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Author Topic: Osteochondritis Dissecans--microfracture performed  (Read 13499 times)

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Offline derek320

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Osteochondritis Dissecans--microfracture performed
« on: July 15, 2009, 11:34:50 PM »
Alright, I'm new here so I'll give all of you a little background of my left knee.

Right now I am 17 years old, going to be a senior in highschool, almost 3 years ago in the fall of my freshman year I was wrestling with a neighbor for fun. He landed on my left knee which caused a loud popping noise, I was in constant pain for about 3 days after this. I went and got an x-ray, nothing showed up. I got an MRI and was told I had a slight meniscus tear, I went to the orthopedic and was told that the tear was small enough that surgery wasn't necessary and that if I took it easy for a few months it would be fine.

Well, ever since that meniscus tear, my left knee swells up and gets stiff whenever I do something like play football, play volleyball, or go hiking. This dealt with because the swelling would always go down within 2 days and was never in pain. Now, only about a month ago, I woke up to find that whenever I bend my knee it makes a popping/cracking noise, I dealt with this for a few days  then decided to call the orthopedic. They sent me in for another MRI and x-ray, both showed that I have osteochondritis dissecans in my left knee and that I have a loose lesion that is about the size of a quarter and at least 2cm deep into my femur bone.

My orthopedic said he he never done a surgery before to correct this issue, so he sent me to a specialist at UMASS Worcester Medical Center. He told me that he could fix the loose lesion by putting bioabsorbable screws through the bone to hold the piece in. I guess these screws are made of a plastic and they are dissolved by your bone after 2-4 years so there is no need to have a second surgery to remove the screws. I now have my surgery scheduled for the beginnning of August. After that, I will be on crutches for 6-8 weeks of non-weight bearing and therapy for a 8-12 weeks.


Has anyone had this same condition and had a similar surgery? What are the long term effects? Did it correctly heal for you?

My doctor told me that the surgery has an 85% success rate, is this a good success rate for the condition I have. From what I've read, OCD is a pretty rare occurrence and is only present in around 30 in 100,000 people.

The doctor already told me that there is no avoiding having arthritis in my knee, that I'll probably have arthritis by the time I'm 30. I'm fine with that, because it will help me for now and who knows, it 13 years they may be able to cure arthritis.


Sorry I wrote so much. I couldn't think of a way to make this shorter since I figured I should explain my entire knee situation. I appreciate you reading this and replying.

Derek
« Last Edit: October 10, 2009, 07:52:08 PM by derek320 »
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline daedalus

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Re: Osteochondritis Dissecans in left knee
« Reply #1 on: July 16, 2009, 03:15:08 PM »
Derek,

Sorry to hear about your injury.  I'm 32 and hurt my knee three years ago.  My OS has diagnosed me with Osteochondritis Dessicans and chondromalacia patella.  He said the OCD was probably a pre-existing condition which was aggravated by my injury.  In my case, the lesion is quite small so he is not sure whether surgery will help.   Basically I don't have a clear diagnosis so surgery seems like a crap shoot to me.

In your case, you seem to have a clear diagnosis so I would think your chances for a favorable outcome are decent.  85% sounds good, but I don't know what to compare that to.  It sounds like you're taking the right course of action so far.  However I would recommend seeing another specialist to get a second opinion, and possibly even a third opinion.  I've seen about 5 OS's over the last three years and you'd be surprised at some of the opinions I've gotten.  One OS told me I have a meniscus tear, and another told me I have arthritis.  When I asked other specialists they literally laughed and said there is absolutely no evidence of either one. 

So do your homework and consult another OS or two, then go with the one you feel most comfortable with.  It sounds like you're keeping a positive attitude and that counts for a lot.  Best of luck and let us know how things go.





Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #2 on: July 20, 2009, 08:20:48 PM »
I actually have seen 3 surgeons, the 1st one said that it would have to be bolted in but he didn't want to do it as he has never done that type of sugery before, he referred me to the second surgeon who is going to be doing my surgery. He said bolting/screwing was the best method, he then had a colleague come in and give his opinion, he said the same thing. So I've had 3 surgeons look at my MRIs and knee and all have recommended the same type of surgery.


