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Author Topic: Room 101's December 2, 2008 ACI (**January 31, 2011 update**)  (Read 32361 times)

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Offline Room 101

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Re: Room 101's December 2, 2008 ACI (4 month update)
« Reply #60 on: March 24, 2009, 08:54:31 PM »
Hey!  here is a 4 month update.  I can't decide if it's gone fast or slow  :P  -- This seems to be the part that lingers, haha.  Phase 2 rehab that lasts for 3 months.  I do feel improvement, although my range of motion is still less than my other leg.  It must have been bad in PT today because my therapist didn't even measure.  He never wants to depress me on a Monday morning.  I feel pretty good though.  I can walk with no pain.  Sometimes it's a little stiff, but we have been consistently walking 2 miles and I could go more.  When it dries up just a little more, we might try the trails by the house.  I think they're pretty flat (we live in the midwest... it's flat!).  My recovery time after working it in therapy or with my trainer is much faster.  I don't get very stiff, but if we push it enough I am sore for 24 hours or so.  I actually get fatigue before pain now.  I still bike with very little resistance, but I can go easily 20 minutes and sometimes 30 before I get sore.  I only put enough resistance on there so my feet don't spin around uncontrollably.  I have started incorporating quarter squats back into my training sessions like when you do shoulder presses, etc.  There is lots of bridging and stability going on in my training sessions right now.  In therapy we are doing step ups 8" and adding more speed to the step ups making them a little less deliberate.  We do resisted backward walking (more like mini lunges) with no pain at all.  Balance and step ups onto the bosu, and step downs vary.  Once I could do a 6" step, but we have backed down to 4" step once a week because I had some pain.  We're working on walking faster and incorporating some turning in there going from forward to backward and so on as well.  I have no trouble at all with that. 

One thing that I think has helped me a lot is to focus on muscles that are stuck.  It had been so long since I walked correctly that my hip flexors and IT band are a mess.  My PT works on all that in therapy, but I have really worked with my trainer on accomplishing it at home with foam rollers as well.  I have noticed a significant improvement in stiffness since I started doing that daily.

I don't know where I expected to be (or if I had any expectations) at 4 months post, but to be honest, I think things are pretty darn good.  I can walk farther and with no pain than I could before surgery by a long distance, so that has to be a good thing.  It makes me look forward to summer and being outside.  I don't have any complaints right now... I just hope my flexion will improve and that I continue to progress positively.  I would think one of the next big improvement would be step downs.  I just feel pain and am not quite ready to go there yet.  i would also expect to see an improvement in stiffness.  I do notice when i sit or stand for any length of time that I get pretty stiff.  I am happier moving.

I must remember patience right now.  I can tell I am at a dangerous point where I forget about my knee when i am doing things like cooking or carrying things (or playing Wii  ;D ).  I have turned and twisted wrong a couple times lately getting into the car or turning to talk to someone. that is just a painful reminder to be aware of what I am doing.  My brain wants to run across the street to beat traffic, but my knee isn't anywhere near ready yet.

Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Hathor

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Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
« Reply #61 on: March 25, 2009, 07:06:52 PM »
Hey 101

Great to read your detailed updates. You mention that you get pain when doing certain things. What sort of pain are you experiencing? is it sharp in some cases? Am curious as my patella is tender/bruised feeling when I do squats in the pool or step ups.

Hathor
aci left patella 05
MACI left patella Dec 08

Offline courtem10

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Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
« Reply #62 on: March 25, 2009, 07:27:08 PM »
It's great to read your posts room 101. It's very encouraging for people like me who are getting ready to undergo this procedure. Hearing other people's success stories helps relieve my fears. Good luck with your recovery!!
7/08 Left knee microfracture
12/08 Left knee ACI biopsy
4/09 Left knee ACI/AMZ

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (March 16, 2009 update)
« Reply #63 on: March 25, 2009, 07:55:06 PM »
Hi, Hathor.  Yes, I still get some pain.  Which exercises seem dependent on what I have done already.  Step downs still hurt quite a lot, although if I am fresh I can do a set or 2 on 6" step... if I am tired and at the end of PT, then I have had to drop to a 4" step down.  Also, lateral step ups hurt some, but that was better Monday than it was last week. 

In PT, we have started attempting some one legged work on the mini tramp, and that is so-so at best.  I still need help there, and it's minimal the bend I can get.  Full weight bearing on the surgery leg while trying to bend it still hurts a lot, but we try it each day.  I also don't squat fully, but I do a ton of short arc stuff completely pain free. 

