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Author Topic: MACI Info  (Read 15665 times)

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Offline Rennschnecke

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Re: MACI Info
« Reply #30 on: November 20, 2009, 06:10:53 PM »
Hi Teepers

Glad to hear that everything went well for you!  I had MACI in a different area (trochlea & patella) so I was fully weight bearing although in a straight leg brace.  It feels really good.

Take Julian's advice and try not to overdo it as inflammation may also promote the growth of adhesions (particularly if you are prone to this).  If these are unpredictable, it may lead to slower progress.  I'm now around 5 months post-op but have problems with fully weight bearing.  Stupidly feel good PWB with a crutch but can't totally ditch it.  This is due to adhesions which stopped the knee bending to 90 degrees and subsequent surgery.  I was feeling great at 6 and 8 weeks post-op then it went downhill.  I really hope you avoid this.

BTW how do you manage to get around car-wise?  I've been on crutches since last December and can't get a disability badge.  I've been unable to do any shopping (including grocery stuff) since then apart from on the Internet.  Being stuck at home is getting to me in a majorly way now and I'm trying to work out how others manage this.
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

Offline Teepers

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Re: MACI Info
« Reply #31 on: November 23, 2009, 12:14:17 PM »
Thanks for your reply Rennschnecke.

At the moment things are progressing well (I think). Have followed phsio's advice, and am happy to report I have about 100 - 110 degrees of movement. The knee also doesn't react too much now, however at night it starts to ache alot. Is this normal?. Thinking of going to the gym on Thursday upper body only! and nothing to strenuous.
 
I haven't been out much, but now I can bend the knee I can get in the car without discomfort and my wife drives. I don't go very far but at least it's a change of scenery.

Have my second phsio appointment on Friday and I hope I can progress into the hydro pool. Still NWB for at least another 3 weeks and then it will probably be PWB for a couple after that. I have to say my wife is finding it hard with 3 kids and me to look after but at least I can do a few jobs around the house to help out now, all be it balancing on 1 leg, good for strength building in my other leg.
I am extremely bored and frustrated however in general I am happy with progress and this week I plan to get out more. The brace I have is a God send as it is much more comfortable than a plaster and allows me to bend the knee in the brace if I want to.

Offline Rennschnecke

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Re: MACI Info
« Reply #32 on: November 23, 2009, 06:02:38 PM »
Sounds like you're doing really well Teepers.  Barely 3 weeks post-op and you have over 100 degrees flexion! ;D

It is quite usual for people to feel pain more at night time than during the day.  It could be due to the accumulated activity through the day or it could be due to the fact that you have fewer distractions at night than during the day.  This then begs the question of whether it is usual to have pain.  As you're still pretty early out of a major surgery I'd think you will still be recovering and aching isn't anything to be concerned about.  I think that other posts have spoken of sharp pains affecting them rather than aching but their grafts were OK despite that.

I guess you could just take the meds and wait for things to settle.  If the pain is disturbing you, you could also try what I'm doing and that is to take an ice pack to bed.  (Take it off before sleeping or you could get ice burn followed by overheating.)  I then use the resultant cool pack in the morning to ease my early morning pain.  If it wasn't for this I'd probably spend all morning rolling around in bed. ???
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

Offline Teepers

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Re: MACI Info
« Reply #33 on: November 25, 2009, 09:41:44 AM »
Rennschnecke thanks for your reply.

I spend alot of time icing the joint especially at night because of the ache. There is on thing thats on my mind and thats the circulation in my leg. Every time I stand up my foot goes very red almost purple and becomes cold. I have noticed that my knee and foot has been cold since the operation although things have improved. My feeling is that the swelling played a part early on, however I would have thought by now this should no longer be a problem. Has anybody else had this problem is this normal after the surgery.

I am seeing the physio on friday the first time for 2 weeks so hopefully will get an answer then.

Offline Rennschnecke

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Re: MACI Info
« Reply #34 on: November 28, 2009, 12:36:49 AM »
Sorry, I'm no physiology expert but I know that I have been advised to do ankle pumps etc for maintaining circulation.  This is important as you're probably not as active as normal and as you aren't WB you probably aren't pumping blood round as much.  Try ankle pumps and circles while you wait to speak to the physio.  Can't really do you harm.
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

Offline Teepers

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Re: MACI Info
« Reply #35 on: December 12, 2009, 04:43:39 PM »
The Voice,

Thanks for your message for some reason my computer will not allow me to reply to you, so I will have to reply from here. Hope your op went well and sit tight for the first couple of weeks as this was the time scale for me before the knee started to settle down. I managed a bath on day 3 and once the stiches were out went for showers instead. I personally haven't had any problem getting around the house and I personally feel you can do alot more than you think.The best advice I can give you is to rest as much as possible as the knee doesn't like being down for very long. After 2 weeks I found I was able to do alot more, but I still had my ups and down. I have been up alot more than I would have hoped but with 3 kids I had no choice, however I feel better for it now as the crutches give you a good workout. From what I've heard everyone reacts differently to the procedure so don't worry if you are not recovering as per the protocle. Do your exercises and don't push it to much as the knee will swell and become painful, you will overdo it at some point but don't worry we've all done it. I found the knee could ache alot at night (probably me doing to much).

