Banner - Hide this banner





Author Topic: ACI and HTO on 10/22/07-It's going to turn out great!!  (Read 37973 times)

0 Members and 1 Guest are viewing this topic.

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
ACI and HTO on 10/22/07-It's going to turn out great!!
« on: October 18, 2007, 04:05:16 AM »
Hey everyone,
I've been lurking around the ACI board for a month or so reading everyone's posts.  Everyone has a lot of insightful information.  On Oct. 22,  I will be having ACI and a HTO with Dr. Andrew Levy in New Jersey.  I'm looking forward to this being my last surgery on this knee for a LONG time.  I will post how things go as soon as I am able to get online after the surgery.
« Last Edit: November 12, 2007, 01:05:16 AM by casey2291 »
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 kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: Surgery on Oct. 22-follow my progress
« Reply #1 on: October 18, 2007, 07:49:41 AM »
Good luck for your surgery. Don't know if ACI is suitable for me but am keeping an eye on these posts so that I can make an informed decision when the time comes for more surgery.

Hope all goes well.

Kathy

Offline kalyjoe

  • Forum Faithful
  • ****
  • Posts: 185
  • Liked: 0
  • User's Text
Re: Surgery on Oct. 22-follow my progress
« Reply #2 on: October 24, 2007, 03:47:04 PM »
Hope the surgery went well.  Post when you can to let us know how you're doing!!!  Good luck!   :)

Kristi
2 x 1.2 cm defect of right medial femoral condyle
Microfracture, right knee, October 18, 2004.
MACI using CaReS, same knee, November 30, 2006

Offline casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Surgery on Oct. 22-follow my progress
« Reply #3 on: October 26, 2007, 03:08:23 PM »
Thanks Kathy and Kristi for your kind words.  Kristi, I think you and I chatted over email last fall or so.  I have read though most of your posts regarding your surgery.  I hope things get better for you!!!

4 days post-op:  My surgery went well.  I had both the ACI and the HTO done.  I don't know the details yet as to how large my lesion was.  I will find all of that out next week when I go in for my post op visit.  The surgery took about two hours and was done on an outpatient basis.  I felt terrible when I first woke up in the recovery room.  I was extremely nauseas and ended up getting sick from the anesthesia.  They put a femoral block in my leg in the recovery room which I didn't even feel because I still half out of it and was feeling so sick.  The femoral block lasted for about 24 hours.  I was also sent home with a pain pump in my leg which stayed in for the first five days post op.  I spent the night in a hotel as my surgeon is 3 1/2 hours from my house.  I had some moderate to severe pain the first night as I didn't quite have my meds figured out yet.  I also had a good bit of pain on the way home in the car the next day.  Every bump in the road caused my knee to hurt and I ended up getting sick again on the way home despite the medicine that I was taking for nausea.  I felt nauseas for the first 24-48 hours post-op until the anesthesia was completely out of my system.  My pain has been on and off and ranges from moderate to severe.  For the most part, my pain is under control.  I usually get pain when I get up to move around or when it is close to time for me to take more meds.  The pain can be severe at times, but once I get some meds in me, I am fine.  I was taking oxycotin and percocet.  I am no longer taking the oxycotin and am just taking the percocet.  I have an immobilizer brace that I have to wear for the next six weeks.  The only time I am allowed to take it off is when I am in the shower and even then I have to keep my leg propped up so it is still straight.  I have to wear the brace while in the CPM machine but I change the flexion on it so that my leg can move with the machine.  The PA said that I need to wear the brace in the CPM because of the bony work that they did.  The CPM machine is a breeze.  Sometimes, I have some pain as the machine hits the 0 degree extension mark, but for the most part is not so bad.  I also try to make sure I have meds in me before I get in the machine.  I have to do eight hours a day in the CPM which I have been breaking up into 2, 3 or 4 hour time slots.  Overall, these first few days have been rough, but each day I see improvements in my pain and how I am feeling.  Thank goodness for my fiance who has so kindly taken care of me.  I would have never made it though these first few days without him.  He has gotten up in the middle of the night to change the ice in my ice machine, help me get in and out of the CPM, gotten me food, meds, etc.  I was uanble to get in and out of the CPM by myself for the two days.  I am just now able to do it myself.  My leg was just so heavy that I couldn't do. I took the dressing off of my knee yesterday and I have an incision that is about 6 inches long and has 25 staples.  I couldn't believe how big the incision was.  I was not expecting it to be that big.  My fiance's sister is a surgeon so I had her check out my incision and she said that it looks good.   I do have an area of redness that she thinks is brusing.  We marked it with a pen to make sure that it doesn't get any bigger.  She is going to look at it for me again sometime in these next couple of days.   I am looking at this procedure as an investment in my future and my fiance's future.  We both love doing sports outdoors and I think that this surgery is what is going to help me to return to the things that I love.   I am hopeful that by writing my progress down that it will be helpful to future ACI candidates.
 