My therapist is aggressive, as am I, and we will try things each day.  I know all is well and we aren't doing too much because I used to get really sore for 2 days after and very stiff several hours after PT, but now I am mostly just tired.  Swelling has subsided a lot and my calf & quad are growing, so all that looks good.

If I have any concerns at this point, I am starting to really feel the screws from the AMZ in my shin and I still have trouble ending which makes me concerned about scar tissue & adhesions... but we'll just keep plugging away, and at least the improvements are motivating.

Courtem10: I know it helped me a ton to read details, and if I remember correctly you are having this done April 1, right?  Best of luck to you!

Room 101




February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (March 27, 2009 update)
« Reply #64 on: March 27, 2009, 07:54:03 PM »
It's Friday.  Thankfully... the day started out with someone at the office eating my breakfast  >:( -- We woke up late and ran out of the house this morning.  I work where my hubby does, and he made his breakfast and set mine in the kitchen in back.  I was on the phone and when I went back a few minutes later, half of it was gone.  Seriously.

Anywho, at PT last night I was at 127 degrees flexion.  The goal was to fatigue the quad big time, so we did lots of reps, but not lots of bending (only short arc), like mini lunges onto bosu, lateral walks, eccentric one leg squats (like a 30 degree bend or so).  Both legs down and one leg up.  I can tell that motion is very weak with no opposite leg help.  Balancing on one leg.  Heel raises and lots of massage and patella manipulation.  I felt good when I lfet, and then we took a walk when we got home for somewhere between 1 & 1 1/2 miles.  I felt good, but woke up quite sore.  My quads are definitely very sore.

Today, I worked out with my trainer, and we did a lot of different bridging techniques, worked on some short arc dead lifts to try and start incorporating some power into those glutes when you come up out of it.  Backwards walking and balance activities.  Any short arc deal lifts are always 2 legged.  It's way too early for one legged stuff beyond straight leg balancing or matt related work.   

All in all, I feel really good.  Sore today, so I will likely forego the walk and maybe only bike for 10-15 minutes to loosen things up.  It's pretty mundane right now doing the same stuff for all this time, but it feels good to do stuff at the same time, if you know what I mean.  We try and put different twists on the exercises also.  I got some raging elbow tendonitis from crutching and supporting myself weird, so I struggle with that right now also.  After a while, you just get tired of always being on the lookout or being careful... like when you go to a busy place and someone stops short on you... you still have to be so careful of others because on the outside, you look normal, but on the inside the knee is still so volatile.

I am thankful for what I can do and look forward to progressing.  At least I have you guys to "talk" to  ;D 

Good luck to those going under soon, and to those who just got past the surgery part!

Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (March 31, 2009 update)
« Reply #65 on: March 31, 2009, 06:00:20 PM »
Not a lot new today.  It's been 17 weeks.  We got 6 " of snow this weekend, so I was back to cooped up inside for exercise... I was getting really used to taking walks in the fresh air, but that will return soon enough.  Tomorrow and the weekend look promising :) - I stuck to riding the stationary bike and did a full workout Sunday.  I can go up stairs without any problems, as long as I go slowly.  I feel absolutely no pain, but when I get really tired, I don't push it and revert.  That is only usually if I've had therapy on that day.

We are staying within the 30 degree bend range limit and really starting to work on endurance and some more power.  The stability in my knee is fantastic, and it tracks really well.  My quad continues to get bigger, and the swelling is still subsiding from the knee, which are all very good things.  My flexion is comfortably at 127, which doesn't make me entirely happy, but it isn't extremely limiting at this point.

I can still really feel some shin pain, I'm thinking from the osteotomy screws... I never felt it before now, and it's when I stand on the leg for a while and then move.  Weird and wacky.  It hurts when I rub that spot also, but not tons.  All in all that is just a small gripe  :P

Good luck to the peeps having surgery soon or just having had surgery!

Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Hathor

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Re: Room 101's December 2, 2008 ACI (March 31, 2009 update)
« Reply #66 on: April 06, 2009, 11:15:48 AM »
Hi 101

Just thought I'd give an update as I'm at the 4 month post op tomorrow and not far behind you. I've noticed a big improvement in my knee and every week it seems to get better. I've worked out what things irritate it and try and avoid those. My main daily regimen is SLRs with 5lbs ankle weights, wobble board, step ups and bridging. In the pool I have been doing squats and multi-angle lunges along with freestyle swimming with a pullbouy so that i don't kick.. I also ride my stationary bike going down the gears and back up. The most I have done so far is 1/2hr with very little discomfort and I even ventured out on my mountain bike the other day for a 20 minute very slow ride ! It was awesome to be outside 'exercising' !!

