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Author Topic: ACI biopsy scheuled for this Monday, Jan. 4th.  (Read 14138 times)

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Offline Melissa S

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ACI biopsy scheuled for this Monday, Jan. 4th.
« on: December 31, 2009, 07:06:59 PM »
I am new to this board and have some questions.  I am scheduled to have the Carticel biopsy and scope done this Monday morning.  I had a previous scope done in January 2008 where they debrided and were supposed to fix a torn ACL but still had over 50% of my ligament so they didn't fix the ACL.  I haven't had any problem with the ACL since then but when the scope was done, they noted a defect in my cartilage.  Since then the popping and catching and swelling has gotten bad enough that I decided to do the ACI surgery.  I am assuming at this point that the defect is larger and will only get worse if I don't do something and that is why I decided to do this.  I am 42 so this is really my only option.
I go to Dr. Noyes in Cincinnati, OH.  Has anyone else went to him for ACI?  If so, have you had success?
I am hoping to have the second surgery as soon as possible after the first.  Did anyone have to wait and has anyone had problems getting approval from Anthem insurance?
Last, are there any golfers out there and can anyone say how long realistcally it is before you can golf after the surgery?

Thanks,
Melissa
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: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #1 on: December 31, 2009, 08:33:44 PM »
I have Anthem Blue Cross Blue Shield. I did not have any issues with them, but someone I know had a VERY long approval process with them.  I had my scope on Oct. 14th, and my ACI is next Wednesday 1/6.  I was approved within a week, but with the time it takes to grow the cells, they told me to wait til after the new year.  This was the soonest they let me go, but I don't know if that was because of the Holidays! Hope this helps! Good luck!
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: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #2 on: January 01, 2010, 06:35:11 PM »
Thanks Murph.  Good luck with your surgery and I hope you will keep everyone upated afterwards.  I am just hoping to have this done quickly so as not to ruin my whole summer.
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: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #3 on: January 02, 2010, 02:22:40 PM »
you'll have to a wait a minimum of 3-5wks after the biopsy is taken and once they initiate the growing process.  I had my aci procedure 4wks(Dec 1, 2009) after we gave carticel the go ahead.  You didn't state the location of your defect, but as far as golfing goes, definitely count on being unable to this summer.  If all goes well, you should be able to the following summer.  Best of luck with everything!
« Last Edit: January 02, 2010, 02:24:55 PM by ajschnelk »

Offline Melissa S

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #4 on: January 02, 2010, 04:04:57 PM »
AJ, I am not sure as of this time where exactly my defect is or how big.  I had a scope in 2008 and they saw it then.  I guess I will know more after Monday. 
Interesting about golf, why is it that it would be out of the question?  I just thought that since it is not too strenuous I would be able to do it, maybe wearing a brace. 
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: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #5 on: January 02, 2010, 08:42:09 PM »
It will depend on the location, but if it's either the trochlea or patella, I would not attempt it, but that's me.  My guess is that you will probably not be cleared by the doc to atttempt golf until you're 6-9 months, if then.   Any strong loading, twisting, impact type stuff is not allowed until 10+ months.  ACI surgery is unlike most knee procedures when it comes to rehab...it is a slow and long process and attempting something early is not worth the risk .

Offline Melissa S

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #6 on: January 02, 2010, 11:47:54 PM »
Thanks for your responses.  I am actually thinking about putting the actual ACI surgery off now untill after summer.  I have a pool and love to golf in my ladies gold league and I don't want to miss out on all of that.  I wonder if I would be able to have the scope now and put the graft surgery off until fall.  I am going to discuss this with my Dr.
I don't know.  It is a hard decision.
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: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #7 on: January 04, 2010, 02:22:28 PM »
definitely consult with your Doc before making the decision.  As far as the scope goes...yes, you can have it now as it can be stored for up to 3yrs.  I had my biopsy scope done 9months before having the aci. 

Offline Room 101

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #8 on: January 04, 2010, 06:36:54 PM »
Hi, Melissa.  Hope your procedure today went well.  I am 13 months post ACI.  Due to work I had to reschedule my OS appt. into December from October.  I was bummed because we went to Hawaii in November and my goal was to do some golfing... since I didn't go and didn't get "permission", I didn't swing a club.  Twisting and pivoting and impact were all out of the question for me (patella defect).  I am feeling really good right now, so I know by spring I'll be hitting the links again.  To me, progress is very individual and your body tells you when you feel like doing more.  It's kinda interesting to see the improvements as they come about.

I also waited months after my biopsy.  One was because there was hope debridement *might* work, and two, we were moving and I needed to help with that... so I was 10 months past biopsy before my ACI.