I have another question related to the recovery period though. While I'm on crutches I realize that mobility is going to be an issue. Does anyone have any suggestions on how to make life easier while on crutches. I bought a new shower head with a hose and found a chair that fits in the shower, so I think I solved the shower issue, is there usually a timeperiod in which you can't get your knee wet due to stitches?
Also, since it is my left knee, do you think I will be allowed to drive, if so, does anyone have suggestions on getting in and out of the drivers seat(left side if car) without putting any weight on my left leg?

Any other suggestions on how to overcome mobility issues I haven't thought of are welcome, thanks...
« Last Edit: July 20, 2009, 08:23:06 PM by derek320 »
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline mollyc

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Re: Osteochondritis Dissecans in left knee
« Reply #3 on: July 21, 2009, 03:57:05 PM »
Derek: There's a really great thread on the cruciates board about what to do to get ready for surgery. (It's at the top of the board, affixed there with a sticky.)  Lots of the advice has to do with things to do in advance to make being on crutches/getting around easier. I found it invaluable when preparing for my ACL reconstruction.  Good luck. Molly
Ski accident 2/14/09
Ruptured ACL, MCL sprain, bone bruise
ACLr allograft 5/27/09
Knee now 100% fine...skiing and playing tennis regularly

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #4 on: July 21, 2009, 06:33:33 PM »
Alright, thanks.

As for my question about showering, I'm all set, I asked today when I was at my pre-op testing. I was told that I would have to cover the stitches with bags, but after that I was fine to shower and it was recommended that I put a chair in the shower.


I also found out alot about the procedure. I will meet the anesthesiologist an hour before my surgery, he will tell me everything I need to know before the surgery then he will put me under. The actual surgery takes 1.5 hours, so I will under for around 2 hours. Then I have to spend 1-1.5 hours in the recovery room before I'm allowed to leave.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #5 on: August 06, 2009, 02:28:38 AM »
Just a little update....

my surgery is Friday, so I am pretty much preparing for it...I had my last day of work yesterday, so I'm done working until I'm recovered

-I bought myself a shower chair at walmart and put a non-slip rubber mat under it to prevent the chair from sliding
-I moved furniture around in the rooms I will be in to make sure I could fit everywhere with crutches
-I put little TV trays next to my chairs and bed to make sure I have places to put down sutff
-made sure I have enough entertainment for the next 6 weeks, cause its going to be boring

I pretty much have figured out how to do everything I need to do while on crutches and without bending my knee (I'm assuming my knee will be immobilized after this surgery-I forgot to ask the surgeon what kind of brace I would have)

The only questions I have unanswered is will I be allowed to drive? It is my left knee, so I see no reason why, at least once I'm off the painkillers whatever other drugs...does anyone have any experience with being allowed to drive after a surgery such as this? I plan on asking him at my surgery, I'm assuming if I am allowed to drive it will be after my post-op.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #6 on: August 07, 2009, 11:58:30 PM »
Well, I'm back from surgery. The loose bone lesion had completely broken loose since my MRI, so they ended up removing the piece of bone. He the did a microfracture surgery to stimulate the growth of new cartilage. I'm in a little bit of pain as the meds from surgery are wearing off and the oxycodone hasn't kicked in yet. I am in a no weight bearing status for at least 4 weeks.

Overall it was a good experience...I met with my surgeon, the nurse, the anesthesiologist and his assistant. They were all talking to me in the OR and next thing I knew I was waking up in the recovery. I was actually really hungry which they thought was weird cause most people feel sick not hungry. All the staff were great, they made sure I wad comfy at all points and were trying to make jokes about the surgery before it to make me less nervous.

I am allowed to drive once I'm off the drugs and am allowed to shower on Monday.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline will1129

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Re: Osteochondritis Dissecans in left knee
« Reply #7 on: August 08, 2009, 07:28:16 AM »
Good luck man, I'm facing an ankle surgery next year where I'll have no weight-bearing for six weeks, so keep me updated on how you're doing. Hope you feel better, and that the surgery was successful.
Deeply regret having knee surgery...hoping it can be fixed.

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #8 on: August 08, 2009, 09:46:14 AM »
Thanks, the non weight bearing really sucks. I had a hell of a time getting up the 2 steps from my garage into my house. We have no rail at those stairs and I didn't feel steady on the crutches to go up the steps. I ended up sitting on the steps and pushing up the stairs on the good knee. Scooted into the kitchen and used two stools to  push myself up while my brother helped stabilize me.