I have just started trying stairs in the house and have felt surprisingly good, ie no pain. I am a bit nervous so going easy. I am seeing my PT once a month now just to make sure things are progressing ok. I am seeing my OS in 4 weeks for my 5 month check up and hoping for a good review. 

By the way, has your PT tried to get you on a rowing machine or anybody else used one at this stage of rehab?

Hathor



aci left patella 05
MACI left patella Dec 08

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (18 week update)
« Reply #67 on: April 06, 2009, 09:41:30 PM »
Hi, Hath.  Thanks for the update.  You are 2 weeks behind me exactly.  I noticed significant improvement around 4 months also.  I seemed to really lose the stiffness after being dormant.  I work in an office, so i sit a lot.  I can't wait for the weather to straighten up so I can take walks at lunch.  We've gotten snow two weeks in a row now.  it's getting a little late for the cold & ice & snow I'll tell you.  We seem to be pretty close in rehab, although I haven't ridden a bike or anything outside yet.  Only taken long walks.

After 4 1/2 months, I am doing pretty well.  I think the improvements have slowed down, but that seems to happen.  We were overzealous in therapy last Monday and I was still really sore on Thursday.  We didn't do any different exercises, but we did step up the intensity and endurance.  So, we backed it down on Thursday.  My trainer was out of town, so I actually took Friday entirely off.  Saturday, I did between a 2 & 3 mile walk and the knee felt great.  I also rode the bike for 15 minutes. Yesterday, I rode the bike for 1/2 hour and felt really good.  I added a little more resistance, but still not a lot.

Today in therapy my flexion seemed better.  I am definitely getting more endurance also.  We've been basically sticking to the same program I've listed here in prior posts, so it's getting mundane   :P  -- The one thing I got out of today was a crazy dripping sweat.  Man, I miss those!  It felt good.  My leg is very tired and my knee is achy, but it feels really good considering the amount of work we did.  My knee actually looks like a knee.  Very little swelling.

I can go up stairs normally and pretty quickly now (not running, but a normal stair climbing pace) without any pain at all.  I can walk for what seems like forever without any swelling or stiffness at the time.  I may get stiffer after I sit down for a while, but I don't get swelling or pain with walking.  Walking hasn't felt this good for me in many years.

I still can't go down the stairs.  I get some patella rubbing, and it just feels wrong to try too hard at this time, so we'll keep getting stronger and patiently wait for the day that I can bend like that again.

I look forward to the next big improvement.  For now, I'll be happy with what I can do that feels good, and we'll progress as the pain allows.   

Room 101

PS - Hath, I haven't done any rowing.  My PT doesn't have a rower.  His office used to be in the facility that my trainer owns and trains out of, but in the last 2 weeks, my PT has moved to his own facility.  They are pretty bare bones as far as big equipment.  Mostly items like bosu & balls & steps & therabands and all.  Rowing would be cool.  He did have this new machine I'd never seen called NuStep.  I used it today for the first time... pretty weird, but it felt really good.
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (19 week update)
« Reply #68 on: April 13, 2009, 06:07:08 PM »
Well, it was a weird week last week.  I didn't have therapy on Thursday due to the holidays, and my workout Friday was cut very short due to a project I was working on going nuts (on Good Friday nonetheless) and making me miss half the time slot.  We were at my Mom's for the weekend, so I had no access to anything, except some walking shoes and the road.  It was fairly cruddy weather, so I really did a lot of nothing.  I think it may have been a good break, though.

Therapy today.  My PT worked on some patellar scar tissue, patellar massage, IT band massage and when he measured I had increased 2 cm mass in my quad and gained 7 degrees flexion.  I was sitting pretty at 134  ;D today, and a week ago was fairly stuck around 122.  So, it seemed like the break really helped the swelling and even though I was stiff this morning, we worked it out and made some great progress.  I went through the "usual routine" of exercises.  side/forward/backward resisted short arc lungey/walkie things to comfort on the bend.  straight leg raises, short arc bosu squats. Short arc presses on his new K26000 (I don't know what it really is, but that's what we call it) and 5 minutes on the nu-step fancy elliptical/bike thing... another of his new toys, haha.    After sitting in my office chair a few hours, I feel really good and tired, but I am not stiff or sore in the wrong places.  That's very nice!

