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Author Topic: ACI and HTO on 10/22/07-It's going to turn out great!!  (Read 38055 times)

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Offline kathat

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #45 on: November 22, 2007, 12:58:18 PM »
I can understand why my OS is holding off at the moment. I am still fresh out of my LR surgery and I have very weak quads, so there is no support for the knee joints. I need to build up the muscles to help support the knees, which takes time. Once I have better muscular support I should be in less pain, so my OS wants to wait to see how much things improve. Also I need to be in better condition before more surgery anyway. I can't afford to lose much more muscle. I am not sure I am ready for ACI surgery just yet either. I want to see if PT helps. Sure, the gnawing ache is really depressing at times, and is so hard to get on top of, and it doesn't seem to be improving at all, but I have a long way to go before I am ready to say I have given things my best shot. I look at how difficult the rehab is and how much difficulty many of you have with it and I know I can't go through it all just yet, especially if I go bilaterally. I want to prepare physically and mentally, as well as set things up so that I can take paid leave from work and my hubby can take leave too, to help me and run around after the kids. The longer I can hold off, the more paid leave I will have accumulated, and the less financial stress the surgery will have on the family.

Offline Peg Leg

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #46 on: November 22, 2007, 01:27:13 PM »
Happy Thanksgiving, Everybody!

My knee is as unhappy as most Turkeys are, today!!  I have also been up with pain the last couple of nights, so we should have a late hour pity party!!  I think my pain is a result of PT on Thursday, he really hurt me going after that tight patella tendon.  He also said this was the way it would be for awhile until we get things loosened up.  Sounds like he's trying to scare me off!! :'(

Casey, I am still going once a week.  At 21 weeks, I should have scaled back around 10 weeks to every 2 weeks or so, but my continued problems have prevented that.  I am still stuck at the 2nd phase of rehab because of muscle weakness and extensor lag.  My Insurance quit paying 6 weeks ago, so I am out of pocket!! :o  My PT, Jason, has become a very good friend and supporter, so I tell him he's cheaper than a psychologist.  He helps me to work through all those insane feelings we go through!  Casey, you WILL be stronger for getting thru this, just realize that you are building character and strenghth along with cartilage!!! Something that most people cannot say!

Blessings!  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 #47 on: November 28, 2007, 10:13:58 AM »
Kathy...I keep forgetting that you just had lateral release surgery.  I can understand wanting to have strong quads and being totally prepared for ACI before you have it done.  It is a big committment and involves lots of down time.  I'm hoping that as your quads get stronger that your pain will decrease. 

Peg Leg...I feel sorry for you that you have to pay for PT out of pocket!!  Were you able to get any kind of discount from your PT place since you are paying out of pocket...like paying the discounted rate that most insurance companies pay?  How's your pain?  Is it still keeping you up at night?  It is 5:00 am here and I've been awake since 3:30 am.  I figured I might as well just get up and hop in the cpm machine and get a few hours in.  This time it is a sore back that is keeping me from sleeping.   

I had an improvement in PT this week.  I got up to 90 ROM for my knee.  I was at 76 when I started a little over a week ago.  I also went from -12 to 0 degrees for the ROM in my ankle.  I was pleased with my progress.  I am still having some pain when in the cpm machine...mostly in the last few degrees of extension.  It feels like it is right on the cell site.  It is annoying to say the least.  I also still have some sharp pain in my knee when moving wrong.  I am having a hard time determining if it at the cell site because it is around my incision, however my PT said that doesn't mean that it is not the cell area that is causing the pain because the pain can defer itself to other areas.  I can see that I am making some slight improvements in my strength.  SLR's are getting a little easier each day and I can see some improvment in the other exercises that my PT has me doing. 

Only 8 more days until I see my OS.  That means if all goes well, ONLY 64 more hours left in the cpm machine.  I CAN'T wait to ditch 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 Peg Leg

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #48 on: November 29, 2007, 01:48:59 AM »
Casey,
Good news on the ROM improvement!! Sorry to hear you're not sleeping well, either.  My back would get so sore sometimes that it bothered me more than my knee!  About the other pain; I had pictures of my knee open during surgery, if you saw what they do to your poor leg, you would understand why you have pain!!! Seriously though, that pain will get better with time as everything heals.
As for my expenses, I do pay the discounted rate the ins. company pays.  I would not still be going every week except for the fact that I am struggling with the weak quads and extensor lag along with the patellofemoral issues.  If I hurt as bad after tomorrow as I did the last 2 weeks, I may drop down to every other week.  I am not seeing the results for the pain I am experiencing. For the most part, my pain is better.  I did have a really bad ache deep in the joint last night; but hopefully it won't come back tonight!
Good luck on losing that CPM machine and sleep tight and sweet dreams tonight!

