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Author Topic: My Scope & the road to ACI...  (Read 11144 times)

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Offline thornburg

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Re: My Scope & the road to ACI...
« Reply #15 on: January 29, 2010, 12:23:43 AM »
Sounds like your doing well, keep it up!  Be careful though on those good days !

I was told the same thing when I was at your point (now 8 week ACI post op) .. increase the CPM.   Do it .. you will be glad down the road.

Take care and keep us updated!

- thornburg

Offline tremy1977

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Re: My Scope & the road to ACI...
« Reply #16 on: January 31, 2010, 08:24:33 PM »
Hi Murph.

The discription on your knee sounds really bad, hope your recovering well after the ACI op ?

I'm  due to go in next week for my scope to take the biopsy. I'm schedualed for the 2nd march for the ACi. I'm having a full meniscus replacement to at the same time. Did you happen to have any construction done on your meniscus ?

keep us posted on your recovery as every little helps on here.

cheers
Paul

Offline Melissa S

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Re: My Scope & the road to ACI...
« Reply #17 on: February 01, 2010, 07:12:42 PM »
Hi Murph:
Glad to see you back on the board.  I am curious as to how bad it is those first few weeks.  Are you basically unable to get out of the house?  Is it hard to get around on crutches with the straight leg brace?  Just asking because it looks like my surgery will fall right in my son's football season and I hate to miss his games. 
Injury with knee hitting concrete 7/07, partially torn ACL, and cartilage damage
Scope and debridement 2/08
2nd scope 1/10 with carticel biopsy
Carticel implant surgery on 11/8/10

Offline Murph324

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Re: My Scope & the road to ACI...
« Reply #18 on: February 02, 2010, 05:29:08 PM »
The first time that I left the house was to go to the Dr.  It went ok.  But, last Jan I had a different surg so I was in the same brace from Jan-Apr.  So, I have it mastered!  First few weeks were ok.  I had good and bad days!

I didn't have anything else done during this surgery.
03/04/08- Left Knee Injury
06/18/08- Lateral Release
01/26/09- TTO/Microfracture
10/16/09- LOA/Cartilage Biopsy
01/06/10- ACI
03/24/10- LOA/Hardware Removal
06/04/10- LOA w/ Drain/Lateral Release

Offline ajschnelk

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Re: My Scope & the road to ACI...
« Reply #19 on: February 02, 2010, 06:44:00 PM »
Hi Murph:
Glad to see you back on the board. I am curious as to how bad it is those first few weeks. Are you basically unable to get out of the house? Is it hard to get around on crutches with the straight leg brace? Just asking because it looks like my surgery will fall right in my son's football season and I hate to miss his games.

Hi Melissa,
It depends on whether or not you have anything else done in additiont to the aci.  I had an amz as well and I did not leave the house for the first two weeks other than the first follow-up appt.  For me the worst part was the first 7-10days due to the amz pain.  After 3wks or so, I was eager to get out and about (a few hours at a time).  It won't be that enjoyable, but I'm sure you'll be able to make it to football games after the first week or two. 

 

Offline Melissa S

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Re: My Scope & the road to ACI...
« Reply #20 on: February 03, 2010, 07:00:35 PM »
Ok, thanks for the info.  I am just having the ACI done.  He did say he might tighten up the outer ligament if it needs it once he gets in there, but I don't need the AMZ because my alignment is good.
I'm sure I will have more questions once my time gets closer but it is great to come on here and talk to people who have went through it.   :)
Injury with knee hitting concrete 7/07, partially torn ACL, and cartilage damage
Scope and debridement 2/08
2nd scope 1/10 with carticel biopsy
Carticel implant surgery on 11/8/10

Offline ajschnelk

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Re: My Scope & the road to ACI...
« Reply #21 on: February 03, 2010, 09:11:54 PM »
Ok, thanks for the info. I am just having the ACI done. He did say he might tighten up the outer ligament if it needs it once he gets in there, but I don't need the AMZ because my alignment is good.
I'm sure I will have more questions once my time gets closer but it is great to come on here and talk to people who have went through it. :)

Best of luck.  As far as the AMZ goes, every doctor has a different belief on it.  My doc routinely does them because he feels that unloading the patella some will only improve the chances of the implant being successful.  He released a study that shows the force the patella generates is reduced by 30% after having an amz.  I did not have any alignment issues, I had a distal amz which is basically raising the tendon away from the tibia a tiny bit to help unload the patella from the trochlea.   It's a little more rehab and initial pain, but after a few weeks, it's not a big deal. 