I don't even think about walking up stairs any more.  It just happens, and I do it normally... still walking, not running.  I still walk down the stairs one leg at a time... bad leg first and not bending, but I can tell I need to wait o n that part for a while still.  I am sure it will happen, but now isn't the time, so for now, I'll be happy with gong up stairs :)

So, today is one of the good and happy days.  I'll take it  :D

hope everyone had a nice holiday!

Room 101





February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (20 week update)
« Reply #69 on: April 20, 2009, 10:40:54 PM »
Ahhh, Monday.  Exhausted today.  We were in Vegas over the weekend.  Too much fun and a delayed flight due to weather in Chicago.  I don't have a ton to report in the last week.  I had 2 great therapy sessions last week where I dramatically improved RoM, and had a great workout with my trainer.  I am definitely getting stronger.

As for being in Vegas, it was the usual great time... the best part was that we walked and walked and walked, and I felt absolutely great.  by Sunday I was pretty stiff, but I didn't elevate or ice at all, and the only time my leg was up was when we were sleeping (which is not often).  I had no swelling and minor stiffness, mostly when we were at the shows and I was confined to sitting in the same position for a couple hours.  I kept to my flat shoes that I bought a few months back.. a pair of cute sandals and a crazy pair of pink shoes that have no heel and a great insole for walking, although it's a dressier shoe, so it worked.  My leg was stiff, but it was nothing like before the surgery.  It really walked off immediately, and I never felt like I was limping or hindered the entire weekend.  For once I kept up with the others!

I am glad to be back where I can ice and ride the bike some, but it sure was nice to be out and walking and the most painful thing that happened was a blister on my foot  :D 

My next follow up appointment is on the 30th of April, so I am interested to see what the OS says and to ask him a few more specific questions regarding activity.   I would figure I am about done with PT at this point.  I am looking forward to warmer weather and being able to enjoy walking around the trails by our house this summer... lucky for me that we live in Illinois, land of the flat. ;D

Take care,
Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline courtem10

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Re: Room 101's December 2, 2008 ACI (20 week update)
« Reply #70 on: April 21, 2009, 02:58:38 PM »
Hi Room 101,

It's so great to read your updates and hear about the positive steps you are making in your recovery. I was wondering how often you were doing physical therapy at this point, as you said you may be near the end?? I had my surgery 21 days ago, and I am due to start therapy next week after meeting my doctor for a 3rd follow up appointment. I am so anxious to start because right now I'm basically just doing CPM for 8 hours each day plus a few ankle exercises that he gave me. Overall my muscles feel so week and limited, and I still have a lot of soreness and muscle spasms in my knee each day, not to mention the constant swelling that won't go down. I don't feel much improvements aside from less pain. I am still only doing 50 in the CPM, per instructions by the doc, but I'm not about to take any liberties and be overly aggressive. I'm just going to stick to the instructions he gives so that my recovery goes smoothly.

Courtney
7/08 Left knee microfracture
12/08 Left knee ACI biopsy
4/09 Left knee ACI/AMZ

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (20 week update)
« Reply #71 on: April 21, 2009, 04:52:14 PM »
Hi Courtney.  It sounds like things are going quite well for you at this point, and that we are on a similar track, at least at the beginning.  I was limited to 60 degrees cpm for 4 weeks and the next 2 worked up to 90 degrees, but I was limited at 90 degrees for 6 weeks total, and in PT for 3 months. 

I started PT at a little over 3 weeks post op.  December 2 was the surgery and I started PT on December 26... the holidays did affect that by a few days for sure.

I have consistently gone to PT twice per week since then, and I work out with my trainer twice per week.  I never knew you could do so much good work on a massage table, haha  -- as for your spasms & soreness, I was very frustrated by that as well, and I think that is what prompted me to start writing here with questions, but it all seems normal.  I was also swollen for a long time.  It's honestly just been the last 2-3 weeks that i can see my kneecap again and my leg looks normal (discounting the lack of muscle and definition of course).  I was totally stoked that it didn't swell with how much I was on it over the weekend.  I just never had a chance to elevate, and i took that as a super sign that healing is going well.