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 kathat

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #49 on: November 29, 2007, 11:31:08 AM »
Hey Casey,
I'll keep my fingers crossed that you get to ditch the CPM!! Sounds ghastly. One thing I definitely am NOT looking forward to! Well done on the ROM increase. Now that you've hit 90 things should fly along! It certainly is hard to figure out where pain is coming from. I get aching in my right foot, which I can only assume is referred from my knee, as I never get foot pain without knee pain, but I get knee pain without foot pain. Make sense?!

Our insurance works differently here. We pay part of every PT visit, and insurance pays part. There are sometimes limits on how much insurance will pay per year, depending on the level of insurance. With my insurance, if we use "insurance promoted" PTs then insurance pays more and we pay less - my PT isn't one of them!!

Sweet dreams guys!!

Kathy

Offline kalyjoe

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #50 on: November 30, 2007, 01:28:40 AM »
Hi Casey.  I feel for you with the back pain and the CPM machine.  Reading your posts bring back so many memories that I think I blocked out b/c I was so miserable at the time.  :-\   But...all I can say is...it does come to an end.  I despised that CPM as well by the end and was really excited to finally ditch that damn brace!  I felt like I won the lottery when I was able to sleep in a different position than lying on my back.  It seems like your time is going pretty fast and those milestones will be here before you know it.

Great job on the ROM!  You are a very hard worker and very dedicated so I'm pretty confident you are going to have great results.  Every little step forward in this process is a HUGE victory so celebrate them all. 

Hope you get a good night's sleep tonight.  I do recall that when I was having those issues, I took my pain meds just to knock me out so I could sleep.  I didn't do it on a regular basis, just when I was desperate.  But it did help. 

Keep up the great work!   :)

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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #51 on: December 02, 2007, 12:34:18 PM »
Hey everyone,

Kristi, Peg Leg and Kathy....thanks for the words of encouragment!!

I am up to 95 degrees ROM in therapy on my knee.  I've been having a lot of pain in my knee (really intense pain) when I move my leg wrong.  I have no idea if this is normal or not.  For example, yesterday, I was doing an exercise where I lay on my stomach and put a rope on my ankle and work on pulling my ankle towards my butt.  The exercise went well, but when I tried to roll over off of my stomach, the pain was terrible and I could only get part way over and then stopped and rolled back on my stomach which made the pain even worse.  In therapy, when the PT first starts to bend my knee, it hurts really bad as if there is something catching.  Once he bends it beyond the first 15 degrees or so, the pain disappears.  This didn't happen when I first started therapy.  It seems that my knee hurts worse now that I have started therapy.  I know that increased pain with therapy is normal, but I worry that it is too much for the graft so soon.  It hurts to do my SLR's and I can't do the SLR's laying on my one side because the pain is too bad.  I go to see my OS in a few days, so I am anxious to talk to him about my pain and see if it is normal.  He did tell me at the last visit that I would feel all kind of strange things, so I keep reminding myself of that.  It just seems to me that at 6 weeks post op that the pain that takes your breath away should be gone by now. 

I'm finally starting to sleep a little bit better.  These past couple of nights, I actually only woke up about two times and got to sleep in until 5:30am which is an improvement from 3:30 or 4:00 am.  I am now able to partially lay on my side for longer than an hour which is helpful. 

I go on Tuesday to get an x-ray of my leg to see how the osteotomy is healing.  I'm looking forward to seeing the x-ray so that I can see all the hardware in my leg.  I'm praying that the x-ray turns out well and the bone is healing perfectly.  I'm very hopeful that when I see the OS, he will allow me to begin to weight bear, ditch the cpm machine and let me unlock the brace.  I'm going to ask if I can get an unloader brace instead of this ridiculously huge one that I am wearing now.  I was told that I would wear some type of brace for three months psot-op and my ACI protcol says that at 6 weeks to consider an unloader brace.  Only four more days until I see the OS and only 31 more hours in 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 kathat

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #52 on: December 02, 2007, 09:32:08 PM »
The countdown begins.....! Some other ACI posts mention overgrowth of the graft being a problem, so maybe it's the cause of your extra pain. It's great that you're getting some more sleep. Lack of sleep can be so draining. I have found it the worst part of knee surgery/problems. Good luck on Tuesday!!