I Will be 6 weeks post op on Tuesday, had my first Hydro session 2 days ago and I have to say I had no reaction at all, worked it quite hard and no swelling that's good. All in all its a slow recovery nothing you can really do apart from rest and do your exercises. Ice is also important, my knee still puffs up if i'm up on it for to long but it settles down with rest. I have about 120 degress of flexion now and I suppose it took around 3 weeks to get beyond the 90 degree mark. I have another phsio appointment on wednesday will get an accurate reading then. I am also seeing Prof. Briggs on Tuesday fingers crossed I can move onto partial weight bearing.

There is nothing  extra you can do for the first 6 weeks that will speed up the recovery. The NWB is hard to get your head around, I've had a couple of stumbles and haven't injured the knee, so try not to get paranoid if you end up putting some weight through the knee. You might find the physios don't want to see you to much early on this I believe is the norm as there is very little they can do. The time does past quite quickly but it is frustrating and boring just hang in there. Goodluck and if you need more info please just ask.

 

Offline thevoice

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Re: MACI Info
« Reply #36 on: December 13, 2009, 09:44:38 PM »
thank you for the reply,

Glad to hear your reaching some milestones with the recovery - it must be great to be at the 6 week mark just about - feels a long way away at moment, although i am approching 1 week.

I get to take my brace off in 2 days - will be having a bath for first time in a week! looking forward to it!

My recovery plan sounds a bit different to yours - i am 4 weeks touch toe bearing, followed by 2 weeks PWB and then FWB at week 6 although i suspect due to muscle wastage it will end up being around weeks 7/8 that i can walk without crutches.

Also have been told to start bending the knee from day 7 when brace comes off - If I can get to 90 degrees by 2nd week i will be pleased as it will make getting in car, sitting on toilet easier.

Good luck with your 6 week review and let us know how you get on.

Offline Teepers

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Re: MACI Info
« Reply #37 on: December 17, 2009, 02:31:04 PM »
The Voice

Thanks for your e mail once again, and once again my computer won't let me reply to your message.

Everything looking good, Prof. Briggs really happy, have 130 degrees of bend now, still some swelling mainly on the top of the knee. Have been cleared for PWB so now down to just the 1 crutch. Have also now removed leg brace, which is an interesting point as I see from your other post you have been allowed to remove your brace after 2 weeks. I have to say that I lived in mine for 6 weeks just removing it when resting the knee or doing my exercises. I also slept in it for 6 weeks as I found it more comfortable to do so. I have to say Prof Briggs made it clear not to remove the brace whilst I was up and about, and having stumbled a couple of times and I could have injured the knee if the brace wasn't there to protect it.

Went to physio on Wednesday and have started light cycling and rowing. Been to Gym this morning managed 10 mins cycling and 5 mins rowing. Infact managed an hour workout all in all and feel really good for it. The knee feels fine in general however a litttle sore now it's taking more pressure. Really happy though as there is no pain at all in the knee when weight bearing or when exercising. 

With regard to the electric shock pain yes I had this as well, must be to do with the scar and nerve damage. As I mentioned before the knee doesn't like to much work early on so don't worry to much, enjoy the rest.  Looking back now 6 weeks for me has flown by (my wife however is ready to kill me though). All I can say is listen to the experts and listen to your knee, take your time beleive me there were times I nearly went to the gym and I am now glad I didn't. My wife spoke to a lady the other day who had a MACI, she is really happy but pointed out that she did very little for the first 6 months and is now reaping the benefits, she also knows people who did to much to soon and are struggling.

Good Luck

Offline thevoice

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Re: MACI Info
« Reply #38 on: December 17, 2009, 04:34:27 PM »
thanks teepers.

Is your brace a straight leg brace? or does it allow movement? Yeah i find it odd that I have been allowed to take my brace off - to be honest i think i will end up sleeping in mine as i have had to many jolts during the night (kind of like when you wake up because you feel your falling or something).

Sounds like your progressing really well.


Offline goobervision

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Re: MACI Info
« Reply #39 on: December 27, 2009, 04:23:15 PM »
I thought I would post, just had MACI (femoral medial condryte) and microfracture (patella) on my left knee on the 8th Dec.  This is following a failed microfracture 4 years ago and a number of tidy-ups.

Anyway, on the 9th I was on the good old knee bending machine and then onto passive knee bends with an orthoglide.  Compaired to my original microfracture this feels much easier, I don't know if this is because I know whats comming.  In terms of bend I am already at 145 degrees and think I could do more but don't want to risk it as being an inch or two short of a full bend is something I can work on later! I have a little pain, mainly around the surgery wounds (4 from keyhole), swelling is there but not too bad and seems to be OK with ice, but I also have a cold foot!