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 kathat

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1520
  • Liked: 1
  • Aussie, Aussie, Aussie
Re: Surgery on Oct. 22-follow my progress
« Reply #4 on: October 26, 2007, 03:20:03 PM »
Great to hear you got through surgery with no complications, and are on the road to recovery. When do you start PT? How long do they expect you to be in the brace? Are you on crutches? Are you non-weight-bearing on the leg? Make sure you keep us posted! Wishing you a speedy journey to less pain.
Best of luck,
Kathy

Offline djs60

  • Regular Poster
  • ***
  • *
  • Posts: 141
  • Liked: 0
Re: Surgery on Oct. 22-follow my progress
« Reply #5 on: October 26, 2007, 04:36:41 PM »
Hi Casey,

Your post brings me back (today is 6 months since my patellofemoral ACI & TTO).

I'm kind of amazed you went right home - I was in the hospital for 3 days, and I really don't know if I could have managed at home for the 1st couple of days.

Where exactly was the lesion that was treated with aci?

Good luck & keep us posted!

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 casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Surgery on Oct. 22-follow my progress
« Reply #6 on: October 27, 2007, 11:47:40 PM »
Hi everyone,
My lesion was on the medial femoral condyle.  I don't know how big it was yet.  I will find that out on thursday when I go back for my post-op visit.  I am non-weight bearing for 6 weeks and will have to use crutches for at least 8 weeks.  I will start doing SLR's at two weeks on my own and formal PT won't start until 6 weeks.  I stopped taking all pain meds and am now just taking tylenol.  I got tired of feeling dizzy and gross everytime I got up to move around.  My knee does not really hurt at all when I am laying down.  I did have one bout of pain this afternoon that I took tylenol for.  It does hurt a good bit when I am up and moving around or sitting in a chair with my leg propped up.  So, I've been spending most of my time in bed.  I'm getting really antsy to get up and move about but the pain that I feel when I am up is not worth moving around.  I'm hopeful that this pain will pass really soon.  My lower calf is really swollen, more swollen than my knee so I've been using the ice machine on it which has helped.  My finance's sister who is a surgeon has been checking my wound each day and my calf to make sure that I don't get a blood clot.  She says everything looks good and that my calf is not as swollen as yesterday.  Having her around is a real relief especially when my calf swelled up so big.  I am starting to get some brusing on my calf and around my knee.  Well, back to the CPM machine. 
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 casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Surgery on Oct. 22-follow my progress
« Reply #7 on: October 30, 2007, 04:21:49 PM »
I have survived the first week.   I have been having severe pain in my calf when I get up and move around.  I called my OS yesterday and was told that the calf pain was normal after this kind of surgery.  They prescribed a very low dose of an anti-depressant medicine which will inhibit the nerve fibers in the leg.  I took the first dose last night and strangely enough I feel some improvment in my calf today.  Still pretty painful but I will take any small improvments.   Each day I feel a little bit better.  I'm anxious to be totally pain free so that I can get up and move about.  Even if I have to be on crutches, just moving around would make me feel more normal.  I'm getting antsy because I am pretty much stuck in bed because of the calf pain.  I am now up to 55 degrees in the CPM.  I'm still icing each day.  I use the ice machine for about 4 hours each day.  The swelling in my calf is decreasing and I'm pretty happy with the swelling in my knee.  Yesterday, I was even able to put my own sock on which I couldn't do before...oh the excitement of the small improvments.  ;)   
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 djs60

  • Regular Poster
  • ***
  • *
  • Posts: 141
  • Liked: 0
Re: Surgery on Oct. 22-follow my progress
« Reply #8 on: October 30, 2007, 04:36:32 PM »
Hi Casey,

I remember having a lot of pain in my shin area (where they took the periosteum for the graft covers) - it was particularly bad any time I stood up.  In fact, I remember avoiding drinking too much, as I didn't want to have to get up to hobble to the bathroom.

If I remember correctly, this suddenly got a lot better at about day 10.