I'm sure I'll get better at doing day to day stuff as it goes on, but right now it sucks. I'm sleeping on my couch for a few days cause I don't think I could make it upstairs to get to bed.

In your case it might be a little easier though cause you can bend your knee if you need to.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #9 on: August 17, 2009, 07:12:50 PM »
I just got home from my first post op, it's been 10 days since my surgery. I got a few pics of the surgery, no video because they had computer issues when trying to get it on a disk. They took a picture of the removed cartilage/bone, it's about 2.5cm x 2cm. They showed a picture of the drilled holes, I counted 8 of them.

I am completely non weight bearing until at least October 1 which puts me at about 7-8 weeks post op. I have an appointment with my surgeon on October 1 and he will decide whether or not to keep me on crutches, go to partial weight bearing, or full weight bearing. Until then I have physical therapy twice per week. He said I should be completely recovered in around 3-4 months.

The removed piece of cartilage was sent to the Carticel labs so that I can have the carticel surgery if the microfracture didn't work. He said this is only a backup option, that he is pretty sure I should recover fine.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline mkurz

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Re: Osteochondritis Dissecans in left knee
« Reply #10 on: August 19, 2009, 04:21:51 PM »
Thank you so much for sharing your progress.  My 12 year old son also has OCD in his left knee and is scheduled for surgery next Tuesday, the 25th.  Any advise on preparation for the surgery or the first week at home?

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #11 on: August 19, 2009, 10:50:53 PM »
Some of my recommendations would be...

-shower chair-it's been a real help when showering
-shower head on a hose
-if you have a house with multiple floors, put your mattress on the first floor along with anything else your son will need, I still won't go up and down more than a few steps
-make sure you have plenty of ice packs, or in my case the doctor gave me a cryo cuff
-plenty of pillows to elevate the knee
-plenty of movies and video game
-backpack to carry everything

I can't think of anything else right now...pretty much make sure everything is easily accessible.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline mkurz

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Re: Osteochondritis Dissecans in left knee
« Reply #12 on: August 19, 2009, 11:16:37 PM »
Thank you.  Are you still having trouble getting around?  We were told he would be able to go to school one week after surgery.  Do you have a brace that keeps your leg straight?

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #13 on: August 19, 2009, 11:43:57 PM »
I'm pretty good at getting around now, once you get used to the crutches it's pretty easy except for stairs. I made it on vacation around 5 days post op. I couldn't really do much besides sit around, but school should be no issue except for discomfort. Sitting on chairs is pretty uncomfy unless my foot is propped up. When I put it on the floor I can feel the blood rushing to my foot because you have poor circulation due to not moving your leg.

As for a brace, I'm not wearing anything. After the surgery, my doctor told me he wanted me bending my knee. So I don't wear anything on my knee, I can barely bend my knee though.

Another thing to make sure you have after the surgery are gauze pads. I'm not sure exactly what your sons surgery is, but in mine they had to make an incision around 1 inch long, this incision oozed blood for almost a week, so gauze is a good idea to cover it up. The other two incisions were very small and stopped oozing by 2 days post op.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft

Offline derek320

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Re: Osteochondritis Dissecans in left knee
« Reply #14 on: August 27, 2009, 08:37:30 PM »
I started physical therapy Monday and had my second session today. I am going to be going twice a week for 1 hour sessions until I'm off the crutches, then they will increase therapy. On Monday I couldn't straighten my knee beyond -31, today I was able to reach -16. On Monday I was able to bend to around 75, now I can bend to 91. They told me that the goal is to get my knee from 0 to 130. The therapist gave me a few excercises to stretch it out at home and increase my ROM which seem to be working well. I'm finding that straightening my knee is a lot easier than bending it.

The therapist is also using electrodes to get my quads to start contracting so they stay strenghtened and to help get rid of the swelling (my knee is still huge).

The cryocuff has become my best friend when therapy is over, icing pretty much provides me with instant relief from the pain and soreness. But I am making good progress according to my therapist.

I'll keep you guys updated.
-Left knee history-
Oct 06- injured knee, MRI shows torn meniscus, no action
June 09- knee begins popping, MRI shows large OCD lesion
Aug 09- OCD lesion removed, microfracture surgery, partial meniscectomy
Jan 19- biopsy for MACI, partial meniscectomy
Apr 19- MACI implantantion, meniscus allograft















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