My physio tells me that I can go on a static bike with no resistance, starting at 5 mins.  Did this in the hospital on the 23rd and didn't feel any adverse effects, so I am off buying a bike in a hope that I can keep some muscle as I can already see the wastage and don't relish the time in the gym to get it back. 

I'm also touch-bearing with a maximum 40 degree bend, but have to keep the barace on 24 hours so swap to a straight brace at night as I can't sleep in the joined brace.

Anyway, good luck! 

Offline Teepers

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Re: MACI Info
« Reply #40 on: January 12, 2010, 08:52:47 PM »
Sorry all for delay in replying.

My appointment with Prof. Briggs at 6 weeks post op went well, he was very happy with the knee, allowed me to PWB for the next 2 weeks and then  lose the crutches. I found however that after a week I no longer needed the crutches. The knee really did respond well to weight. I was allowed to cycle and row and the knee again responded really well. The knee ached alot at night (RESPONDING WELL TO ICE) but this lasted for a couple of weeks and is now fine.

Since then the knee has come on leeps and bounds I am now 10 weeks post op and allowed to do most things apart from running. I have my aviation medical back and I am now squating with light weight, cycling 30 mins at a time, using the X trainer and rowing with no pain. I am really happy and even had a big fall the other day in the snow with no problems which ironically has given me more confidence. One thing I would say is I found the power plate really good and I have also worked using a foam roll to stimulate the IT muscles which has relieved alot of the knee pain.

Good Luck to you all and if you have any questions just ask away.

Offline Crazynasha

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Re: MACI Info
« Reply #41 on: January 13, 2010, 12:07:10 AM »
Hi Teepers,

Hope your rehab is going well and wish you all the best in recovering. I am going to have my final stage of MACI on my right knee on the 18th Jan & I am starting to feel anxious and somewhat scared in terms of what lies ahead.

I was wondering if you could tell me abit more about the rehab process involved after the operation. You mentioned in one of your previous posts about electric shock pain, could you elaborate abit more on this as it sounds painful. The thing that worries me the most is the rehab itself, I dont want to rush it too quickly and at the same time I want to regain movement as soon as possible...what a situation!

Another thing I am not looking forward to is doing nothing for 6-7 weeks, i guess this gives me the time to catch up on TV...lol!

I would appreciate all your advice and will keep updating on the progress of my rehab.

Thanks

Crazynasha

Offline Rennschnecke

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Re: MACI Info
« Reply #42 on: January 13, 2010, 01:13:53 AM »
Congrats Teepers!  Sounds like it's going really well and that the time on crutches is now a dream (nightmare?).

Hope it continues to improve as it has been doing!  :)
1/05 Ski accident: 5/05 ACLr LK; 10/06 Scope – debridement, trochlear cartilage lesion (Gr4); 12/08 Scope – chondroplasty, hematoma; 5 & 6/09 MACI patella & trochlea 'kissing lesions', ROM 0 to 80; 9/09 Scope – LOA, IPCS & patella infera; 9/10 Scope – AIR & LR.

Offline thevoice

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Re: MACI Info
« Reply #43 on: January 13, 2010, 02:38:31 PM »
excellent progess teppers! I think this is the most postive short term outcome I have read so far. Glad its all going well keep up good work.

Offline Teepers

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Re: MACI Info
« Reply #44 on: January 13, 2010, 08:37:39 PM »
Thanks for all your replies.

Crazynasha my advice is to enjoy the rest, 6 weeks pass quickly (not for my wife however), there is very little you can do early on the knee just wants rest and will swell if your up on it too long. After about 3 weeks you can certainly do more, with 3 kids I had lots to do. This meant I stayed quite active on the crutches and my upper body got a work out . The electric shock pain is nothing to worry about it's like a slight nerve twinge along the scar. The rehab I have found straight forward and the knee has responded well. I would recommend the hydro pool early on but honestly just rest it this will benefit you later on.

With regards to the operation I only had pain straight after the operation, the drugs deal with this quickly so is nothing to worry about. I didn't start bending the knee if I remember correctly for at least 2 weeks and found the knee bend returned pretty quickly. I had no problems bathing, using the toilet or getting around. Rest is the key.

The MACI recovery is quicker than the ACI my physio has informed me and alot more straight forward, which is where I was confused. Remember everyone reacts differently so work at your own pace. I am not blowing my own trumpet but I have found the recovery easy (however I like to exercise) and the knee surgery is certainly not as dramatic as some people would have you believe, however remember mine was a straight forward MACI procedure with no other complications, some people have various surgical procedures at once. Each surgeon seems to have a different protocle so stick to it the best you can.

Goodluck