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Author Topic: ACI and HTO on 10/22/07-It's going to turn out great!!  (Read 37876 times)

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Offline casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #120 on: April 15, 2008, 06:13:08 PM »
Spoke with my OS today via email to update him on my knee is doing now that I have been off the antibiotic.  Found out some info.  He said that 5-9 months is when I will see the most improvement and that it is important to remember that the cells continue to improve for up to three years...wow, I thought it was 18 months.  I am to wait 3-6 more months before I can even consider rock climbing (which was not really a surprise to me) and I need to wait until all the swelling in my knee resolves before I can try any hiking (which at this rate may be awhile).  So, I will just keep plugging away at my current exercises and hope that the swelling decreases soon!!
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 David3

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #121 on: April 30, 2008, 06:24:13 PM »
Hi Casey,   

Interested to hear how things are going after your scope. Is swelling still continuing to subside? ROM getting better? No signs of any recurrence of scar tissue?

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 casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #122 on: April 30, 2008, 06:58:26 PM »
David,

I posted my progress over in your post-op diary, but I figured I might as well post here as well.

I still have some swelling in my knee that increases and decreases with activity.  I have not seen much change in my swelling since my scope and to me it is still pretty swollen.  I have increased my time on the elliptical to 25 minutes and I am now walking on an incline on the treadmill for just a few minutes at a time.  No pain in the graft area when on the elliptical or treadmill. After about 7 minutes of incline walking on the treadmill, I start to limp just slightly and that is when I stop.  I get occasional pain if I move wrong or if I try to do the elliptical two days in a row.  I may feel some soreness, but nothing that is significant and it always goes away overnight.  I have had some pain on the lateral side of my knee which is not even close to my graft.  I'm not sure if that is scar tissue or the mechanics of my knee being altered due to swelling.  I am close to full ROM passively and am about 10 degrees off from full active ROM.  Still have a slight limp.  I'm happy with my progress at this point. 
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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #123 on: May 12, 2008, 01:57:16 PM »
I found out that Blue Cross/Blue Shield has decided that they are going to pay for my ACI procedure.   ;D ;D ;D   The claim for growing my cells was denied the first time.  I appealed it and the medical reveiw board approved it.  I anticipated a much longer battle to get it paid.  This is a huge relief!   
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 Peg Leg

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #124 on: May 12, 2008, 03:26:20 PM »
Casey,

That is great news!! I am sure you are very relieved!  A good early wedding present  ;)

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 celinenj03

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #125 on: May 15, 2008, 06:46:46 PM »
YAY! That is a big relief! You don't need that extra stress/worry. So how many days until the big day!!!! Maybe you could start another thread and keep us posted. We need good stuff to look forward to!!! Weddings, new babies, etc. It gets kind of hum drum around here sometimes so any thing you can share please!!!! ;)
Terrible Triad - 1/16/06 - Basketball
3/15/06 - Scope/Cleanout of to achieve full ROM
5/3/06 - Surgery-ACL Reconstruction-Allograft
9/12/07 - Large Loose body removed;Grade 4 Lesion on LFC
9/17/08-Microfracture, Lateral Release (all right knee)

Offline casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #126 on: May 23, 2008, 03:55:27 PM »
Well, less than a month until the big day!  I am getting married June 20th and can't wait.  I saw my OS yesterday to try and resolve some pain unrleated to the ACI before my wedding.  I've been having pain on the lateral portion of my knee right along the edge of my kneecap.  OS thinks it is patellafemoral due to muscle imbalance or the osteotomy putting some extra pressure in that area.  I am going to try a brace and celebrex to see if I can get it calmed down before the wedding and while I am away on my honeymoon.

As for the ACI, I am now 7 months post op.  I have a little bit of swelling.  My limp is pretty much gone, although I do still limp some after working out or sitting for an hour or more.  The limping doesn't last long and seems to quickly resolve itself.  I still feel like there might be just a little something off in my gait although my finance says I'm walking completely normally.  The graft area feels pretty good.  I overdid it recently as I was moving and had to do a lot of stair walking.  That aggravated the graft area and I got several sharp pains every day for about a week.  However, it calmed down and I am back to being completely pain free.  My OS said that the random pain is still normal at this point.  I am now able to walk on the treadmill at the highest incline level for about 8 minutes before I start to tire.  I am up to 30 minutes on the elliptical and can now do the elliptical more than one day in a row without any pain.  I can easily walk several miles.  My OS just cleared me to "try" some light hiking on level terrain.   I intend to be very cautious at first and test the knee out to see how it feels.  I do still have some difficulty with stairs which I'm sure is due to my still weak quads.  I am still shy of having full active ROM, but can passively achieve it.  MY OS's PA said that it will mostly likely come with time.  I see improvements each month with my knee.  Still happy that I had the procedure done!!!   
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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #127 on: May 27, 2008, 06:31:48 PM »
I took my first short hike yesterday since the surgery.  I walked for about 20 minutes on a trail that was mostly flat, but also had a few hills.  I hung onto my finance when going up and down the hills, mostly because my leg is still weak and I don't want to risk reinjuring myself.  The knee felt fantastic.  It did swell some and is still swollen today, but the swelling is not accompanied by any pain.  I plan to wait a few days and then go out again for a longer hike, increasing my time each time if the knee responds well. 
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 zoeygrl

