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Author Topic: ACI and HTO on 10/22/07-It's going to turn out great!!  (Read 38043 times)

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Offline kalyjoe

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #60 on: December 07, 2007, 12:09:42 PM »
Casey that is AWESOME news!  I'm so happy for you.  Oh my gosh..let me tell you...when they come pick up that CPM machine, it is the best feeling ever.  I can totally relate to your happiness with being done with it and having it removed from your home.  I really hated that part of my recovery as well.  (Then again, is there anything fun about ANY part of this recovery?) I'm so glad to hear that you are able to partial weight bear and you aren't experiencing any bad pain.  You are going to start to feel human again!  I'm glad OS was able to give you some reassurance as well; those are great odds about destroying the graft site.  That actually gives me some hope as well.  I know how hard it is to not be scared of damaging it.  The last thing we want to do is go through this again! 

As for me, I was just feeling really down last night.  I'm having a lot of pain still from the scope and can't walk right yet and have resorted to using one crutch again.  I was reassured it was all normal, but I am just so seriously sick of this knee.  Out of the past 4 Christmases, I have spent 3 of them on crutches.  :-\  It just gets old, yk?  I doubt I will still be using a crutch by then this year, but just the fact that it is so hard to shop and get what needs to be done, done....well, once in awhile it just gets me down.  I was probably naive in thinking that after this scope I'd be fine in a week, but I was comparing it to step one of the CaReS and that's how I was with that.  Obviously, he did much more this time and I wasn't expecting to be so limited again.  It's simply my own unpreparedness that is causing this.  And then to not be able to do cardio again at the gym, it affects my brain.  So...every once in a while, on a rare occassion I let it get the best of me.  I'm feeling better now.  My husband gave me a great back rub and let me cry to him last night and I'm meeting my mom for breakfast today for some TLC.   :)  So it will all be good again.  And when I focus on the fact that my knee has cartilage again and I have proof of that...well...that is INCREDIBLE!  So, I just have to take my own advice and be patient again, focus on the positives, and endure this long recovery we all have go through with this procedure. 

Have a great day and I hope you continue to progress!  Thanks for letting me vent.   :)

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 #61 on: December 07, 2007, 10:06:19 PM »
Hi Kristi,
Sounds like you've had a rough time. I think we all have days like that though. I certainly do, and it can be the silliest little thing that sets it all off! I am dreading having more surgery on my knees. Most of me wants to go bilateral, as I don't want to have to go through it all twice, but a little bit of me is terrified at the thought of it! I have a lot of soul searching to do before I have any more surgery. By the way, what is CaReS? How does it compare to ACI? I am really dreading having a CPM machine, or two!! You all seem to hate it. I don't know which surgery my OS is going to suggest first though, so I may be worried for nothing. It also may not happen for many years (I wish!!). I suppose I can just take each day as it comes.
Bye for now.
Kathy

Offline casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #62 on: December 08, 2007, 12:08:37 AM »
Hi everyone!

Kristi....I can totally understand how you feel.  When I had my other knee scoped over the summer, I too had the impression that within a week or so I would be back to normal and when it didn't happen I was frustrated.  I'm sorry to hear that you are having a lot of pain from the scope.  Not being able to be active (like I think we are both used to) really can play with your mind, especially when you realize that it may take longer than you expected to return to activity.  I'm glad that you are mentally feeling better today.  A good cry always seems to help me.  Sounds like your hubby is understanding which is so important.  I wouldn't have been able to survive this ACI surgery without my fiance and the support that he has been to me.  Just keep in mind that this is temporary and that when you are all recovered you will have a knee with good cartilage and that has been the goal from the beginning.  This is just a temporary set back that unfortunately you have to endure.  Feel free to come vent here when you need to.  Hang in there and I will be keeping my fingers crossed that you are able to ditch the crutch by x-mas.  Maybe both of us will be crutch free for x-mas...I'm hoping!!!

Kathy...I'm right there with you in the lack of sleep department. I feel for you that you are not sleeping and having to go to work.  I hate being tired when I am at work.  I'm worried about not being able to sleep when I go back to work and how I will function.  Not being able to sleep because of the knee gets really old really fast.  How are you functioning at work?  We are getting our christmas tree tomorrow which I am excited about.  I don't get to help cut it down this year, but I'm still looking forward to it.  I am jealous that it is summer where you are.  We had 3 inches of snow on Wed. and freezing rain today....scarry when you are on crutches. 