Take care,
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 Melissa S

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #9 on: January 06, 2010, 01:05:34 AM »
Hi everyone, had my scope yesterday and everything went fine.  There was a little more pain the first day than I remember from my last scope.  Went to PT today and met with my OS.  He said my defect is under my kneecap right about the middle and it is about the size of a quarter.  He said I am definitely a candidate for ACI.  I talked to him about waiting and he suggested I do that.  Since this is such a slow rehab process he suggested that I am positive and in a good place with my life to get the best results.  He said I can wait up to 2 years.  Obviously I probably will just get it done right after summer for financial reasons (insurance deducts and copays).
I am glad that I found this board and I will definitely be following everyone's progress for my upcoming surgery.
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 thornburg

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #10 on: January 06, 2010, 01:36:04 AM »
Good news and you seem pleased with the outcome!

I am 5 weeks post-op from a patella ACI (about 75% knee cap was the size of my defect .. the actual size was 2 in x 3 in).  I am doing well, considering.
I had my ACI 4 weeks to the date after my scope, but due to work commitments and daily pain levels, I had to get my surgery ASAP.

Good luck and enjoy your summer of golf!   ;)

Any questions come up in the mean time, I'll be glad to help!

Take care,

- thornburg!

Offline Melissa S

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #11 on: January 06, 2010, 05:23:16 AM »
Thanks Thornburg, sounds like you were in a much worse place than I.  Your defect was large, I hope everything works out for you.  It is such a hard decision to go thru with this surgery when they tell you that the success rate is a little over 50 percent.  But then again I still consider myself young and I don't want to be limited the rest of my life by my knee.
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: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #12 on: January 06, 2010, 02:55:04 PM »
Thanks Thornburg, sounds like you were in a much worse place than I.  Your defect was large, I hope everything works out for you.  It is such a hard decision to go thru with this surgery when they tell you that the success rate is a little over 50 percent.  But then again I still consider myself young and I don't want to be limited the rest of my life by my knee.

Glad to hear things aren't bad enough where you need to have it done asap.  I was in a similar position and tossed around the idea for nearly a year before going forward.  I had very little pain with most daily activities, but could do very little when it came to sports and intense activities.  I could a lot of stuff, but nothing that involved heavy loading within the knee...running, hiking, skiing, jumping, stairs, etc. 

As far as the success rate goes, did you doctor mention the 50% rate?  It is well documented that ACI overall has around an 80%-85% success rate.  The success rate is based on being pain free with normal daily activities.  However, only about 50% get back to pre injury levels when it comes to sports. This doesn't mean that folks are unable to be active, it's just that they can't perform at the same level as they once did.  If ACI overall only had a 50% success rate, it would rarely be an option for most people.
« Last Edit: January 06, 2010, 03:02:53 PM by ajschnelk »

Offline Melissa S

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #13 on: January 06, 2010, 05:21:05 PM »
Yes, my OS told me the 50% rate.  He said that he had been having higher success rates than that though.  Maybe it is because mine would be the cartilage under the kneecap.  Doesn't that have a lower chance of working because of the location?
I can pretty much get through my day without pain except that I live in a 2 story house and have recently changed the way I come down the steps to relieve pain (one foot at at time).  I can still golf although it does swell afterwards if I play 18 holes.  I have pain when using my treadmill and I really can't do yoga anymore which I enjoy.  I can still swim in the summer so that is a good form of exercise.  I did enjoy skiing but haven't even attempted that since I injured my knee.  I would love to be able to do that again someday.  I just want to get back to being able to do what I want and not worry about how my knee will bother me afterwards.
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 Room 101

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Re: ACI biopsy scheuled for this Monday, Jan. 4th.
« Reply #14 on: January 06, 2010, 05:38:47 PM »
Hi, Melissa.  Glad your scope went well.  AJS is correct that the success rate is higher than 50% for patella.  My defect also was patella.  I am at 13 months post.  All is well and I am far beyond what I could do pre surgery, which was basically nothing.  My lesion was a similar size to Thorn's... pretty big and I couldn't even golf... well I could try and golf but walking up the slopes to the tee & green were just brutal and the twisting when I would swing... ehhhh.  So I was doing very little.  I am excited at this point that I can get back to playing sports.  With the improvements I see, I feel like it's not just if but when... while I am not able to snowboard at 13 months like Hathor, I can walk & bike & swim & do anything in daily life.  My weight lifting workouts are great, and we are progressing.  I think everyone heals at a different level and it's very individual. 

Just be good to yourself, follow the doc's rehab very specifically and find a really good physical therapist... it's hard at first because you're limited to nothing, and then it's hard to contain yourself because you feel better, hahaha.  This year has gone very fast for me, though.

Take care, enjoy your summer and all the golfing!

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