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Author Topic: Can I join the A.C.I. party ??  (Read 11969 times)

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Offline thornburg

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Re: Can I join the A.C.I. party ??
« Reply #15 on: November 24, 2009, 01:52:05 PM »
ajschnelk -

eek, 3 hour car ride post surgery! atleast you'll have good drugs to pass the time by! :) 

Good luck if we don't write much before you head to Chi'town. Seems like we will be lock step with each other for rehab - we'll stay in touch
and support each other thru the boredom and pain! :-\

I am just ready for to all to begin, as I am sure you are! the waiting is getting irritating now. I woke up this morning my normal knee pain, the lovely daily ache that I am so ready to get rid of.


Offline ajschnelk

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Re: Can I join the A.C.I. party ??
« Reply #16 on: November 24, 2009, 04:43:02 PM »
yes, we'll definitely have to keep in touch as we recover. Unlike you, I don't really deal with much daily pain...I'm one of the rare ones having it done in hopes of becoming highly active again. If I had to make a decision based on my daily pain, I would not have it done. I can walk endless miles pain free, it's the strong loading, stairs, and high impact stuff that causes me pain. I can deal with the pain, the part I'm trying to prepare myself with is the boredom and 6-8wks of being on crutches.

The silver lining is that I'll be able to spend the month of december home with the little ones. :)

Offline thornburg

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Re: Can I join the A.C.I. party ??
« Reply #17 on: December 02, 2009, 01:58:29 PM »
surgery day has arrived, let me go get this done!

wish me luck!

Offline Room 101

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Re: Can I join the A.C.I. party ??
« Reply #18 on: December 02, 2009, 10:33:06 PM »
Hope everything went well for the 2 people having surgery this week!  I have been in Hawaii for 10 days, and will update my diary soon.  I definitely concur about back seat riding.  It was necessary.  I actually needed my hubby to help me by holding my leg for a while when getting out... so it wouldn't go crashing to the ground... I hope you guys recover well and look forward to following your rehab!

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 thornburg

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Re: Can I join the A.C.I. party ??
« Reply #19 on: December 04, 2009, 11:47:00 PM »
48 hours post. Textbook procedure per Doc. Defect was low kneecap, 70% of kneecap. New post at blog http://thornburg99.wordpress.com/

How soon could everyone do PT exercises? I can't lift leg unassisted.

Offline ajschnelk

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Re: Can I join the A.C.I. party ??
« Reply #20 on: December 05, 2009, 02:23:16 AM »
glad to hear...I'm 24hrs ahead of you and mine went as planned as well except for the AMZ. I had that done as well.  My defect was much smaller than what my OS(based on the pics) had thought it was going to be with it just under 2x2cm. My pain was bad for one day and is currently not too bad.  I could probably stop taking the pain meds, but will probably keep popping them to be safe.  best of luck with the recovery.

Offline Rennschnecke

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Re: Can I join the A.C.I. party ??
« Reply #21 on: December 07, 2009, 12:56:38 AM »
Glad to hear that everything went well for you all! :)

PT well I started some immediately, e.g. ankle pumps, quad sets and SLRs.  I was immobilised for 1 week so no CPM and I didn't feel too bad with the brace (but not brave enough to ditch pain meds as I've had a dreadful year yo-yoing with pain from trying to drop my doses stepwise.  Going for a tapering approach this time.

Don't worry too much about comparing yourself with others though.  Your op will differ by size, position, aspect and possibly other procedures which makes comparisons complex.  I know that some people had problems with quad strength for leg lifts for a while they sometimes shut down from pain.

Hope you continue to improve! ;)
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 thornburg

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Re: Can I join the A.C.I. party ??
« Reply #22 on: December 07, 2009, 01:51:07 AM »
thanks for checking in Rennschnecke!

each day seems better and the pain level has dropped dramatically in the last 24 hours!  I am tappering down the pain meds now.

first post-op doc appt tomrrow, anxious as I have lots of questions!

Offline thornburg

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Re: Can I join the A.C.I. party ??
« Reply #23 on: December 09, 2009, 01:12:04 PM »
first post-op follow up (5 days) and first week status:

its been a week now since surgery!  is it a milestone?  ;)

OS said all looks really good!  I need to hit exercises harder and stay in the CPM machine and push it to as much as I can tolerate.  I was at 30-35 degrees when I saw him, the goal is 90+ by 12/16 when I have staples removed.  No bending that knee unless its in the CPM machine, he said!

Straight leg raise:  still not successful!  I keep trying and was told if not successful by next week, going to PT to get the quad firing.  Very frustrating!
He said it is due to the nerve block and amount of swelling I am having, need to wake that muscle back up!