Offline Room 101

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Re: My Scope & the road to ACI...
« Reply #22 on: February 05, 2010, 12:20:53 AM »
Hi, Melissa.  I am right with AJS.  I had my AMZ done with my ACI biopsy and the blood rushes the first week were ... interesting.  I remember I went to vote 4 days after the surgery.  When I was sitting on the couch I felt great and needed zero meds, but that hour I was up and trying to vote not only wore me out but the pain returned like crazy for a day.  I was back at work at my desk job 6 days after surgery.  I'm not sure that was the wisest move.  10 months after that I had the ACI, and I saved all of my vacation for that timeframe.  I went to the office like before, but only 2 days a week, if that.  Both times was winter, so I was very careful, but I had my ACI just prior to Christmas, and we went family to family like always.  It wasn't that bad getting around with the brace, and it sounds like the weather will still be good for you.

I was weight bearing to tolerance after ACI, as long as my brace was locked at 0.  I went to a company Christmas party less than 2 weeks after and visiting family on other days.  I even went to shop at the Apple store for an hour.  I must also note that there was no place like home and no place like my couch or my chair for that first month, but I am one to go nuts just sitting also.  The holiday activities made the time in the brace go quite quickly.

Take care, and best wishes to you.

Room 101

I hope it is encouraging that you can get out if you feel like it.
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 Melissa S

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Re: My Scope & the road to ACI...
« Reply #23 on: February 05, 2010, 05:19:14 PM »
Room 101, yes that is very encouraging that you were able to get out and around so soon after surgery.  I am like you.  Just the week I spent home after my biopsy drove me nuts.  So, i am a little apprehensive about the long recovery with the next.  But, it will all be worth it if it works and my knee is better and I can avoid a TKR.
Injury with knee hitting concrete 7/07, partially torn ACL, and cartilage damage
Scope and debridement 2/08
2nd scope 1/10 with carticel biopsy
Carticel implant surgery on 11/8/10

Offline Murph324

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Re: My Scope & the road to ACI...
« Reply #24 on: February 25, 2010, 05:32:13 AM »
Hi Everyone!  I know that I am not very good at updating this.  You would think with all of the free time I have, I would be better at it!  Things are going well.  I started PT, and that's going good.  We are still at a stage where we can't do very much.  I'm having a very hard time with ROM.  I was measured yesterday, and I am still at 70 degrees with my leg hanging off of a bed.  I can reach 100 on the CPM.  We are waiting for my surgeon to call my PT back.  I have an appointment next week, so I will have more info then.  I have been able to get out more recently, and the quad muscles are starting to do their job again.  Straight leg raises have been no problem, which is a relief.  ;D  After my TTO last year, that was something I had a hard time with.  And, there is nothing more frustrating, sitting there, and not being able to lift your leg off the bed. Not even an inch.  My PT and I both let out a sigh of relief when I got it on the first attempt this time! It's nice being with a physical therapist who knows my story, what i've struggled with, accomplished, ect.  I have the same PT that I saw from Jan through July last year.  Since my first surgery in June 08 I have struggled with ROM, so I am hoping within the next week I will get some answers on that.  ???  Thanks for everyones encouragement & kind words!  Will try and remember to check back in soon!  Hope everyone is doing well.  :)
03/04/08- Left Knee Injury
06/18/08- Lateral Release
01/26/09- TTO/Microfracture
10/16/09- LOA/Cartilage Biopsy
01/06/10- ACI
03/24/10- LOA/Hardware Removal
06/04/10- LOA w/ Drain/Lateral Release

Offline Rennschnecke

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Re: My Scope & the road to ACI...
« Reply #25 on: February 25, 2010, 12:18:35 PM »
Hi Murph

It's great to have a good PT that knows you and that you trust isn't it?  That means you have someone who fully appreciates how good it is when you achieve something.

