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Offline Army John

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new member question
« on: January 14, 2008, 01:25:47 AM »
Hello all, I am new here and I am not too sure where else I am supposed to put my question.

Background- I just had my 4th knee surgery on my left knee on Friday.  The initial thought was that I had torn my menscus again.  The good news is the meniscus wasn't torn.  The bad news is I have little cartilage left in my knee and my knee cap is not properly aligned. 

That said, they took some of my cartilage so they could grow more- something to do with genzyme biosurgery?  I guess the procedure for the cartilage implant is a carticel procedure.  Sound correct?

What I don't know is what the name of the procedure is to correct the alignment in my knee cap.  It sounded horrendous from the brief description my doctor gave me.

Can anyone help me out eith either procedure in terms of post-op recovery, etc?  I know physical therapy will dictate a lot of my recovery and as I am (unfortunately) a veteran of knee surgeries, I take rehab seriously.  I turn 37 next week, I am active, and I would hate to think that I am going to be the one who watches from the sidelines, or be limited in playing with my son.

Thanks in advance for any help!
« Last Edit: January 15, 2008, 01:52:08 AM by Army John »
L knee meniscal repair- 6/89
L knee scope- 11/95
L knee ACL reconstruction- 2/96
L knee scope (included a lateral release, cartilage biopsy, and the ever fun bone shaving)- 1/08
L knee ACI/TTO- 4/08
L knee scope/manipulation- 7/08

Offline casey2291

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Re: new member question
« Reply #1 on: January 14, 2008, 02:08:10 AM »
Hi,

Welcome to the board.  Sorry to hear of your knee troubles.  I don't know what the name of the procedure is to realign your kneecap, but I can tell you the name of the procedure for the Carticel.  It is called Autologous Chondrocyte Implantation (ACI).  You should check out the board under the Knee Arthritis section for ACI and you will find info about ACI, including lots of info about post-op recovery.  I recently had ACI done and can try to answer any questions you might have about it.  Good luck to 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 Army John

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Re: new member question
« Reply #2 on: January 14, 2008, 02:02:44 PM »
Thanks, Casey.  I'll check it out and don't be surprised if I have a question or two for you!  I don't remember too much from my conversation with the doctor post-op because of the sedatives.  Also, I just wasn't expecting that news, especially when I am only 36 (well for another 6 days anyway)!
L knee meniscal repair- 6/89
L knee scope- 11/95
L knee ACL reconstruction- 2/96
L knee scope (included a lateral release, cartilage biopsy, and the ever fun bone shaving)- 1/08
L knee ACI/TTO- 4/08
L knee scope/manipulation- 7/08

Offline GemmaLeigh

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  • suffering with my knee for 8 years. i'm only 20!!!
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Re: new member question
« Reply #3 on: January 14, 2008, 02:38:05 PM »
Hi John, I'm having a realignment at the end of the month and mine is a TTT (tibial tubercle transfer). I think there a few different option but mine is where they move the kneecap to it's rightful place and then put 2 screw in to keep it there during recovery. I think that's about the gist of it, but i'm like you and get a bit lost when the doctor explains things.

Does this sound like what the doc explained? The recovery involves 6 weeks in a brace and on crutches and then continued PT. I was told it would be about 4-5 months all together but would be back on my feet after a few weeks.
1995 - first trip to the doctor with 'growing pains'
1998 - xrays show left patella is out of place
1999 - first dislocation
1999-2006 - Physio therapy every week
Jan2007 - Traumatic dislocation
feb 2007 - OS suggests surgery
Jan 2008 - date for surgery 30th jan

Offline Army John

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Re: new member question
« Reply #4 on: January 14, 2008, 03:32:52 PM »
GemmaLeigh-

  I am not sure what the procedure is called.  I do remember something about "cutting bone, flipping the knee cap up, using the cut bone to help align it, and screw it in".  I do believe I will be non-weight bearing for 6 weeks.  I was told to prepare for a 9-12 month recovery.  Now that may be because I am also having a cartilage implant.  So maybe the two procedures together give me the bonus round of therapy!!

