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Author Topic: Osteochondral Allograft  (Read 304 times)

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Offline A_sure_sky

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Osteochondral Allograft
« on: November 12, 2019, 03:37:46 AM »
I just underwent an Osteochondral Allograft on my left knee.  I saw there haven't been many reports on this type of surgery here lately so I thought I would add my journey. This site has been really helpful in getting to this point so thanks to everyone who has posted here.

First a little background on me. I dislocated my left knee in my early teens and for over six years I dealt with multiple dislocationsÖit was to the point I didn't trust my knee anymore. Finally I went and had lateral release surgery. That stopped the dislocations so the surgery was a success.  I didn't have any major problems with my knee for a couple decades. A few years ago my knee started to give me problems so I saw an orthopedist who recommended a total knee replacement.  Another year later I sought out another orthopedist who recommended a partial knee replacement. My bone on bone pain had become so frequent that I needed to do something.  After hearing about OATS surgery, and that I was a candidate for it, I decided to go with this route.

Surgery Day: I underwent surgery early in the morning. They put a nerve block on my leg.  The pain was manageable with the medication.  I stayed at the hospital that night and used the CPM machine for many hours to 30 degrees.

Post-op Day 1:  The pain is still bearable thanks to the medication. My nerve block in my leg is over though I didnít notice a huge increase in the pain.  I still have a little nerve catheter in my thigh just above my knee. I have a hinged brace on my knee and I try to get out of bed to practice using crutches (toe-tap, no weight bearing on my left leg) for the first time after surgery and I pass out for a few seconds (my blood pressure got too low I think).  After resting a few hours I am able to navigate the crutches. Straight leg raises are excruciating but I can get through them. The ROM on my knee brace is set to 60 degrees until my first follow up visit. I spend this night in the hospital as well. I use the CPM machine a lot on this day too.

Post-op Day 2: My vital signs are good and the doctors clear me to go home.  PT clears me to go home after a session with the crutches and practicing going up and down stairs. I decide to go home and my dad takes me on the two-hour drive home. Pain level increases really that evening until I take the pain meds.

Post-op Day 3: I get up several times to use the bathroom.  It is a major pain to use the toilet while on crutches.  Being on crutches and non-weight bearing makes every little journey tiring.  Straight-leg raises are too painful for me to do today. I sound like someone being attacked when I try to do them.  I am very disappointed.  I can do all of the other exercises I am supposed to do. Pain level is bearable with pain meds.

Iíll keep my little recovery journal going for a little while if anyone finds it useful. Let me know if there are questions.

Thanks!

Offline A_sure_sky

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Re: Osteochondral Allograft
« Reply #1 on: November 12, 2019, 08:55:07 PM »
Day 4: Much better night of sleeping.  Pain level has deceased thankfully. I am able to do all my exercises including the straight-leg raises! Hopefully that was just a temporary set back.  I am able to get my knee to 60 degrees (my limit) without too much discomfort. I am looking forward to being able to get to 90.  I can see when I do my quad sets that my quad isnít firing like it did yet.  I wonder how long that takes to recover?  I am still feeling my way with the crutches.  Every little journey in my house is tiring. I think I may not be using them as efficiently as I could.

Offline A_sure_sky

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Re: Osteochondral Allograft
« Reply #2 on: November 16, 2019, 03:55:32 PM »
It has been just over a week now since the surgery.  Pain is really low. I expected much worse, honestly. I can do straight leg extensions with no pain.  I am doubling up my assigned exercises to give my knee and leg more to do.  Stitches should come out next week. My knee still is quite swollen and looks like hell--especially in the back. I can't wait until I can be weight-bearing on my left leg.

Offline A_sure_sky

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Re: Osteochondral Allograft
« Reply #3 on: December 03, 2019, 02:26:11 AM »
It has been three and a half weeks since the surgery.  I can finally be weight-bearing (locked straight knee brace only) which is a big relief. It is so much is easier to get around now.  I think I will be able to get down to a single crutch very soon.

Pain still is pretty light.  On the down side I still can't get my quad to fire like I want it to do.  I also have a little pain below the knee on the right side when doing quad sets.

I go back to the doctor in just under three weeks to see how the grafts are doing. I worry constantly if they have taken. I don't want to go through this again.

Offline A_sure_sky

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Re: Osteochondral Allograft
« Reply #4 on: December 22, 2019, 05:25:37 AM »
It has now been six weeks since my surgery. I went back to the doctor this week for a checkup. He said the X-rays show the patella graft looks good for this time period post-surgery. I can get my knee to 105 degrees ROM which apparently is also good at this point. I also can take the brace of my knee at night which is a big relief.

My main tasks over the next six weeks before my next checkup are to rebuild the lost strength in my leg and my hips and to regain my normal walking gait. I am not restricted on limiting my ROM anymore. I have tried walking with the brace unlocked a few times and it feels strange. There is no pain but I don't trust my knee to operate normally. It seems a little unstable but maybe that is because of the lack of strength in my quads? Anyway, I hoped I would regain my normal walking gait pretty quickly but I see now that is something which will be more difficult than I expected.


Offline Celina1989

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Re: Osteochondral Allograft
« Reply #5 on: December 22, 2019, 12:48:52 PM »
Hi Sky,

Thank you for posting. Although I am not getting an allograft I think recovery for my cartilage (and bone) lesion will be like this (although it is my femur). So I am reading all your posts. I have some experience with my unfortunatly failed microfracture before. Seems that you are doing well. Hopefully continues like this. Wishing you strenght in your recovery! 

