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Author Topic: 2 WEEKS OFF AFTER ACI SURGERY?  (Read 23998 times)

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Offline cfranc

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #30 on: March 27, 2010, 12:00:49 AM »
Hey LILS

I am in Massachusetts.  Glad to hear you are starting to feel better already.  Thankfully my dog is not afraid of the crutches...though he is picking up some bad habits of lounging around (with me) :)

I'm also glad you say your PT is taking it easy with you.  Have they worked with an ACI patient before?  Most PTs aren't familiar with the surgery and try to start you on exercises too early that can damage your graft.

Just had a quick thought...maybe if you had some bones hanging from your crutches the dogs wouldn't be afaid of them anymore :)
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

Offline LILS

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #31 on: March 29, 2010, 04:01:08 AM »
No, my PT has never worked with an ACI patient before. She had her cheat sheet with her. And you're right, she did try to start me on exercises too early. Luckily I knew not to do some of them. Her technicians kept asking me what type of surgery I had and I would say "ACI". They all would ask, "You mean an ACL"? So, they definitely didn't know what to do with me, but my OS has been good at telling them what they can and can't have me do. Since I'm not weight-bearing I'm not doing much. I reached 110 degrees on my CPM today, which was a shock. The CPM does give you kind of a false progress sometimes. Even though I was 110 on the machine with no pain, when I sit at 90 degrees, there is more pain. I have my 1st post-op visit with my doc tomorrow. We'll see if I'm going back to work Wednesday or not.

My poor dog jumped on my injured leg today and I accidentally flung her out of the bed (reflex). She only weighs 3.5 pounds, but I felt so bad doing that; luckily she wasn't hurt at all. My husband was more concerned about her, than me  :-\. I think if I had bones hanging from my crutches, my dogs might break my other leg trying to get at those bones. And then my husband would blame me for teasing them  ::)
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline cfranc

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #32 on: March 29, 2010, 04:31:06 PM »
LILS...

Thats great!!! 90 degrees already...you should be really happy! As you move up your ROM the max is never comfortable...I would just make sure you only push it to a point where it is uncomfortable but tolerable. 

Good luck with your appt...but it sounds like things are going really well for you.  Let me know what your OS says.

LOL re: your 3.5lb dog.  I think just one of my dog's paws weighs that much!!  He's a 110lb Nefoundland/Golden retriever mix and impossible to move if he doesn't want to :)
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

Offline LILS

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #33 on: March 29, 2010, 10:41:18 PM »
1ST POST OP APPOINTMENT (13 days post op): I drove myself 25 minutes to my 1st post op appt with my OS. My husband was the only one in his clinic today, so he couldn't drive me. I couldn't wear the brace while driving, but I took it with me to put on when I got out of the car. Since I was driving, I also couldn't take any narcotics, so I just took Extra StrengthTylenol, which is what I was pretty much on anyway at this point. I knew parking at the hospital (where I also work) was going to be an issue, so I got there early to make sure I could even find a spot. I found a relatively good one. Unfortunately, as I tried to put on the brace, I had extreme pain in my leg, so I said screw the heavy brace, since there was no way I was going to be able to crutch across the parking lot all the way to orthopedics. I work in a Regional Medical Center, so ortho was not right at the front door. I was so glad the temperature outside was in the upper 40s, since I knew I would be sweating doing all that crutching. By the time I made it halfway across the street, some guy was yelling, asking me if I needed a wheelchair. I guess my crutching skills weren't impressing him. Even without the brace, I think I had pretty good control of the leg, so I declined. When I got inside the hospital, the heat hit me. I felt so sweaty and sick to my stomach. I finally made it to the front desk of ortho after a couple of catch my breath breaks. I know I had to be as pale as a ghost. The technician took me back to the room, took off my ace wrap, and cut the 2 ends of the internal dissolvable sutures off. The OS came in and said everything looked fine. I told him I left my brace in the car, since it was just too much without the pain meds. He offered me more meds, which I didn't need. There is a baseball size lump below my knee, on the left side where the metal plate is. I told him that is where all my pain is coming from. Of course he said it will get better with time. He also showed me the x-rays of the plate/screws; pretty cool. He wants me to work on my range of motion more. I asked him if it was ok to drive, since I already drove there.  :-\. He said it's fine if I don't take the narcotics. I asked him when I could start taking Motrin, which is my drug of choice for most things, i.e., headaches, backaches, etc. He said I can be expected to be off of it for about 6-9 months! What?! Noooo......I love Motrin! I love Motrin more than my kids and husband!