  My biggest wish is that I am allowed to work on range of motion immediately.  When I had my ACL reconstructed, I wasn't allowed to bend it very much and it was a nightmare getting my range of motion back.  I almost ended up back in the ER to do a manipulation.

  I still don't have a surgery date.  I'm told the cartilage they took from me takes about 3-4 weeks to grow.

  But yeah, I don't always understand the medical terminolgy I hear-- I majored in criminal justice when I was in college!  I am glad I found this site!

Thanks for the response.

John 
« Last Edit: January 15, 2008, 01:51:07 AM by Army John »
L knee meniscal repair- 6/89
L knee scope- 11/95
L knee ACL reconstruction- 2/96
L knee scope (included a lateral release, cartilage biopsy, and the ever fun bone shaving)- 1/08
L knee ACI/TTO- 4/08
L knee scope/manipulation- 7/08

Offline KW

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Re: new member question
« Reply #5 on: January 14, 2008, 04:02:00 PM »
I believe you two are talking about a Fulkerson TTT (or some version of a TTT)  It is a realignment procedure.  Basically they cut and realign the tibial tubercle (the bump just below your knee where your patella tendon connects to your tibia) to correct how your patella tracks.  Once the alignment is corrected the cut piece of bone is the secured back into place with screws to heal. 

Some people are on crutches some people are not.  I was never on crutches for more then 2 weeks with either of my Fulkerson’s.  John – Yours many be different due to the ACI.

Every Dr follows a different recovery plan and it is most important to follow your instructions regarding WB vs NWB and ROM (which you should work on as soon as allowed).

Best of luck,
Karen
Right Knee
2000 - 2002 - Scope,LR,TTT,Unscrewed
01-10-12 - PFJR

Left Knee
04/07 TTT/LR
08/07 Bone Grth Stim
10/07 Loose/Bent Screw
1/08 Unscrewed/MRI~NON-UNION
02/19/08 Lt  TTT Revision W/Graft
12/09/08 Scope
05/15/09 Scope
09/04/09 PFJR/Unscrewed

Offline Army John

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Re: new member question
« Reply #6 on: January 14, 2008, 06:16:08 PM »
Karen,

  I believe you are correct on the name of the procedure.  I understand that no two patients are alike and no two doctors are alike.  I am in the Army and our docs are typically aggressive in our recovery programs so I suspect he'll allow ROM as soon as possible.  I do believe I remember him saying I will NWB for 6 weeks post op. 

  I have a follow up with him next week so I'll ask him some more detailed questions.  I do know that I have a significant amount of lost cartilage and what little I have left is not very good. I just really hope the implant gets rid of a lot of the pain I Have experienced for so long.

  Either way, I'll take it one day at a time when it comes to recovery/rehab.  One thing I have learned is that the easy part is the surgery, the hard part is the recovery.  I have always been dedicated to my rehab and my goal is to always be ahead of schedule. 

Thanks again!!

John
L knee meniscal repair- 6/89
L knee scope- 11/95
L knee ACL reconstruction- 2/96
L knee scope (included a lateral release, cartilage biopsy, and the ever fun bone shaving)- 1/08
L knee ACI/TTO- 4/08
L knee scope/manipulation- 7/08

Offline stgiles16

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Re: new member question
« Reply #7 on: January 23, 2008, 08:51:48 AM »
as part of your recovery from the ACI, you will definately be NWB for 6 wks or more. my OS is considering a donor transplant for me and i was told that i would be NWB for 3 mnths (not looking forward to that at all). if you dont keep the weight off of the new cartilage, it will be destroyed so whatever your OS tells you to do,, make sure taht you do it.

good luck
missy
2 ligament recons right ankle
2 arthroscopic,
5 open knee procedures
2 Plica removals
bone spur removal
2 microfractures
4 debridements
2 open LOAs all on left knee
Arthritis,both knees, ankles, shoulders, elbows, hands,spine
Fibromyalgia
Arthrofibrosis
LOA & PKR 2/15/06
RA
in pain mgmt
TKR JAN 2012















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