Sorry to hear about the problems you've had with ROM.  I had similar ones after my ACI.  Since yours have been ongoing since June 2008 did you get any treatment for that then?  Have you done any research into it yourself?

I hope you get some good answers to your questions next week.  Let us know how you get on.
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 Murph324

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Re: My Scope & the road to ACI...
« Reply #26 on: March 07, 2010, 03:59:53 AM »
This week I had another Dr. appt.  My PT faxed him all my info, so he knew that the ROM issue hadn't improved.  I'm still barely reaching 70 degrees.  My Doc was hoping that I would be at 110 by this point.  In a few weeks he is going to do a scope and remove scar tissue.  They'll do the LOA and put the drain in for 24 hours.  The next day I take it out.  it prevents more scar tissue from forming.  He felt horrible, even though we both realize that this wasn't avoidable.  Ordered to stop PT and send the CPM back.  I can go back to therapy after the procedure.  I'll be on crutches for another 2 weeks.  I'm just discouraged.  I was starting to feel ok, and now this is just a big set back.  I'll update after the procedure!
03/04/08- Left Knee Injury
06/18/08- Lateral Release
01/26/09- TTO/Microfracture
10/16/09- LOA/Cartilage Biopsy
01/06/10- ACI
03/24/10- LOA/Hardware Removal
06/04/10- LOA w/ Drain/Lateral Release

Offline Melissa S

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Re: My Scope & the road to ACI...
« Reply #27 on: March 07, 2010, 04:33:20 PM »
Sorry to hear that Murph, that is a real bummer.  Hang in there!
Injury with knee hitting concrete 7/07, partially torn ACL, and cartilage damage
Scope and debridement 2/08
2nd scope 1/10 with carticel biopsy
Carticel implant surgery on 11/8/10

Offline Rennschnecke

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Re: My Scope & the road to ACI...
« Reply #28 on: March 07, 2010, 11:15:28 PM »
Hi Murph

Sorry you're having problems and need another scope.  You may find it useful to read through some posts on arthrofibrosis in the soft tissue section.  In particular posts by Heather M, Laurie and Janet contain some info on the rehab protocols they followed to get rid of the scar tissue successfully.  I was a bit too aggressive with my rehab so will need to go back for a further LOA and an anterior interval release.  Plan to be successful this next time.

Take care and keep us updated on how you go.
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 cfranc

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Re: My Scope & the road to ACI...
« Reply #29 on: March 09, 2010, 05:02:28 PM »
Hi Murph...

I just had my ACI and TTO with Dr Gomoll on Feb 3rd. I had pretty good ROM prior to my ACI but I too struggled a bit the first few weeks.

I know Gomoll wants 90 within 3 weeks.  It took me 4 and even then I wasn't really confident that I reached it as 90 was only with my PT putting pressure on it.  Now almost at 5 weeks, I've sucessfully hit 95 with only my own assistance.

Things really started improving after I modified my routine a bit.  I am supposed to be on my cpm 6-8 hrs day.  Originally I was hitting only 6-7 at 2-3 hr intervals and just dangled my leg over the side of a chair and bed. 

I finally moved to the full 8 hrs on the cpm and broke it up to 1 1/2 hr intervals.  After each 1 1/2 hr interval I used my kitchen table to dangle my knee and rigged up a rope that I could put around my ankle and pull to put some pressure to stretch the knee a bit.  I pull until I feel a stretch that is uncomfortable but bearable and hold for 10 minutes.  (Listening to my ipod helps as a distraction).

Then I move to the floor and do a heel slide down the wall....again 'til its uncomfortable but bearable and hold another 10 minutes.  I then do a bit of knee cap manipulation and get back onto the CPM. 

This week I also added in the foam roller to loosen my quads...not comfortable but I think it's made a huge difference! 

All in all it makes for an extremely long day - 10-11 hrs but I've made progress and have keep whatever ROM I have gained at each PT session. 

Hope this helps!
Christine

Oh..yeah...I let myself have an occasional bathroom break and snack  :D

Jan 1991 Lateral release
Nov 1997 VMO/Lateral release
April 1998 scope to remove bone chips
Feb 2002 VMO/TTO
Oct 2009 Biopsy for ACI
Feb 3, 2010 ACI/TTO