Last night I realized just how terribly out of shape I am  ::) -- I rode the bike and I upped the resistance just to see how my knee would do.  I made 10 minutes riding hard enough where I had to push it, 10 minutes at one level lower and 10 minutes at the pace where I was just getting the motion and no work.  i was huffing and sweating like I'd run a 10k or something   :P ... but today the knee feels awesome and my legs are tired, so i did accomplish something, and it felt great doing it  :D

Take care,
Kim
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Hathor

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Re: Room 101's December 2, 2008 ACI (20 week update)
« Reply #72 on: April 23, 2009, 11:02:35 AM »
Hey 101

We must be due for your 5 month update !! I was interested in your trip to Vegas. How did you go on the flight to and from Chicago. I did a 4 hour flight cramped in economy on Monday and really struggled with being able to keep my leg straight (I'm 6ft). I got stuck in the middle seat as there were no aisle seats left when I checked in. I was a bit sore for the rest of the day after that as I couldn't get my leg stretched out properly.

I also found a gym at the hotel where I stayed where I could at least do some exercise. I used a treadmill for the first time, power walking for 15 mins but then as it felt good I raised the incline on the machine for 5 minutes to max. It felt ok at the time but my hamstring on that leg has now been tight and really sore for 3 days  ;D At least the knee feels ok.

I'm really looking forward to my second bike ride outside again this week-end...

H
aci left patella 05
MACI left patella Dec 08

Offline Room 101

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Re: Room 101's December 2, 2008 ACI (20 week update)
« Reply #73 on: April 23, 2009, 06:21:18 PM »
Hey, Hath!  Yep, 5 month progress appointment w/ Dr. Cole is next Thursday.  I figure I have about 3 more PT sessions left, unless he gives me more, but I think he won't.  You're a couple weeks behind me, right?

As for the flight, I am shorter at 5'5" so I can straighten the leg out some.  I was a little stiff on standing up after the flight, but it was worse coming home after being on it so much all weekend.  It walked right out though, and I really was no worse for wear.  The worst by far for me was going to a show on Saturday night and sitting in the middle of a row.  It was close to 3 hours with no leg room (and if I don't have any leg room, wow) and a really big guy on my bad leg side so I couldn't impede on his space... even if he was my friend.  There was no room!  I was sore during the show, but again it was gone as soon as I could move it some.  FYI, I did ask before the flight if i could get my seat changed from the middle, and they were able to accommodate that, which was great.

Wow, power walking.  I haven't gone there yet, and I haven't tried a bike outside either.  I am happy to hear it's going well for you  :D  - My protocol up to 6 months is slow paced walking & balance drills, w/ some very basic sport specific things... which we have done a lot of lateral movement, etc.  I will wait for my appointment to make sure it's ok to do more things like that. 

I have only tried to put some mid resistance on the bike once so far, and it was great, but I did get some knee soreness 2 days after (a day & a half because it was Wed. morning after I rode on Monday night).  I'll definitely push the resistance again on the bike, but it won't be until this weekend because I have PT tonight and my training workout tomorrow.  I am always sore after working it for 2 days.

I'm interested to see if I sustained my RoM or if it is less again.  I do feel a little swollen & inflamed, but most likely I just need the deep scar tissue massage again... somehow I have a hard time creating that kind of pain on myself  :o

I think this weekend is supposed to be great weather, so I am hoping to walk the trails by our house.  If it doesn't rain anymore, they should be solid enough.  The dogs will love it  ;D

Hope everyone else is doing well.

Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline Hathor

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Re: Room 101's December 2, 2008 ACI (20 week update)
« Reply #74 on: April 25, 2009, 08:52:53 AM »
Ok 101, maybe 'power walking' was a bit of an exaggeration...maybe more of a brisk walk, longer strides. As you know I'm on take-two so would never take an unnecessary risk at this stage. having said that it was really tempting to start running as I've never actually used a treadmill for anything but running!

The bike ride today was awesome, outside on flat road spinning mostly in the easiest gear for 1/2hr. All very slow but fun.
My PT has introduced pedaling with one leg last week by standing to the side of the stationary bike and turning the strokes with the injured knee. It's really hard work and excellent for inner range quad esp. VMO. I'm up to 5mins at a time and my leg feels like it weighs a ton when I'm done because the muscles are so tired. As it's only 5mins it doesn't seem to give me any soreness at all. :P

Hathor
aci left patella 05
MACI left patella Dec 08















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