My con leave was extended through Sunday, so I go back to work Monday. I think I will be ready by then. I even had to go up a couple of floors to my job to drop off the extension. I actually hung around work a little more, since I was too tired to crutch all the way back to my car and my foot/leg was starting to swell. My husband pops up out of the blue and rescued me. He called ortho looking for me and then figured I must be at my job. He had a sec and he said he would go get his car and drive me to mine. A co-worker wheeled me to the front door, while my other co-workers joked, asking me if I was their next patient. I work in Gastroenterology and our main patients are colonoscopy patients. I guess they were just tickled pink thinking of me getting scoped.....sick people. My husband drove me to the car. The drive home was a little harder, since my leg/foot was more swollen, but I made it just fine. I didn't even want to go back into the house, since I feel like I'm on house arrest.

Anyway, the moral to this story is: 2 weeks off after ACI/HTO surgery was not enough for ME. I think 3 weeks off will be more sufficient (hopefully). If not, I will just suck it up.

HAPPY ACI SURGERIES, ACI POST OPS, AND ACI RECOVERIES TO ALL!!!!!!
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline cfranc

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #34 on: March 30, 2010, 07:46:14 PM »
All I can say is "Crutches suck!" 

As for the pain around the plate/screws...I think I was closer to 5/6 weeks before I could let someone touch that area without whincing a bit.  Now it is fine...just takes awhile for the area around the break to settle down. 

Warning though....careful not to bang that area on a table/chair, etc....if you ever thought hitting your funny bone was uncomfortable...just wait.  I have been told by my OS that the area will forever be sensitive.  I am now very careful about keeping it clear of tables/chairs, etc.

Glad to hear you appt. went well ...
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

Offline LILS

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #35 on: March 30, 2010, 10:04:43 PM »
Thanks cfranc for the warning and YES, crutches suck! I have been trying my hardest for the last week to lay on my left side (facing the TV), but I just can't get comfortable, since the plate in my inner right knee touches whatever I am laying on or touches my other leg. I'm fine now laying on my right side, since the plate doesn't touch anything when I do that. Since I spend my days watching TV, this situtation sucks too. Hopefully, it will work itself out in a few weeks. Your post gives me hope!
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline cfranc

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #36 on: March 31, 2010, 04:01:02 PM »
It will definitely get better.  At 8 weeks that area is now only sensitive when I put real pressure on it. 

Hmm...my favorite TV since being couch bound:  Animal Planet Big Cat Diaries...I go on Safari every day :)  I'm also a LOST addict and found that I can watch old episodes on ABC.com

The dog has also gotten spoiled.  I think I am beginning to rub the fur off his ears!
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

Offline AndrewH

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #37 on: March 31, 2010, 07:57:19 PM »
The lengths some folk will go to to get a few extra days off work...........  :lol:

I've been following this with interest LILS. I had microfracture on a 1.5cm2 defect on my MFC last June and its failed. My OS gave me the options of ACI & mosaicplasy in Feb and was hinting at ACI (I know he's conducting an ACI trial here in the UK and so knows quite a bit about it).

My problem has been that I was in the middle of being redundant and looking for a new job and didn't want an ACI operation to get in the way. I've now got myself a new job and start mid April. My plan now is to get the ACI op done in July and take a couple of weeks of my annual leave after it to recover. I don't want to go in and start taking sick leave! It seems I may have to take more than 2 weeks after reading this!

On the flip side however I do have the experience of crutching from last year and do a lot of upper body works outs to keep fit (seeing as I can't run anymore!) so crutching isn't a problem for me. Indeed, I look at crutching as a great work out in itself! The other advantage is that its not anywhere near as hot here in the UK, even in July!

All the best LILS. Seeing as you will probably be about 4 months ahead of me with this op I'll follow your progress with interest.

BTW - what size was your defect and where?
June 09 - Microfracture to MFC right knee 1.5 x 1cm
July 10 - Mosaicplasty to MFC right knee 1.4 x 1.2cm (4 plugs) plus mosaicplasty to small lesion on patella (1 plug) and microfrcature to another small lesion, also on patella

Offline AndrewH

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #38 on: March 31, 2010, 07:59:15 PM »
cfranc - what is the background to your injury? Size? Location? Did you have prior microfracture?

Sorry to be a pain if this info is to be found elsewhere!!
June 09 - Microfracture to MFC right knee 1.5 x 1cm
July 10 - Mosaicplasty to MFC right knee 1.4 x 1.2cm (4 plugs) plus mosaicplasty to small lesion on patella (1 plug) and microfrcature to another small lesion, also on patella