Kathy

Offline casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #53 on: December 05, 2007, 09:04:50 AM »
Right now I seriously REGRET having this surgery done.  I am six weeks post-op and I have a lot of sharp pain in the knee.  It is to the point where I don't want to move because I know that any slight movement might cause a sharp pain.  I don't want people touching me because if they move me wrong, then I might get a sharp pain.  I don't want anyone sitting on my bed because the wrong movement of the bed might disturb the knee and make it move the wrong way causing sharp pain.  I can't sleep at night because when I move, I get pain in the knee.  I am supposed to go back to work in three weeks from today and right now, I can't even imagine that.  I know that everyone says that this surgery requires patience, but I didn't know that it was going to feel like this.  Lately, I feel like the pain that I had before this operation was not nearly bad enough to justify this operation and I wonder if I made a mistake and should have waited until I was in a lot more pain.  I can't seem to find any stories on here where anyone who had this operation done had sharp pain like this at 6 weeks out.  So, if anyone out there had this kind of pain, I would really appreciate them posting.  I'm not sure if it is because my quad muscles are just so weak that they can't support any movement of the knee or if something is not going right with the cells.  I would feel better if I was seeing improvment in the pain but I have had these sharp pains for weeks now.  For a short period of time they got better  and now lately they seem to be getting worse.  I go to see my OS tomorrow and I'm hoping that he will be able to give me some reassurance that everything is ok.       
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 kalyjoe

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #54 on: December 05, 2007, 07:56:07 PM »
Awwww...hey girl.  Hang in there.   :-[

Remember, it is only six weeks.  I know it is hard being patient (believe me...I KNOW...go back and read all my frustrations) but honestly in the grand scheme of A.C.I., six weeks is relatively early.  In fact, it is crazily early!  I believe it's normal to have any kind of pain right now.  I mean, think about the procedure they performed on your knee.  I know it's hard, but try to stay positive.  One of the worse things is not knowing....I know.  You wonder if the graft is gone.  Did it just, wipe off and all this is for nothing?  Unless you went and and did some crazy impact work on your knee (which I know you did not) that probably did not happen.  Could you possibly be doing too much at PT?  I know for me...when I was in PT...he told me that anything that caused pain to the implant site should be stopped.  It wasn't easy for me because I really wanted to progress. And keep in mind as well that the weaker your quad is, the more pain there seems to be in your knee.  At least for me that is true.  And that is frustrating b/c how do you build up your quad without causing any stress to the site?   ??? It's hard to know what's going on inside that knee.  You need to be cautious and most importantly.....PATIENT.  This surgery is totally a one step forward two steps back kind of thing.  Not easy to deal with I know.  But it is way to early to fear the worst.  I think you will feel better once you talk to your OS tomorrow.  I will be thinking about you and sending you positive vibes and be sure to post when you can.  Feel free to email or PM me if you need to vent some more.  I know I can say for sure that I know exactly how you feel.   :)

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 kathat

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #55 on: December 06, 2007, 06:37:14 AM »
Oh Casey! I'm sorry to hear that you're feeling crap. Pain is just so demoralising and depressing. Hang in there and take it easy for a bit. If you hadn't had the surgery done then you'd be in a downwards spiral of pain, and the knowledge that it doesn't improve would probably have you feeling worse than you do now. You have been proactive and tried to do something about your pain, but it involves a long painful journey as part of the process. I am currently feeling worse than I ever did before my LR and chondroplasty, but I have to keep in mind that my quads have taken a major blow and that if I hadn't had the surgery then I'd still have excessive pressure under my patellae causing further cartilage erosion, and my quads probably would have bit the dust anyway due to the longstanding pain I have had. So OK, I feel bad now, but if I hadn't done anything then I'd probably be in this position and getting worse within a short space of time anyway - I was on a downwards spiral when I decided to see an OS. Now I know my tilt has been corrected and I know what damage I have in my knees so I can adapt my activities to suit.

Feel free to vent as much as you need.

Best wishes,

Kathy

Offline Peg Leg

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #56 on: December 07, 2007, 01:56:52 AM »
Casey,

I am anxious to hear from you.  What did you find out at the Dr. today?  How is your pain?  I'm so sorry that you are having such a hard time.  Please let us hear from you, soon!

Hang in There........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 kalyjoe

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #57 on: December 07, 2007, 03:04:10 AM »
I've been thinking of you too Casey.  I really hope you got good news. 

And if you have a pity party, let me know because I'm sort of having one myself.   ;)

Post when you can...we're anxious to hear your news.