Pain level is down greatly!  down to 1/2 a pain pill post rough exercise session.

so, all is progressing as expected it seems.  next steps to be provided at next appt on 12/16 when I get staples removed!!!!! 

more later ...

Offline thornburg

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Re: Can I join the A.C.I. party ??
« Reply #24 on: December 09, 2009, 08:24:51 PM »
question for all ...

how many of the ACI'ers had ONLY the ACI ?  I feel "strange" not having the AMZ with my ACI.  I have read so many post on here about the ACI with other procedures, but very few who had only the ACI?  I gotta trust in my OS and I do, just seems to be one of the "lucky" and unusual ones.

just curious!

thanks!

Offline ajschnelk

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Re: Can I join the A.C.I. party ??
« Reply #25 on: December 09, 2009, 08:50:31 PM »
question for all ...

how many of the ACI'ers had ONLY the ACI ? I feel "strange" not having the AMZ with my ACI. I have read so many post on here about the ACI with other procedures, but very few who had only the ACI? I gotta trust in my OS and I do, just seems to be one of the "lucky" and unusual ones.

just curious!

thanks!

To be honest, I'm very surprised you did not have an AMZ/TTO done.  My OS says that he automatically does it with any patella defect and will do it just to increase the chances of reducing overall pain.  THe only reason why he did mine is becuase he noticed that I had a soft spot on my patella, but no real damage or defect area.  The whole purpose is to unload the pressure of the patella.  Maybe the location of your defect had something to do with it.  I'd definitely ask especially since you already said  your OS had it listed as a possible procedure going into surgery.

Offline thornburg

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Re: Can I join the A.C.I. party ??
« Reply #26 on: December 09, 2009, 09:50:01 PM »
I did ask and was advised the way my knee is positioned, if the AMZ was performed it would have actually added more
pressure to my patella and defect region.   So, he advised to leave it as in his view did would have not offered any benefit, perhaps make
things worse.

I often wonder of my lateral release in the mid-80's help to prevent the need for the AMZ as it was to relieve the patella
pressure way back then, just me the patient wondering?

I am going to dive into the topic more when I see him next week.  i'll share any info I get!

take care!

Offline Rennschnecke

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Re: Can I join the A.C.I. party ??
« Reply #27 on: December 15, 2009, 12:31:25 AM »
Hi Thornburg

I've have just had ACI no other procedures.  This was probably because my defects were due to trauma not uneven wear and pressure.  I've seen a paper that indicates a higher success rate for those with an alignment corrective procedure compared with those without.  However, some surgeons may refrain from carrying out some procedures prophylactically as they may introduce additional complications.  Your lateral release may well have meant not other procedures for you at this time and the fact that it was considered by your surgeon but rejected means he made the decision on some rationale and did not simply overlook it.

Hope you get reassurance from your OS at the next appointment.

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 ajschnelk

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Re: Can I join the A.C.I. party ??
« Reply #28 on: December 16, 2009, 03:47:28 AM »
Rennschecke is probably right on with his statement above.  I didn't really have any wear or alignment issues, but Cole tends to do the amz routinely when doing aci.  He shared a long term study that he did and it shows that an amz will unload the patella by 30% and feels that regardless if there are tracking or wear issues that the reduced pressure will only help support/protect the aci graft when fully matured. 

Offline thornburg

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Re: Can I join the A.C.I. party ??
« Reply #29 on: December 16, 2009, 09:40:01 PM »
Two Week post-op follow up:

I got my staples out and the knee looks good, he says! However, I got a 'lecture' that I am way behind on my ROM. :( I am only at 69 flexion (as I sit in the CPM now) and I need to be at 110+ by next wednesday (a week!). I am allowed to bend the knee as long as no weight is on it. I need to sit on the edge of a bed or counter top and let the leg hang, getting the knee to 90 degrees. I also need to not wear my brace when I am around the house. I need to start putting weight on the leg. I am headed to PT next Tuesday (12/22) to get this quad working and we will work on ROM there too.
So, visually he said swelling is normal and the incision looks good. Just now to need to really focus on bending and ROM.

He said by the next time he says me in 2 weeks, I should be able to ride a stationary bike at least one revolution. EEK .. that seems like quite a goal!

I did ask about the decision not to do the AMZ, he explain how the knee cap was lying and the position of my defect/wear area, it just did not make sense to do the AMZ. He felt in could do more damage as the alignment and spacing looked fine in his opinion. I gotta trust that!

I'll am just so nervous about bending the knee .. afraid to damage the area he patched up. I assume everyone feels this same nervous/fear too?
Anyone know or heard of someone one who actually has damaged the patch? I wonder how often that happens or are we all so scared, we are more careful than we truly need to be?

I'll keep updates coming .. hopefully I will reach my goals !!!!















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