Offline LILS

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #39 on: March 31, 2010, 10:27:02 PM »
Hi AndrewH,
    We have the defect in the same place, but mine is 4cm. Honestly, if it wasn't for the High Tibial Osteotomy (HTO) I had along with the ACI, I would have been ready to go back to work at probably the 10 day post op point. My OS didn't even tell me about the HTO part of the surgery, until a few days before the surgery; I had no idea I needed that too. When I initially posted this question, that was even before I found out about the HTO. If you are just having an ACI, you might be okay going back to work before 2 weeks, IF you have a job where you can sit most of the time. There are people on this forum that went back to work just a few days after their ACI. My incision doesn't hurt at all so that part of the ACI doesn't bother me, it's just the area with the plate and screws for my bone realignment (the HTO). Do you know if you will just be having an ACI, or will they be performing an osteotomy or anything else along with the ACI? I think an osteotomy or an additional procedure with your ACI would be the main issue. I've gotten pretty good with the crutches too; they're my friends now. They have to be, since I will be living with them for 4 more weeks. You sound more fit than I am, so you should be fine. BUT, as they say, everyone is different. I reached a personal milestone today. I took my first real bath in my deep tub. I was determined to get in and out of there on my own, and it was a piece of cake. I was so excited. Yeah, it's 15 days post op, but 2 weeks ago, I was stuck in the hospital for 3 nights. On another note, I am looking forward to going back to work on Monday. I AM SO BORED. I will post on Monday how going back to work went.

Christine, glad you and your dog are still friends. After flinging mine out of the bed, she doesn't really want me petting her  :(. Oops.....
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline AndrewH

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #40 on: March 31, 2010, 11:24:03 PM »
Thanks LILS, although obviously bad for you, its good to know that its not the actual ACI that causes you the most main.

I've had no mention of HTO from the OS. My injury came as a result of excessive running - I was averaging 60 - 70 miles per week and then even after I felt there was a problem I clocked up over 140 miles in the 2 weeks after the initial injury. I then spent the next couple of months mamking attempted comebacks after my physio had assured me that there was no serious injury.

I think my problem actually started with a tendon problem on my ankle on my other leg. I ran through it for a few months before consulting a podiatrist. She gave me heel wegges to take the strain off the tendon behind my ankle. These wedges were on the medial side of my heel. I'm pretty sure that the hard mileage I was doing with these wedges is what caused it - it seems more than a coincidence that the injury happened not long after I started using them and on that exact side of my knee. Ironically the wedges cured the tendon problem!

The initial injury happened when I ran to work one morning. I live 9 miles from work and on that particular morning decided to make it a 12 mile run including a big hill in the last mile and to do it all at marathon pace (around 6.50 / mile) and finish the last mile at 6.00 pace. I used to do this type of run every 2 weeks and I would essentially jump out of bed, get my gear on and get out the door and start running with no warm up. I don't think that running at marathon pace for 12 miles within 15 mins of waking up with no warm up, no food, etc was essentially a good idea. However I thought nothing of it at the time and many of the guys I trained with had equally crazy training schedules. I felt some pain behind the back of my knee later that morning and it all began from there.

I think also the fact that I didn't start running until my mid 30s and within 2 years of starting from a point of being overweight, a smoker and completely unfit I had jumped into a crazy training schedule was too much too soon. But it becomes very addictive, particualrly when you are running races with and against guys you are training with and continually trying to get your times down. It just became an obsession.

Anyway, what is done is done and there is no going back. But in summary, I don't think I have any alignment issues with my knee and my OS has never mentioned anything like that. I think the heel wedges may be what caused the alignment issues and contributed to my injury along with my high mileage.

I'm disappointed that the microfracture didn't work but am much more hopeful about ACI.

All the best and I will be fe following your progress with great interest.

Before I clock off, can you give me some background as to how your injury occured? What sort of pain levels did you have before and after microfracture when walking? 4cm sounds huge compared to my 1.5cm yet I am limping about with a fair amount of pain.
June 09 - Microfracture to MFC right knee 1.5 x 1cm
July 10 - Mosaicplasty to MFC right knee 1.4 x 1.2cm (4 plugs) plus mosaicplasty to small lesion on patella (1 plug) and microfrcature to another small lesion, also on patella

Offline LILS

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #41 on: April 01, 2010, 12:42:40 AM »
Holy crap Andrew, that's a lot of damn running :o! Thanks for making me feel like a lazy bum. My injury history is not that exciting. Back in 2003, I actually tore my meniscus while moving a dresser by myself. Don't laugh. I had the meniscus repaired and over the years, my cartilage just wore out. My knee got worse around 2006, as I was running more often. At the height of my running, I ran about 3 miles a week. Don't laugh. I only ran because the military made me. Before the microfracture, my pain level was about a 4-5 on a 0-10 scale (0=no pain-10=extreme pain). After the microfracture, it was a 5-6, so the microfracture failed miserably. I was mad with myself for even getting the procedure, since the pain was worse after. I also limped for a couple of months after that, so I thought I was permanently damaged, but that went away as my muscles improved. Yes, 4cm is big, but I don't do high impact activities, so it's probably a little more manageable for me. Are you going to go stir crazy not being able to run for many months? And yes, I have become a lazy bum, when I'm not at work, because of my knee pain. Hopefully, your OS won't spring a surprise extra procedure on you, like mine did. The way my post op is going, I think if I would have just had the ACI alone, it would have been a piece of cake for me. At this point, my only pain is from the osteotomy. Even with that, I am off all of my major pain meds and I just take Tylenol twice a day.
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline AndrewH

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #42 on: April 01, 2010, 11:49:39 AM »
Hi LILS

My running days are over and I have no intention of ever running again. There is no way I would ever take the risk. As it is, I've not ran since January last year. Its took me a while to get my head around that fact but I've got used to it now.