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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #58 on: December 07, 2007, 04:00:05 AM »
Hi everyone,

Kristi...no pity party for me today, but I've had so many lately, that I'm sure that I can empathize.  What is up?  Fill me in!

Kristi, Kathy, Peg leg....Thanks for asking how I am doing and thanks for your encouraging words and for just understanding what I am going through.  It really helps to know that other people understand!!!  Thanks for helping me to rationalize that I probably shouldn't regret having the surgery just yet.  I was just so frustrated with my pain yesterday that sometimes my ability to be rational goes out the door.  I hope that all of you are having a good knee day and that each of you are feeling at least a little better.  I hope the three of you feel free to vent to me if you ever need to.  I know that you have each helped me as I go through my recovery.   

Today was a good day!!!  I saw my OS and he gave me the go ahead to start weight bearing.  I am allowed to weight bear as tolerated and ditch the crutches when I feel comfortable (although I am to work with my PT and allow him to help me make the decision as to when I should really ditch them).  I am allowed to unlock my brace and I don't have to sleep in my brace any longer.  And I am done with the cpm machine!!  Can I say that just one more time...I am DONE with the cpm machine!!   ;D ;D My OS said that the x-rays of my osteotomy looked great.  I have to continue to wear the big immobilizer brace (unlocked now) for the next five weeks.  I asked about getting an unloader brace and I was told that I have to keep the big one because of the osteotomy.  I am to wear my brace whenever I am up and walking but can take it off if I am just sitting around the house.  I am happy with how my knee feels when putting weight on it.  I am not able to fully weight bear yet and need both crutches.  I tried to walk with just one crutch at the doctor's office, but my leg feels way too weak for just one crutch.  I am putting maybe 30-50 lbs of weight on my leg.  I noticed that towards the end of the day today, I was starting to feel a little soreness in the cell area.  The area where the screws are in my leg is pretty uncomfortable.  Not painful, just uncomfortable.  I'm hoping that with time I will get more used to the screws being there.  My OS said that there was not really any time line for ditching the crutches and to just do it as I felt comfortable.  Since my brace has been unlocked, I have only had a few sharp pains in the knee.  A big difference from yesterday, so I am very happy about that.  I asked if the sharp pains were normal and I was told that it was hard to tell what exactly was causing the pain at this point, if it was from weak muscles, the cells, the incision or what and that it was not necessairly abnormal.  My OS told me to expect pain and that I should see improvement between the 4-6 month mark.  He reminded me that we all heal differently and that at this point that I was to use common sense when recovering (i.e. increased pain and swelling means take a break).  He said that aside from going out and doing impact activities or falling or just doing something stupid that I was not likely to blow the graft.  He said that in all the ACI surgerys that he has done (somewhere around 100) that he has only had two people who destroyed their graft and that when it happens that you know it.  He told me that it was ok to do my PT exercises even if I had pain.  I have decided to sleep in my brace tonight with it unlocked at about 75 degrees.  I feel more comfortable that way right now due to the sharp pains that I have and I want to prevent myself from rolling over on my stomach which causes major pain.  Because of my poor quad control, I don't feel good about rolling around in bed without support to the knee.  My PT wrote on my progress report for my OS that my quad control and quad strength was poor.  My goal is to be off of crutches by Jan 2 when I return to work.  My PT thinks this is a reasonable goal.  I hope that it is achievable.  I am scheduled to go back to see my OS in five weeks and I am to email him an update each week on how I am doing.

 

 

       
« Last Edit: December 07, 2007, 10:54:54 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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #59 on: December 07, 2007, 09:52:53 AM »
Fantastic Casey!! What fabulous news!! No CPM machine, no brace at times, weight bearing - you won't know yourself! Now you can start getting those muscles working  :P I have had all sorts of weird pains since my surgery, and it wasn't anywhere near as complicated as yours, so I am not surprised it is not abnormal, though it's always good to have confirmation.

Do they remove the screws eventually as a standard treatment, or do they only remove them if they cause problems?

I have been doing OK, despite lack of sleep. We got a Xmas tree, I managed to find a heat pad despite it being summer here, and things are generally going well in my life (apart from my knees) so I have been feeling pretty good. If my knees would let me get some sleep then I'd be over the moon! I find I can't sleep on my tummy because the pressure of my knees on the bed must irritate the defects under my patellae - ouch! Generally I just get lots of pinching and aching in my knees that makes me restless. If I take pain killers then I feel just as hungover as I do if I don't take them and my knees keep me awake.

Well, must fly. Have to go to work. Blah!

Kathy