Hang in there,
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 kevinnjaime

  • Regular Poster
  • ***
  • Posts: 72
  • Liked: 0
Re: Surgery on Oct. 22-follow my progress
« Reply #9 on: October 30, 2007, 06:05:29 PM »
I am three months postop and the one thing that bothered me was not being able to leave the house on my own.  When my wife would come home from work I would have her just drive me around in the car just to get out.  I agree with djs if the pain is in the front of your calf it is probably from the grapht that they took but if it is in the back of your calf it could be a clot.
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 casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Surgery on Oct. 22-follow my progress
« Reply #10 on: October 31, 2007, 07:17:48 PM »
Thanks DJS and Kevin for your input.  I actually only have one incision instead of two.  My OS said that he was using a graft other than periosteum which avoids the second incision and the tissue seems to work better and be more consistent.  I'm not sure that I really understand that, but that is what he told me over email when I was asking him about the second incision.  My calf pain is a little bit better than it was over the weekend.  The med that I was put on for calf pain is keeping me awake at night.  I see the OS tomorrow and will ask if I should be concerned about a blood clot.  I got out last night for a few hours which was very nice.  My fiance took me to my house to pick up my mail and a few things.  I'm really anxious for this calf pain to go away so I can have a little bit more freedom.  For those of you who have been through this surgery, when did you start PT and SLR's?  I've been trying the past couple of days to do a SLR but I am unable to do one.  I've been trying to just squeeze my quad muscle to get it to fire. I can feel it moving so that is good.  I'm trying my best to just enjoy having all this free time on my hands.  When else do you get to relax so much?    :)
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 kevinnjaime

  • Regular Poster
  • ***
  • Posts: 72
  • Liked: 0
Re: Surgery on Oct. 22-follow my progress
« Reply #11 on: November 01, 2007, 04:36:49 PM »
Casey,

I started my PT one week after the surgery and I was put on the CPM machine immediately after the surgery.  I just was taken off of the CPM my OS kept me on it for 12 weeks.  Once you are able to get the quad firing you will feel a lot better I did.  It just took about 4 weeks for me to see a difference in the strength in my quad.  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 djs60

  • Regular Poster
  • ***
  • *
  • Posts: 141
  • Liked: 0
Re: Surgery on Oct. 22-follow my progress
« Reply #12 on: November 01, 2007, 05:26:37 PM »
casey,

I started outpatient PT 19 days after my surgery.  I think I had too much swelling & limited mobility to do much before then.  I used my CPM machine for 6 weeks.  I don't remember doing SLRs early on - I don't think I could.

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 Peg Leg

  • Forum Faithful
  • ****
  • Posts: 495
  • Liked: 0
Re: Surgery on Oct. 22-follow my progress
« Reply #13 on: November 02, 2007, 12:50:22 AM »
Hi There Casey!

My name is Robin and my defect was also on the MFC; my surgery was 18 weeks ago today.  I started PT 5 days post-op and I could not do a SLR for almost 3 weeks; so don't be too hard on yourself just yet!  Keep working those quad muscles!!  Lots of good books and movies help time to pass nicely  :D!! Take care and keep us 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 casey2291

  • SuperKNEEgeek
  • *****
  • *
  • Posts: 1011
  • Liked: 0
  • User's Text
Re: Surgery on Oct. 22-follow my progress
« Reply #14 on: November 02, 2007, 03:03:53 PM »
Thanks everyone for answering my questions!!  I had my first post-op visit yesterday.  I had half of my staples removed and I will remove the rest of them next week on my own.  Typically, I would have to go back next week to remove the rest of the staples but since I live 3 1/2 hours from my OS, they suggested that if I was comfortable taking them out, that they had no problem with that.  Both the PA and the OS were pleased with how things are going so far.  I have four screws and one plate in my knee from the osteotomy.  My lesion was about 2X2 sq. cm.  They used horse pericardium as the graft which is why I had just the one incision instead of two.  I was told that I have a high chance of this surgery being successful based on where the lesion was on the medial femoral condyle and the size of my lesion.  I was told to work my way up to 90 degrees in the CPM, but that I don't have to go beyond 90 degrees because anything beyond 90 would not be of any benefit to me.  I will get a new x-ray at the beginning of december and then return for another visit on dec. 6.  If everything is going well, then I will get to begin weight bearing and get to unlock the brace.  The past two days, I've been having some sharp pains in my knee when I move.  I think it has something to do with my incision and not really my knee.  I'm having trouble figuring out exactly what is hurting.  My calf pain is better than it was but it is still not gone.  The PA suggested that I trying stretching it and putting heat on it.  I can tell the muscles are really tight.  So, I'm gearing up for five more weeks in the CPM and to begin doing some isometric quad exercises and hopefully in a week or so to be able to do a SLR.  The OS said that he would not expect me to be able to do a SLR for at least two more weeks.     
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















support