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #128 on: May 29, 2008, 02:02:49 AM »
Hi Casey, I know your wedding is coming up soon and I wanted to say thanks for how much you've inspired me on this board. I am now 9 weeks post op HTO and ACI and feeling pretty good.  I too am a hiker and can't wait until I get back to hiking.   I havent been cleared to do too much more than walking weight bearing as tolerated and have much swelling and pain in the evenings. Once my OS clears me I'll be doing pool therapy and more pt.   I hope I'm hiking in 6 months!   

Anyway, congrats on your upcoming wedding and stay in touch!   

zoeygrl 
1989 first arthroscopic surgery to clean up knee
1992 2nd arthroscopic surgery for clean up of cartlidge flakes
1/24/08 harvesting of cells for carticel transplant
3/27/08 HTO and Carticel transplant

Offline celinenj03

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #129 on: May 30, 2008, 07:14:47 PM »
You gals are doing great! It's nice to hear such good results as I am a "pending" victim. haha.
Terrible Triad - 1/16/06 - Basketball
3/15/06 - Scope/Cleanout of to achieve full ROM
5/3/06 - Surgery-ACL Reconstruction-Allograft
9/12/07 - Large Loose body removed;Grade 4 Lesion on LFC
9/17/08-Microfracture, Lateral Release (all right knee)

Offline Peg Leg

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #130 on: July 14, 2008, 02:26:08 AM »
Congrats, Casey, on your wedding!! I'm glad to hear that it went well and that your knee behaved!  Sounds like your honeymoon was a lot of fun (at least the part you shared with us knee geeks ;D)!!!!!!!  Let us know how it goes with those screws and whether they have to come out or not.  Take care and don't be a stranger!!

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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #131 on: July 25, 2008, 04:17:37 PM »
Peg Leg...thanks for the wedding congratulations!  How is your knee doing these days?  Is the recovery from your recent surgery as long as ACI?  I HOPE NOT!

zoeygirl....Thank you for the wedding congrats.  I'm glad that my post-op diary has been helpful to you.  how is your knee doing? Are you completely crutch free now?

9 months post-op:  I am generally happy with my knee at this point.  I was able to do some hiking on my honeymoon.  One day we did about 4 miles of hiking.  It was broken up into several short hikes.  Another day, we hiked along the coast line in sand.  And another day, we walked along a bunch of broken lava rocks.  Overall, it did really well.  I would get occasional sharp twinges of pain, particularly when I was on lava rocks.  And when I say occasional, it really was pretty infrequent.  My knee definately swelled, but the swelling has since decreased.  Sitting on the plane for a long time was uncomfortable after awhile and caused swelling, but nothing major.  I did find myself limping after awhile on the hikes.  I was not in pain.  I think my muscles were just tired.  We did lots of walking in sand and I had no absolutely no pain.  My husband notices that when we go out for walks around the neighborhood that I start off going at a good pace and slowly my gait and pace decreases.  I typically don't even notice that my gait has changed. 

Even after a month of not formally working out, I was able to jump fully back into my workout routine within a week of returning from my honeymoon.  I can still tell that my gait is not quite right and my knee still turns in a bit.  After watching my wedding video and seeing that I am still limping a bit,  I talked to my PT about helping me with my gait and he suggested that I have a gait analysis done.  One where they use electrodes on your legs and feet and do a really thorough investigation of what is wrong with your gait.  I have that scheduled for next Thursday (given that insurance decides to pay for it).  Both my husband and I have noticed that since I've been wearing shorts, a lot of people stare at my leg.  I'm not sure if they are looking at my scar or my poor gait....probably both.

I can still tell that there is a good bit of weakness in my leg.  It is visible, as well as I can feel it.  I still have trouble with stairs, but see improvements each month in my stair walking. 

I've been having some pain in my knee where I think the screws are located.  If I work out too much, they get pretty sore.  I have thought about having them taken out, but I'm just not ready quite yet for more surgery.

