step of rehab: get to 90 degs flexion... Got to around 75 degs already and have around 3 weeks to get the last 15 degs or so. Extension is already at around -4 degs, which is the same as my left leg, so pretty happy. The swelling is down nicely too. Have reasonable quad wastage, but not as bad as after my ACL. Lots of SLRs to do: did my first few today, though feel pretty week, and am yet to do one with full -4 degs extension, at the moment whenever i do one, my leg sags to about 0 degs, which is minor, but annoying.

More physio on wednesday and friday. Fun, fun, fun. Oh, and picked up the old bell from our front hall to summon room service as and when necessary. Family are gonna get annoyed soon!

Hope everybody is well.

Charles

Offline bb_forrest

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Re: A.C.I For Gibbon :)
« Reply #29 on: November 22, 2007, 06:35:02 PM »
Well, back from Surgeon.

He was happy with the surgery and told me to listen to the Physio as they have been briefed by the company who supply the procedure.

The bandages have come off, there are no staples, it is stiched and the stitches will dissolve.

The funniest bit (if your sense of humour is as sick as mine can be occasionally) was that they supply more than 1 graft.

When they put the graft in they bend and straighten your leg (before they stitch it) to check that the graft is ok and doesn't move.

Mine fell out....

So after using a 2nd one he checked it 7 times!

Eventually the representative of the company told him that he thinks that its all ok.

He's used Cartical and other varieties of this type of implant but he was very impressed with CaReS - basically it is almost like a sponge material that acts as a scaffold for the growth.

Swelling is going down but as I've had a tube bandage on it for a week there is a lovely pattern on my skin.

Oh well, at least I can now exercise and see my knee.

Physio on 4th December, partial weight bearing awaits after that.















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