I only started running as part of a general keep fit thing and was playing football and doing weights as well when I started. The running just overtook everything else and became an obsession when I realised I was capable of good times and I kept getting better. Every race I ran was a personal best time and I was getting nearer to the top runners. In my last 10k I ran a time of 35.15 and finished 16th out of a field of almost 1,000 in a race in which I'd ran in 46 mins 2 years previously finishing mid pack. My last half marathon I ran 1.22 and finished in the top 100 out of 7,000 odd in a race I ran 2 years earlier in 1.46, again finishing mid pack.

By the time of my injury, I knew from my training that I was capable of much more and was throwing everything into it. It was also very convenient as my house was 9 miles from my work. I was therefore able to get most of my training done just by running to and / or from work in more or less the same time as it took me to get to and fromn work by any other means of transport. That therefore meant that I wasn't using up any family time and my wife had no problems with my obsession. All I did was throw in a couple of lunchtime sessions a week (again, no family time, just giving up my lunch hour) and a long run early on a Sunday morning before the family was up. It was perfect..... an obsession that I was good at, required huge amounts of training and yet for which I didn't actually need to find any time to do!!

The downside is that I became very skinny, despite eating huge amounts of food and of course I knackered my knee!

There is no way I could go back to running now with this knee. What fuelled me was racing and my knee just wouldn't be able to stand up to that amount of training. I didn't particularly enjoy running for the sake of it, what I enjoyed was the racing and competiting with my mates. If I can't have that then there is no point - there are other forms of cardio that I can do.

My hope is to take up cycling for fitness. Again, there is scope to cycle to and from work which would also mean not needing to find any time to do it. I doubt I will get to the same level of obsession again.....  but you never know!

For now though, my only concern is for my knee to get better!

Thanks for your insight. Its good to know from my perspective that the actual ACI itself isn't the main source of your pain. My concern with the op is that I don't want to take time off work from a new job on sick leave if at possible. It sounds like I will probably be able to get away with taking a couple of weeks holiday after the op and then get back to work and that would be ideal. I have a desk job so it shouldn't be a problem.

I'll keep following your progress - keep your updates coming!
June 09 - Microfracture to MFC right knee 1.5 x 1cm
July 10 - Mosaicplasty to MFC right knee 1.4 x 1.2cm (4 plugs) plus mosaicplasty to small lesion on patella (1 plug) and microfrcature to another small lesion, also on patella

Offline cfranc

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #43 on: April 01, 2010, 05:27:07 PM »
Hey Andrew ...

I must admit I am a wuss at least in terms of having technical medical discussions.  So, I am not exactly sure how big my lesions were...I know I had four seperate moderate sized grafts done during my ACI.  As I go in tomorrow for scar tissue removal, I am going to ask my OS to write down the specifics. 

As for my injury (ies), I have had 13 + knee dislocations between 1990 and 2001, combined with 2 major surgeries and 2 scopes (prior to any of the ACI work). 

Essentially I too learn the hardway, after having to quit track in college, I eventually picked up soccer, replaced running with hiking, and waterskiied as much as humanly possible in the summer.  And now here I am...with the cartilage of an 80 yr old.

During my ACI, I also had an osteotomy like LILS...unfortunately the second for me though...

I am now at 8 weeks and have been fortunate enough to take the entire time off of work...not great for the sanity...but better for the healing process. 

After my surgery, I had a ton of swelling and had a really hard time getting it down to be able to extend my ROM....because of that I am now going in for a scope to remove scar tissue build up.  I am told it is a fairly common occurence ...about 35% of ACI patients go through this. 

At 8 weeks, I am full weight bearing and can walk without crutches though at a turtles pace and not for long...not sure how the scope will set me back, but I will let you know as I progress. 

As LILS says there are many people that go back to work very quickly after an ACI and do so successfully...from experience though I've found the longer you can rest after a surgery the quicker you will heal.


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

Offline LILS

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Re: 2 WEEKS OFF AFTER ACI SURGERY?
« Reply #44 on: April 01, 2010, 05:40:09 PM »
Christine,
    Good luck on your procedure tomorrow! I wish you well. That will just be more time you and your dog can bond  ;D. I'll be waiting for your update.....
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair