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Author Topic: Ben's Patellar ACI  (Read 15378 times)

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Offline bsonday

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Ben's Patellar ACI
« on: July 03, 2008, 06:36:09 PM »
Done!

The most painful part so far has been the catheter (they put it in while I was asleep and took it out before I woke up, but I can still feel the pain).  I've been icing basically nonstop ever since with this "Gameready" device they gave me, and I just put the CPM on for the first time.  My surgical dressing and ACE bandage are still on my knee pretty tight, so I'm only going to 35 degrees on the CPM until the dressing and ACE come off tomorrow.  Then I'll go to 45 degrees as instructed.

Anyway, that's all for now.  I'm basically pain-free, drugged up, and relaxed.  My girlfriend has demonstrated time and time again in the past 24 hours that she is, in fact, marriage material.

Best,
Ben
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

Offline Peg Leg

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Re: Ben's Patellar ACI
« Reply #1 on: July 03, 2008, 09:55:44 PM »
Ben,

Great news that things are going so well at this point!!  So glad this part is behind you.  The best part of your post is the last line!!  The fact that you acknowledged this, also means that you are a keeper!!  ;D

Hang in there and enjoy those pain meds!!

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

dileigh

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Re: Ben's Patellar ACI
« Reply #2 on: July 03, 2008, 11:17:02 PM »

Don't forget to keep up with your pain meds once whatever is in your system wears off.  It's hard to play catch up.  You're already ahead of me, I only started at 20.

If she's a keeper, make sure she knows how much she's appreciated, it'll help later when she gets "tired" of waiting on you.


Diana

Offline bsonday

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Re: Ben's Patellar ACI
« Reply #3 on: July 04, 2008, 12:34:33 AM »
Hey thanks for all of the tips, everyone :).  I'm trying to be super appreciative, and I just talked to a buddy on the phone, and he had the great idea of ordering flowers for my girlfriend from my laptop one of these days when she's out of the room.  Could be fun.
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

Offline bsonday

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Re: Ben's Patellar ACI
« Reply #4 on: July 06, 2008, 01:13:20 AM »
After two pretty painful days, I'm starting to come back around.  I'm almost pain-free when laying down, but my leg screams every time I stand up and walk over to use the restroom.  I've started doing some pretty basic quad exercises as well like isometrics and rolling up a towel under my leg and straightening my leg--just little stuff.  With all of the swelling in my leg, though, I can't help but think I'm going to burst this porcine patch every time I extend my leg.  Can someone please tell me I'm crazy?

-Ben
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

dileigh

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Re: Ben's Patellar ACI
« Reply #5 on: July 06, 2008, 04:30:49 PM »
Ben

You are crazy  ;D.  The swelling will go away and not bust the patch.  Ice, Ice, Ice and elevate above the heart.  Are you not on crutches at all?  The CPM will also help with the swelling since it raises your leg for such a long time.  What did the OS tell you to do about exercising?


Diana

Offline Army John

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Re: Ben's Patellar ACI
« Reply #6 on: July 06, 2008, 07:05:51 PM »
Ben-

You're crazy.   ;D


Glad to hear things are going well for you.  The pain you're experiencing when you get up on your feet will slowly subside. 

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 bsonday

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Re: Ben's Patellar ACI
« Reply #7 on: July 07, 2008, 09:09:37 AM »
Haha, thanks everyone.  Stay on top of my meds and my ice and elevate.  Pretty simple, really.  Feeling better every day.  I am crutching around on the rare occasion I do decide to get out of bed, and the doc told me that I should do basic quad exercises as tolerated.

In fact, if anyone is interested, I would be more than happy to send a copy of my rehab protocol to you so that you can compare it to yours and perhaps even comment on it.  The title at the top of my rehab protocol is "ACI of the Patellofemoral Joint with Distal Realignment Rehab Protocol".

Best,
Ben
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

Offline Army John

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Re: Ben's Patellar ACI
« Reply #8 on: July 07, 2008, 01:22:00 PM »
Ben,

  Keep that leg moving.  If you haven't read my thread, I just had a scope done on Thusday because I was socked with scar tissue- I am apparently very good at growing it.  While my OS was in the joint he looked at the grafts and they were healing/maturing better than he had anticipated.  So I can tell you that you're crazy because I had a few instances where my leg fired up and my knee clamped down.  The pain I experienced convinced me I screwed up my grafts.  Nope, I didn't.

