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Author Topic: aj's Trochlea ACI and AMZ 12/1/09  (Read 15677 times)

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cdubb

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #45 on: November 09, 2010, 04:38:36 PM »
Hi AJ,
Just read through your diary because I don't think I had done that before.  Was kind of getting an idea of what to expect going forward the next few months for me.  I know you are trochlear and I am patellar, but it's still all the PF joint and we both had AMZ and with the same surgeon.  Interesting that you stayed at 30 on the cpm and Cole told me I could go to 45 right away, but not to progress further until after my post op.  So, I've been at 40 the first day and have been at 45 since.

I wanted to get a posting on here, so I get notified if you update on this thread.  I did see that somebody else that posted on here Cole did Denovo on a patellar lesion? Interesting because I had asked his PA (after my cells were already growing, so not so much an option, but more informative) and she told me that they aren't doing the Denovo on patellar lesions as often because the research isn't there yet to support it's use in the PF joint.  So, they obviously still are doing them, but not as often.  I wonder how they decide who to do Denovo on and who to do traditional ACI on?   Maybe in a follow up, I'll ask about it for my right knee.  Don't know those lesion dimensions yet, but I should find out at my post op on Friday. 

Offline ajschnelk

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #46 on: November 12, 2010, 03:26:38 PM »
Hi Cdubb:  I'm sure the reason for the difference in degrees is due to the exact location.  I remember Cole telling me right after surgery that i could with 40 degrees, but ended up following the generic protocol to be safe. 

11 Month Update:
I am just past 11months post and have a scope scheduled for Dec. 7th.  I have not progressed much the last couple months and have a bad vibe that the graft did not take.  I am still unable to load the knee past 25degrees pain free, so strengthening by loading the knee has been tough.  I can only assume that the graft has delaminated or just didn't fill.   I still bike 30-45min daily along with all  of the other rehab stuff that I was doing at 6months.  I will know for sure on the 7th, but mentally, I am already preparing my next steps which more than likely will be Denovo NT.  I already have the AMZ/TTO out of the way, so the 2nd time around won't be nearly as bad. 

cdubb

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #47 on: November 12, 2010, 06:40:00 PM »
AJ, just had my first post op today and I won't put too much on your thread and I'll go update mine, but interesting...I am still to stay only at 45 on the CPM.  Natalie told me post op 30, but Cole told me 40-45, so I went with Cole not Natalie.  Got brace unlocked to 30, but still don't fit in vehicle to drive.  I need to continue to dangle to 90 a few times per day, which I was able to get by by 2nd day of doing it. Saw Kyle today and he was actually very impressed with how my leg looked swelling wise and that I was able to get to 90 passively dangling 9 days post op. He say they don't see many people back until 12-14 days post op and my swelling was much less than most they see at that point.  I look at my leg and it looks huge, but he'd know better than I would what is normal. 

Please update after your Dec. 7 surgery.  Very curious the findings....

Offline ajschnelk

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #48 on: November 12, 2010, 08:06:49 PM »
wow, that is good to hear.  I can't recall exactly, but I know I was no where near 90 at 10 days post.  As far as the swelling goes, your pics in the other thread look like how my knee looked at 4wks.   

cdubb

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #49 on: November 12, 2010, 08:09:43 PM »
He also said I could sleep without the brace, which actually makes me a little nervous...I may wait until I'm officially 2 weeks post op before I attempt that....but then I feel stupid for sleeping in a brace when I've been told I could take it of to sleep.

Offline ajschnelk

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #50 on: March 09, 2011, 04:59:45 PM »
Update:  15 Months

Well, here i am at 15mos post and I still haven't improved much since my last update.  I had it scoped in December;  the graft looked good, a little thin in some areas, and had a lot of scar tissue.  My Doc also released my suprapatellar pouch, which really improved my patella mobility.  Given the amount of scar tissue, my doctor thought I'd see huge gains once i recovered from the scope.  Two months passed and I still didn't have any pain relief when loading...basically the same pain as before the ACI surgery, but only worse.  Being that there was zero improvement i had an MRI right away and it showed that there's an osteophyte(bone spur) underneath the graft.   My doc couldn't  say for sure if this is causing the pain and threw out some options as well as seeking a 2nd opinion.

I saw a second OS last week and he confirmed that the knee will not improve and that the osteophyte is fairly large and is more than likely causing my pain.  He is recommending that I have it revised. 

It wasn't a huge shocker to me since I've had very little improvement since the 6-8mos mark and have always known something wasn't right.   The fact I can't load the knee at all without pain makes it a pretty easy decision for me.  I am now looking to have it revised within the next 2-3mos and this time  will be going with DENOVO NT rather than ACI. 

I will start a new thread in the Denovo NT section.   

Offline Rennschnecke

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Re: aj's Trochlea ACI and AMZ 12/1/09
« Reply #51 on: March 09, 2011, 11:59:31 PM »
What a bummer!  Know that I'm in complete sympathy/empathy with you with having no progress.  I thought your progress to 6 months was great and am really sorry you've been stuck for so long.

I can't believe you have an osteophyte UNDER the graft.  It makes me wonder how it happened.  It certainly must be rare as it hardly gets a mention in the literature.  I hope that you have good results from a revision.  When you start you new thread remember to come back here and post a link so that we can go straight to it and follow your progress.

Fingers crossed that you can manage the wait. ;)
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.