Hope everyone is having a good knee day!       
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 Peg Leg

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #132 on: July 26, 2008, 01:23:31 AM »
Casey,

It's so good to hear that things are going well for you! It would be interesting to see the results of the gait analysis. I've noticed the same thing with people staring at my leg when I walk.  I assumed it was my big honking scar they're looking at, but it may be my limp!  You also mentioned feeling pain where you "think" your screws are; there's no doubt where mine are as you can see 1 and feel both!!  I have really skinny shins, so no where for them to hide!

As for the recovery from my AMZ and LR, I was told to expect about 6 months of therapy.  My PT says we are rehabing from all of my surgeries and not just the latest, due to the muscle wasting and the limping I've done for almost 2 years. True to form, my quads are being very slow to recover. I'm biking and swimming everyday and doing my PT exercises,so hopefully those quads will shape up soon! The really good news is when I finally get my strength back, I won't have any limitations with the Carticel!! ;D Yea!!!  I'm 13 months out from ACI surgery, and I have no pain in my MFC at all;  for that i am thankful.

Keep us posted on your progress; I miss hearing from you!

Peg
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 MegTX

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #133 on: July 26, 2008, 06:29:22 PM »
My gait's pretty ok... I limp some when I'm tired.  My husband tsks at me when I start limping.  :)

If I'm wearing shorts, people do tend to stare at the scar.  I've taken to wearing bermuda shorts and capris... the bottom part of my scar (below the kneecap) wasn't under much stress and it's healed to be not as visible and people tend to not see it as much... but if I'm exposing the kneecap and the area above it... that part was under tension with the CPM and healed much wider and is still pretty red.  It draws attention and I get stares.  Most of the time I don't care, and I've ended up doing a lot of explaining that no, I didn't have a knee replacement ... it's why I'm messing with some henna 'tattooing' and seeing about covering it up with something a little prettier. ;)
Lateral Release, Medial "Reef" - '91
{16 years of grinding, pain, swelling and lots of ice}
'scope 7/07 - .7cm2 tibial plateau microfracture, 2.5cm2 grade4 patellar CP debridement
ACI & Fulkerson TTT 2/08 (patella lesion then 4.5cmx3cm)

Offline casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #134 on: August 07, 2008, 04:01:50 PM »
Meg...My scar sounds just like yours.  The bottom part of my scar has turned white and looks pretty good.  The top part is still purple, although in the past month I have noticed that it is starting to look better.  I too wear bermuda shorts sometimes, but I also have shorts that are not bermuda shorts so my whole scar shows.  Sometimes, it is kinda fun to see who will stare at my scar....I know that it is just a natural reaction.  I work out at my PT clinic so it is mostly just patients and former patients at the gym.  I have made quite a few friends because people see my scar and want to know what I had done.     

Peg Leg...sounds like you are doing good.  I'm so glad to hear that you don't have any pain on the MFC!!  I bet you are really looking forward to having a "normal" knee again.  How long until you can start doing more things on your knee after your recent surgery? 

My gait analysis was a waste of time.  It was all computerized and it compared knee flexion, knee extension, hip rotation and force between the two legs.  Anything that was plus or minus one standard deviation from the norm was considered to be within normal limits.  Everything came up as normal for me except the rotation of my ACI knee which turns inward.  The test was done by an engineer who help design the gait analysis technology.  A PT came in at the very end of the test.  He looked at the results on the computer and said that everything was normal except for the rotation of the knee which he said was done to me on purpose by my OS when the osteotomy was done.  I was glad to hear that everything came up normal, but I asked him about my concerns that my gait is still slightly off and that I am still getting comments about my gait.  He just told me that the computer says that it is normal and that anything beyond that is between me and my OS or me and my PT.  He did not bother to actually watch me walk, he just went by what the computer said.  I was rather annoyed because I thought that they were going to really figure out what is causing my gait to be a little bit off.  Instead, they just went with what the computer said.  I understand stardard deviations quite well and I know that just because a result falls within the 'normal' range, that doesn't always mean that there is not a problem.  Oh well.  My PT is going to look at the report when I get it and see if he can't get to the bottom of my problem.  He suggested that maybe my problem is muscle fatigue.  It was kinda funny because the evening of my gait analysis, I had a friend over and my friend said to me "How is your knee because you look like you are walking kinda funny?"  I just had to laugh. 

I have noticed a big decrease in swelling lately.  I looked at my knees the other day and saw both kneecaps quite visibly. 

Still plugging away at my exercises to get my strength back. 

     
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















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