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 bsonday

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Re: Ben's Patellar ACI
« Reply #9 on: July 10, 2008, 09:02:38 AM »
Here's an update.  Healing seems to be going very well so far.  My swelling has dropped dramatically over the past few days to the point that my leg looks somewhat normal, and along with it, I feel like I could bend my leg to 90 degrees even though the doctor is having me stop at 45 right now.  I'm guessing that getting back my range of motion will not be a problem.  Most of my pain is the Fulkerson stuff (which equals broken bones, I guess).  Other than that, just bored :).

Until today, every time I stood up, my leg screamed at me and hurt so bad that I could only be on my feet for a minute or two at a time.  Today I discovered that by wrapping an ace bandage around my leg incredibly tightly before getting up, I could avoid any pain in my leg at all.  This means I can take my girlfriend to the movies finally, I guess :).

Best,
Ben
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

Offline bsonday

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Re: Ben's Patellar ACI
« Reply #10 on: July 15, 2008, 01:48:36 AM »
Things continue to improve.

My stitches have come out, although there were only 3 anyway.  The rest were subcutaneal and dissolvable--somehow my doctor stitched me up real well under the skin.  Perhaps there won't be a scar after all.

My CPM is now at 70 degrees, and I've spent the past few days fighting off withdrawal symptoms since I was taking so much hydrocodone in the beginning.

My girlfriend is driving me back to New Jersey from Michigan tomorrow, and then I'm back to work on Thursday.

It hurts less when I stand up now, but my Fulkerson bony parts still hurt quite a bit.

The worst is over!

Best,
Ben
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

Offline bsonday

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Re: Ben's Patellar ACI
« Reply #11 on: July 16, 2008, 10:49:30 PM »
Hello again,

Things continue to improve, although gradually.  The 12-hour car ride was not fun at all, and I was glad to lay down at the end of it.

I've been wondering recently--what kind of pain is normal and expected and what kind of pain is not?  My pain is very much like my pre-op pain:  my knee generally doesn't hurt much at all, but I get the same sharp pain I had before when I bend my knee to about 40 degrees and try to extend it every so gently.  But 40 degrees is right about where my graft is, so who knows.

Thanks in advance for the input.

Best,
Ben
Removal of loose bodies (cartilage pieces)--7/2/2007
Lots of rehab (quad strengthening) which didn't help much
Biopsy for ACI, 1.5cm x 1.5cm patellar cartilage lesion found--5/7/2008
Patellar ACI with Fulkerson, slight lateral release (to get under the patella)--7/2/2008
Happiness--Early 2010?

Offline Gibbon35

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Re: Ben's Patellar ACI
« Reply #12 on: July 17, 2008, 09:42:18 AM »
Hey Ben. Keep up the good work my man. The questions your asking is pretty much what i was asking myself when i was at your stage. Just remember that your knee over the next year or so will have ups and downs. Will swell maybe one day for no apparent reason and then be fine the next. Pain will be present especially at the beguinning but things do get better. Dont beat yourself up over worrying about the graft site. The knee would have to take a damn hard knock to break that patch. Dont go running on it now, but just look after it and things will be A oK

G

jonhark

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Re: Ben's Patellar ACI
« Reply #13 on: July 17, 2008, 04:03:27 PM »
Your cells in your defect will proliferate over the next 12 months and then mature/harden over the following 12-18 months.

There will be a constant tradeoff between gaining your strength and ROM and experiencing pain and swelling. At two weeks your implanted cells are not much more viscous than water.

Take a look at cartilagerepaircenter.com. Minas's site is the most comprehensive for explaining the the maturation of the grafts and what to expect.

This is by no means a perfect solution for your defect. It is a long process so I would just enjoy the ride.

dileigh

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Re: Ben's Patellar ACI
« Reply #14 on: July 17, 2008, 11:06:39 PM »
No scar- I'm jealous  :o :o :o

The pain will lessen as you go along, and the TTT will heal faster than the ACI part.  I'm almost 4 months and still experience some pain, but at a lower level.  In fact, my shoulder hurts worse than my knee.

Keep up with the rehab, and you should be fine.  it's still pretty early.


Diana