Offline jomann75

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Re: Osteochondral Allograft
« Reply #6 on: December 24, 2019, 02:08:09 PM »
Hi - appreciate your posts as I had the OATS procedure on 5th December so it's good to have sight of other people's experiences. This is my second knee operation in 12 months - I firstly had the microfracture done on my right knee (small osteochondral defect on the medial femoral condyle). This didn't work and in actual fact my knee got progressively worse afterwards. So I got a second opinion and the second surgeon suggested OATS.

The op went well, although much more invasive than a standard arthroscopy - I now have a nice 4 inch scar on my knee! That said, I had much more swelling with the microfracture so I'm pleased with progress so far, albeit 3 weeks in.

Getting used to the different aches/pains is part and parcel of any knee recovery I think - each day is different and as long as you do regular rehab you give yourself every chance of a decent recovery. I am partial weight bearing right now until mid January - can't wait to ditch the crutches.

Good luck with your recovery!
Jan 2019 - arthroscopy/microfracture for 10mm lesion on femoral condyle

Dec 2019 - OATS surgery in same area as microfracture failed

Offline A_sure_sky

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Re: Osteochondral Allograft
« Reply #7 on: January 04, 2020, 06:01:19 AM »
It's nice to see comments from others. I hope my experiences might help others. Good luck with your surgery/recovery Jomann and Ceiina!

I am now eight weeks out from my surgery. My knee is getting better slowly.  I can now pretty much ditch the crutch and walk without limping if I am wearing the knee brace (fully unlocked) or with a compression wrap around my knee for shorter distances.  Without anything around my knee it feels too weak and I limp and feel unstable. Still, I have progressed a lot from a couple weeks ago when I first could unlock the brace and put weight on my leg/knee. Walking with 10% ROM with crutches felt highly unstable for a while.

I am doing PT a couple times a week.  I have started doing quad sets with a blood restriction cuff on my leg which is supposed to work the quad without weight training (I am not allowed to do that for a while). I have started walking on a Zero-G treadmill for 10-15 minutes at 60 percent of my weight. Those sessions went well so today I used the regular treadmill at my work gym and walked slowly for 10 minutes. That went fine too.

I was kind of concerned for a several days because after doing a set of unweighted leg lifts while locking my bad leg and then doing the lifts with my uninjured leg, I could not get a full bend in my bad knee without pushing it up from below. If I didn't use my hand to help bend my knee  I would feel an unnatural resistance and then get a large popping noise (it didn't hurt, it had almost the sensation of like cracking your knuckles). Anyway, I haven't had that for a few days now so I hope I am past that.

I still don't have full range of motion in the knee yet but it continues to get better. There is still swelling in the knee. I think I may be even starting to build a little muscle back in my quad thanks to the PT. My leg doesn't seem to be quite as feeble looking now (or maybe I have grown more used to it)!

Offline jomann75

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Re: Osteochondral Allograft
« Reply #8 on: January 16, 2020, 08:59:19 PM »
Hi A_sure_sky,

Seems you are going well, and I fully empathise with the cracking knuckle sounds! When I do certain stretches my operated knee makes all sorts of those sounds at the moment - I expect itís a mix of scar tissue and the knee getting more movement as the swelling goes down. At times I actually need to stretch to relieve the pressure but it doesnít feel painful.

I am six weeks lost op and am now on the stationery bike at the gym whilst doing most walking without crutches. Iím just not doing anything silly and resting when the knee swells, which is still most days.

Good luck with continued recovery



Jan 2019 - arthroscopy/microfracture for 10mm lesion on femoral condyle

Dec 2019 - OATS surgery in same area as microfracture failed

Offline A_sure_sky

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Re: Osteochondral Allograft
« Reply #9 on: Today at 05:42:56 AM »
It's been a little over ten weeks now since my surgery.  I haven't used the crutches in several weeks and I only put on the hinged knee brace a couple times (for safety) last weekend when I had to walk a little bit in snow/slush.

On the positive side, I am able to walk longer on a treadmill for up to 20 minutes with a good portion of that time on an incline and at a faster pace than I could a few weeks ago. I think my everyday walking stride is improving too. I don't think I limp much (except the first step) on shorter trips. Longer journeys may have a little degradation in my stride. I always use a wrap or compression sleeve on my knee.

On the negative side, there is some swelling in my foot and calf in addition to my knee.  I wasn't doing a whole lot of icing and elevating my knee for the past few weeks but I have resumed that. I am not sure if the more extended walking has brought that on or not.

I had one twinge of pain from my knee a little over a week ago (the first time really since the surgery) which freaked me out a little but have had nothing like it since then. Hopefully it was only a one-time thing.

Jomann, it is interesting to hear you are on the stationary bike now. I think I am like four weeks ahead of you in the recovery process and I don't think I am allowed to get on the bike until four months after the surgery. I guess different doctors may have different recovery plans...or perhaps the differences could be explained by the size and placement of the transplants? Thanks for the well wishes and continued success in your recovery.

Offline jomann75

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Re: Osteochondral Allograft
« Reply #10 on: Today at 01:53:33 PM »
A_sure_sky,

I would expect the swelling you are experiencing is down to that greater frequency of walking. I definitely found the same when I had my first knee op 12mths ago - as soon as you try to walk normally the joints in that area tend to swell. Like you are doing, elevation and ice is the key.

Does sound like the size of our lesions differ, and probably the location too. For mine, a stationary bike is normal after 6 weeks based on research. Yours is around the patella right? Either way, I think aches and pains are very common as you progress to greater exercise levels. For me, Iím waiting for a few months before deciding if the surgery was successful. So far so good though.

Stay in touch
Jan 2019 - arthroscopy/microfracture for 10mm lesion on femoral condyle

Dec 2019 - OATS surgery in same area as microfracture failed