I am SO much happier now that I am able to weight bear.  I feel like my whole world has opened up.  Not having to use the cpm machine is fantastic!!  Although, I am so used to being stuck in bed connected to the machine that I am feeling pretty bored.  I find myself looking forward to returning to work...am I really saying that?  In therapy today I was able to put 55lbs of weight on my leg without pain.  I started doing heel raises and some leg presses on the total gym.  My knee is really stiff and I feel like my ROM is not as good as it was.  The cpm really helped with the stiffness.  I have an increase in swelling so that is affecting my ROM.   I'm going to try to use the ice machine tonight.

I got to take a shower today without having to keep my leg completely straight and propped up.  It was nice.  I am now allowed to stand up when I take a shower putting minimal weight on my leg, but my OS told me to be VERY careful.  Since I am supposed to be wearing the brace whenever I am standing, I need to be careful to protect the osteotomy.  I am still using the shower chair just because I don't feel comfortable just yet standing in the shower.  I still need support of some sort when I want to turn my body, so I will continue to use the shower chair until my leg muscles are a little bit more built up.  I look forward to the day when I can shower again like a normal person.  I figure that there is no sense in taking the chance of accidently falling because of my weak quads.  It is nice to know that when I am ready for it, I can stand up and shower. 

kathy, Kristi, Peg Leg...hang in there ladies...I'm thinking about you.

   
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 #63 on: December 08, 2007, 02:37:55 AM »
Casey,
I am so glad to hear that you are playing it safe. You have too much to lose to risk a standing shower or injuring yourself by turning over in bed without the brace. Easing into these things is much better. I wish more of my patients would be more like you and less gung-ho.

Work is OK. I am a nurse in a rehab hospital. I get to sit down for most of the night. Getting in and out of the chair can make my knees ache by morning, especially as it gets cold on the ward at night, which seems to make any aching worse. We have two of us per ward, for safety reasons, so we can take it in turns dozing in an armchair if we really need to. I find that most night shift workers have developed an ability to hover in light sleep, so we will wake at the slightest noise or disturbance. When we get home it's different. During the early heavy sleep that I have when I first go to bed, I have slept through our smoke alarm before, and the phone (which is next to my bed). Once the heavy sleep is over then the outside noises and other irritations (knees!) begin to filter in and it gets harder to stay asleep, or get back to sleep once awake. I am currently on work restrictions, which may result in me being independently assessed through work, to determine if I am capable of staying on night shift. I hope so. I wouldn't last an hour on my feet during the day. Part of me would like a reason to give up work, but I know it would affect so much of our lives that I don't think it would be such a good thing.

Well, gotta sleep. Bye for now. Keep well girls.

Kathy

Offline casey2291

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #64 on: December 09, 2007, 03:26:39 PM »
kathy...I'm glad to hear that you have the opportunity to sit down at work and rest your knees.  I spent some time as a graduate student in a hospital setting training to be a speech pathologist and the nurses were always so busy running around all over the place.  I guess that at night most of the patients are asleep which makes it not quite as stressful on the knees.  For your sake, I hope that you don't have to switch to day shift. 

Things seem to be going well for me.  I can now comfortably put about 80lbs of weight on my leg and up to 100 if I push it.  I put my leg on a scale and shift my weight on it to see if I can increase the amount each day.  Right around 100 is when I start to feel some pain, so I'm assuming that I am putting about 80lbs on it when walking around.  I can now take some steps with just one crutch but it is not easy so I'm sticking with two crutches for now.  Each day I see improvements in my ability to put more weight on my leg and anticipate that I will be down to one crutch sooner than I expected.  I was up and about a lot yesterday and I noticed that when I got home last night, putting any weight on my leg was difficult and I actually resorted to NWB for comfort reasons.  I am not using the brace now when sleeping.  Sleeping is such a problem for me right now.  I can sleep comfortably on my side now, but still can't move around in my sleep because my leg is so weak that rolling over and even moving without me assisting my leg is not possible.  I wake up multiple times a night with my hip hurting or my back hurting or just muscles hurting because of staying in one position for a long period of time.  I do not wake up with pain in my knee except for early in the morning and that seems to quickly resovle itself.  The sharp pains that I was having are pretty much gone.  I have maybe one or two a day and they usually happen when my leg is in full extention and even then they are not as bad as before.  What a relief that they are gone!!  I have some aching in the knee when I sit or lay with my legs completely straight so I just avoid that.  Swelling also seems to be an issue.  I have had increased swelling since I have started walking and my calf is also swelling now (I guess from the osteotomy?).  I hate icing because it is winter here and putting a cold ice pack on my knee is not fun.  And of course I have one roommate who wants to turn the heat down/off to save money.  I'm also having trouble motivating myself to do my exercises.  I hate doing those things.  I've done so many PT exercises over the past two years for knee/back problems that I want to barf.  I've got to figure out how to get motivated to do them.  Even though I want to ditch the crutches badly and you would think that would motivate me, it isn't it.  I only did my exercises twice yesterday.  I was thinking that if I increased the reps of each exercise when I actually do them, then maybe I could just do them twice a day instead of three times a day. 

Last night my fiance and I went out on a date which is the first time we have been able to do that since my surgery.  It was fabulous and so nice to be out, even though I got lots of stares from people.  We went out to eat and then to look at Christmas lights.  When we went out to eat, we were waiting to get our table and I caught one lady staring at me and I kindly smiled at her and looked away.  Later when we left the restaurant, I caught the same lady staring at me again.  This time, I stared back at her and suprisingly it took her awhile to look away.  Crutches and a big old brace sure do attract attention.  But, I don't care, I was just happy to be out. 

I picked up a new prescription yesterday from my OS.  I asked him if he could prescribe something stronger than tylenol  but that was not a narcotic.  He prescribed ultracet.  After reading the info about the drug, I'm not so sure I want to take it.  It says that it can be habit forming which is not what I wanted.   I have not tried it yet for pain because my pain has been very tolerable these past 24 hours, but there are those moments when I would like to take something for pain and tylenol doesn't cut it.  I'm not sure that I understand why ibuprofen/anti-inflammatory meds are not an option after ACI surgery.  I understood why after my microfracture, but I don't understand the science behind it for this surgery. 

Off to do my exercises!  :P
« Last Edit: December 09, 2007, 03:29:42 PM 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 #65 on: December 09, 2007, 09:49:46 PM »
Hi Casey,
I wouldn't worry too much about the Ultracet. Use it if you feel the need. I take Tramadol (Ultracet is Tramadol and Acetaminophen/Paracetamol) and I have had no problems with it. I actually find it's hard to take too much of due to it's side effects. I get very nauseous if I take too much. We use it a lot at work and have much less problems with it than other narcotics, so far as dependency. Just be aware that it contains Acetaminophen (Paracetamol) so you cannot take it within 4 hours of anything else containing Acetaminophen, and you can only have a maximum of 4g Acetaminophen per 24hours. Tramadol is available here in a slow release form, and my GP will give it to me once I have an idea as to how much Tramadol I take over 24 hours - that way I might get better sleep.

If I had to switch to day shift I think I'd leave work. Though I'd give things a fair go first. Being a rehab hospital helps keep it quieter at night. Our ward is geared to people almost ready to go home. they are the sort of patient who has been ill and lost condition and just needs a bit of intensive physio before being able to cope at home. So for the most part they are independent. Night time consists of giving bedpans, giving pills, taking blood sugar levels, assisting people to get up to the toilet (mostly just standing there to make sure they are safe), and emptying urine bottles. I was on a spinal injury unit, where we had to turn patients every three hours, and it was quite heavy. I requested a move from there before my surgery, as I was struggling physically, as well as being mentally drained. Now with my restrictions I can't go back there.

It's funny what people stare at. You'd think braces and crutches would be common enough not to warrant that much attention, but some people are just plain nosey!

I wonder if your swelling is due to the increased movement from weight bearing and flexion. Things may be getting a bit irritated, as they haven't worked that way in a while. I imagine it will settle down soon. The other night I was dreaming that I was out with my family and we were walking up and down a steep hill. My knees were getting more and more painful and, in my dream, I got out two walking sticks and hobbled around with them. I woke up to find myself on my stomach with my knees pressed into the mattress - they were killing me! Just the pressure on them was enough to start them aching big time.

I know what you mean about the exercises. I increased my reps in order to drop the amount of times I did my exercises, as I was struggling to fit them in with work and everything else. I don't think it has made a difference. I don't see much improvement in my quads, but my calf muscles are getting stronger, so it's not the change in exercise regime. I think it's knee pain causing quad inhibition. I'm not quite sure how to overcome that. I try to contract my quads here and there as a gentle way to strengthen them, but they are very resistive. Oh well. I'll get there in the end.

Kathy

Offline djs60

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #66 on: December 10, 2007, 03:18:45 PM »
HI Casey,

The reason some OSs don't want their ACI patients to take ibuprofen or other NSAIDs (non-steroidal anti-inflammatory drugs) is that NSAIDs (at least in theory) can interfere with cartilage growth.  My OS doesn't want me to use any NSAIDs until 9 months postop (I'm now 7.5 months out).  It hasn't been much of an issue for me, as I really don't have any pain now.  Hang in there - things will get better.

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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #67 on: December 11, 2007, 12:36:30 AM »
djs60...thanks for the info about the NSAID's.  My OS didn't tell me how long after surgery before I could take them again.  I'm glad that you mentioned that your OS doesn't want you to take them until 9 months post op.  What kind of activity are you able to do at 7.5 months out?  I'm glad to hear that you don't have much pain. 

Kathy...thanks for the info about ultracet.  That makes me feel better to know that it is not that easy to get addicted to it.  I took it last night at bedtime and again in the middle of the night and it is the best that I have slept in awhile.  I actually stayed asleep for 5 hours before I woke up.  It definately helped with the aching muscles.  I'm sorry to hear that you are also having trouble sleeping.  When I was using the cpm machine, I used to wake up frequently thinking that I was in the cpm machine and I felt like my leg was moving in the machine and I was not in it.  It is weird what our minds can due when our bodies are not working correctly.  Is your PT using e-stim on your quads to help them?

Today I used just one crutch all morning long.  I was extremely encouraged by this since I was just given the go ahead to weight bear four days ago.  My knee was painfree when using one crutch.  My PT watched my gait as I walked with one crtuch and he said that it was pretty good and that I was walking heel to toe.  After therapy, I had to go back to two crutches as my leg was just too tired after all the therapy exercises.  Since therapy, I've been having some pain around the kneecap which is also preventing me from using just one crutch.  My PT also said that my quad muscles were starting to feel better.  I have to start spending a couple of hours a day with my leg completely straight because I am starting to lose some extension because I've been keeping my leg bent almost all the time.  So, overall, I feel as if things are going really well and each day I see progress.   
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 #68 on: December 11, 2007, 01:17:27 AM »
Well done Casey! Each day seems to be bringing you more improvement. Good to hear you got some sleep with the new meds. I just wish they didn't make me so tired when I take them. I am sick of feeling tired all the time. I do have my good days, don't get me wrong, but I feel like I am constantly tired due to lack of sleep of the effect of pain meds. I think I need to be more careful about what I eat and maybe take a multivitamin or something, just to help perk me up a touch. I must admit, when you do permanent night shift you seem to get sleep obsessed, and sleep or lack of sleep dominate your life. I look forward to having a different job one day.

My PT hasn't used e-stim. I am hoping he sees some improvement when I see him next week. I have been trying the bike in short spurts, to decrease the irritation to my knees. I haven't made it into the pool yet, as I just haven't had time. I prefer things I can do at home. I am persisting with as much exercise as my knees can tolerate, and have gone back to little amounts of exercise often (rather than one or two big efforts daily). I feel pretty good at the start of the day now, once the morning stiffness is over, and I don't limp until I have been up for a while. My right quad is what does me in. It still trembles with sustained contraction and doesn't have much strength or endurance.

Good luck with the extension stuff. Hopefully you can regain what you've lost and stop any further loss. Gee, all the things we need to look out for with our knee problems! It's enough to give us headaches for the rest of our lives!

Keep up the good work.

Kathy

Offline kalyjoe

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #69 on: December 12, 2007, 12:59:51 AM »
Hi Casey. Sounds like you are doing great.  That is so encouraging.  It really helps to move forward and using one crutch instead of two is quite a feat considering you've only been given the WB okay a few days ago.  I really think it makes a huge difference having PT during your whole recovery period.  By the time I was allowed to do PT, my quad was so atrophied, it took quite some time to get it back.  Keep up the good work!   ;D

The Ibuprofen thing.  Dare I say I have no memory of not being allowed to take it after my surgery?  :-\ I took Percocet for that first week at least and for quite some time after that just to sleep at night, but I've been taking Ibuprofen since I stopped needing that. Now I'm all curious as to why I wasn't told to stop it or if I was, if I just don't remember and maybe I did start later?  But I know there is no way I stopped taking it for 9 months or even 6 or 3.  I'm going to pull out my post op instructions from last year and see what they say.  It's so interesting to see the different protocols we all have isn't it? 

As for people staring, I totally know how you feel.  You can do what I did last year: I decorated my crutches.  I figured if I was stuck on them through Christmas, I might as well make the best of it. And since people stare anyway, might as well give them something fun to look at.   :o  I went shopping over this past weekend by myself and it was pretty aggravating.  I still have to use one crutch or else I limp horribly and put too much pressure on my calf and I swear, people are so rude!  You wouldn't believe how many people didn't bother to hold doors for me or even move out of the aisle (if they were standing there talking) when they saw me coming.  I was so tempted to accidently "bump" them as I went by, but I didn't. I finally finished what I needed to do and came home pretty frustrated.

Kathy, CaReS is similar to ACI but it uses a  3D scaffold that OS can fit in the depth as well as the area of the defect.  It is also "glued" as opposed to being stitched.  This is supposed to make recovery quicker and it's supposed to reduce the complications you see in normal ACI.  My OS so far is encouraged by what he's seen as far as it being a better option for articular cartilage damage, but it's certainly not the cure all we all are hoping to find.  If you are interested, you can read more about it in the link on my first post of my thread here. 

Good luck to both of you!   :)

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 djs60

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #70 on: December 12, 2007, 09:26:12 PM »
Casey & Kristi,

On the NSAID thing, I don't think all OSs tell their patients not to take them post-op.  As I wrote above, they  can in theory interfere with healing, but I think that info is in vitro lab stuff, and hasn't  necessarily  been shown to be a problem in people.  I'm guessing that the reason my OS told me not to take them for 9 months is that by 9 months, one hopefully has good graft fill.

In terms of my current activity, I ride a stationary bike 3 or 4 times a week for 25 minutes at moderate resistance.  I have been going to the gym 2 or 3 times a week to do some weights with my legs.  I still have quite a bit of quad atrophy on my operated leg.  My PT (i'm no longer doing formal PT) had thought it would take a year to get the quad back to normal. I don't think I limp at all at this point, but I do notice weakness in the leg going up and down stairs.

Regards,
Dan
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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #71 on: December 15, 2007, 10:13:08 PM »
Hi everyone,

Things are still going good for me.  I was given the go ahead to weight bear one week and two days ago and I am officially down to one crutch when I am walking around the house.  I still take two crutches when I go out just because I might come across steps and plus I can get around so much faster with two crutches.  Also, it helps to remind people to stay clear of me.  My knee has very little pain.  The only pain that I feel is if I put too much weight on my leg.  It is not quite ready to take the full weight of my body.  However, I am able to take a few steps completely crutch free.  I limp horribly when I try it but at least it lets me know that I will soon be able to walk crutch free.  My hip muscles have been bothering me more than anything.  My PT says that it is from weak glute muscles.  My hip muscles ache and they keep me awake at night.  It seems that no matter what position I lay in at night they hurt.  Tylenol seems to help but does not completely solve the problem.  I continue to see improvements in the overall strength of my leg.  I still need to assist my leg to move it at times, like when putting it in and out of the brace and moving in bed.  My biggest complaints at this point is that I am still having a lot of trouble sleeping and that my hip muscles hurt.  I have noticed that getting back into a daily routine is very tiring.  Spending 6 weeks in bed took a big toll on my overall stamina.  Just going to therapy tends to wear me out and I want to take a nap when I get home.  I'm not sure how much of this is due to lack of sleep and how much is due to my body adjusting to a new routine.  I am still planning on going back to work at the first of the year.  Because I have to walk a lot at my job, I have decided to go back for half days for at least the first week.   

Dan...thanks for the info about anti-inflammatories.  I think I will ask my OS at my next visit to see when he clears me to take ibuprofen.  I can't believe how long it takes to rebuild the quad muscle.  My PT also told me that it would take 6 months to a year to get my quad back.  How long did you do formal PT for?  My PT keeps telling me what a long rehab I have and that I will be in therapy for awhile.  I'm ok with going to therapy because it keeps me motivated to do my exercises at home.  I'm surprised that you still have difficulty with stairs.  I had no idea that it would take that long to get back to doing stairs normally.  I hope you continue to see improvement!

Kristi...Sorry that you had an aggravating shopping experience.  It is amazing how people either stare at you when you are on crutches or completely ignore that fact that you struggle to open a door or get through an aisle.  Now, that I can get out and about, I have been to several stores where I have been trying to open doors and just look ridiculous because it is difficult to do and no one bothers to help.  However, I have run into several very nice folks who have opened doors for me.  I guess it will only make us better people because we will know to jump at the chance to open the door for someone who needs it.  How is your knee progressing?  Have you been able to ditch that crutch yet?  Good idea about decorating the crutches...I might just do that!

kathy...The ultracet makes me very tired as well.  I couldn't stand how tired it made me so I quit taking it.  It seemed to linger in my system for a good 12 hours after I took it.  I hate being so tired.  You should ask your PT if e-stim would be beneficial for you.  Maybe that would help your quad.

Hope everyone is doing 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 djs60

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #72 on: December 16, 2007, 03:17:16 PM »
Hi Casey,

I did formal PT for 5 months (although at the end I was just going once a week).  At that point, my insurance co. cut me off (although I was really at the point then when I was ready to fly on my own).

My PT told me one year to get all of my quad bulk/strength back (which is amazing, since I lost it all in a month!).

To clarify, I can do stair pretty normally, but I am aware of the weakness I have in my left quad when i'm doing stairs.

Dan
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

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Re: ACI and HTO on 10/22/07-It's going to turn out great!!
« Reply #73 on: December 19, 2007, 08:08:21 PM »
Tomorrow will be two weeks since I was given permission to weight bear.  I'm down to no crutches and I'm quite happy about it ;D  I will still take one crutch with me when I am about and about.  Yesterday I used one crutch on and off and today I have not used the crutch yet, however I can tell my leg is pretty tired.  I may need the crutch this evening.  I am at 90 degrees active ROM and 98 passive.  I have not really made any progress with my ROM in the past two weeks.  I was at 95 degrees two weeks ago. My PT got in touch with my OS to see if he could start doing some type of manipulation on the knee to help with flexion.  OS cleared for some manipulation techinques but not others.  My PT would like for me to get at least 5 more degrees of flexion in the next five days.  Today I got an e-stim/TENS unit to use at home to help with the quad muscles and pain.  My knee feels good.  A little pain if I put too much weight on it.  My gait is not so good.  I have to work on bending my knee as I am keeping it pretty straight when I walk and I am also to work on thinking about walking heel to toe.  Apparently, I look like a "zombie" when I walk with my straight leg.   :P
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 #74 on: December 20, 2007, 01:42:33 PM »
Wow! 2 weeks already! That time has flown. Supposedly once you have got beyond 90 degrees flexion the rest is fairly easy to come by, so I hope it doesn't continue to be a long hard slog for you. Hopefully manipulationg will help. How's the strength progressing? Mine has come to a standstill, at least in my right leg. I still cannot get a strong and steady quad contraction. The muscles quake and quiver every time I contract them. My left quads contract well but have poor endurance, but I think I have had some improvement, though very slight. My PT has said that I am probably not going to progress beyond my current exercises (great, how boring!), and that my main aim now is to not go backwards. One worry is that now my patellae are in a different position (from the LR) the cartilage damage might spread  :P The damage I have now is what my PT called a "significant amount". I don't really want more!! I might be joining you on the ACI road sooner than expected! My PT was surprised I haven't been offered more surgery already, though he is under the impression the damage is too much for grafting and that I am an ideal candidate for patellofemoral resurfacing. I am less sure. My OS mentioned grafting, so I assume it IS an option. I am not so sure about PFR as I have read that its not overly successful, and where do I end up if it fails? They can't just remove it, and the only surgical option it leaves me with afterwards is total knee replacement. At least with grafting I don't end up in a worse situation if it fails, and I can still have various other surgeries afterwards. Hmm. I hope my OS can help explain it all better and give me some advice. I am happy to continue as I am for the moment, though I had hoped for better endurance. If I don't do too much then I don't ache excessively, and I have good ROM and sound ligaments. I am worried about surgery making things worse somehow. The LR surgery didn't improve things much and just bumped off the last bit of strength in my quads. I don't know if it was a good trade off!!

I hope your improvment happens quicker than mine!!  ;D Happy walking!

Kathy