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Author Topic: ACI done, time for Rehab  (Read 9340 times)

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Offline kralldaddy

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ACI done, time for Rehab
« on: March 26, 2010, 02:38:19 PM »
Just had my ACI procedure done at Ohio State University Hospital East in Columbus Ohio by Dr David Flanigan on March 23rd.

The procedure started about 7:00 am and took about 4.5 hours.  They when in with scopes to debreed and check everything out and finished with a nice 3-4 in incision over my knee cap.  I had localized nerve block which was fantastic.  The pain was very tolerable and I still had feeling in my foot and upper thigh which was nice.  I had my catheter out by 5:00 pm which was a huge improvement, I just couldn't relax with that thing in.  I was able to crutch back and forth to the bathroom without much problem.  I started just taking percocet since could take it every 4-6 and it ddin't seem to bother my stomach, but as teh nerve block wore off, i changed to the Oxy since it seemed a little stonger and was only every 12 hours.  Plus the percocet made me itch like a MF.

We ended up using a bio patch from a pig instead of a periosteum patch from my shine.  My Dr. said it is an off label use, but has better results abroad and is one less incission they have to make and for me to recover from. 

The night in the hospital was a pain, I didn't sleep hardly but was glad we did it to make sure the pain was under control.

The first night at home was pretty rough too, only a couple hours sleep and not in a row, but as I got more on the oxy and off the percocet that got better.  I had a great nap that felt like days yesterday.  The only major issue so far was the lack of having BM's.    IT made my stomach hurt and thus not want to eat but that has resolved itself with lots of benefiber and other OTC stuff.

Took the bandages off last night and it really looks good.  It really isn't much more swollen than the scope and menicus repair back in November.  The incission was much smaller than I thought, only 3-4 inches.

I'm up to 40 on the CPM and so far since i been home gotten at least 6 hours a day in.  I really think I might be able to sleep in this thing in our spare bedroom.  I don't think the wife will care for it in the bed.  The Dr. says due to the location of the defect/repair, I will only getting to 90 degrees initally. 

PT sent me home with a standard list of Ankle pumps, Quad sets, Straight Leg Raises.  Pumps and Quad sets are no problem, the Leg raises are extremely painful and nearly impossible right now.  I almost have to help lift the leg with my hands.  From reading on here that sounds normal, but I'll follow up with the Dr next week at the post op and first PM appt. 

Well the CPC is calling me.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline LILS

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Re: ACI done, time for Rehab
« Reply #1 on: March 26, 2010, 09:12:32 PM »
Hi kralldaddy,
   I was wondering the other day how your surgery went. 4.5 hour surgery? Wow, I thought mine was long at 3.5 hours. Glad to hear things are going well. I tried the Oxycontin a couple of times, but it always made me nauseated, even on a full stomach. Good that it's working for you. Did you end up having to have the HTO as well?
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #2 on: March 28, 2010, 03:06:29 PM »
No HTO, which is a good thing I think after hearing all the pain issues on this board.  My pain has been very tolerable and haven't taken anything since Friday Night.  I am completely sick of the brace and CPM, but have along road ahead.  I definatly need to find a way to sleep in that thing.

The 4.5 hours was due to the lack of the HTO, there was very small access to my defect.  The HTO lets them essentially un-hinge your knee for easy access to the defect.

Just trying to think positive that all this work will payoff.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline LILS

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Re: ACI done, time for Rehab
« Reply #3 on: March 29, 2010, 04:06:27 AM »
That's good news about the HTO. That is what is giving me the most pain. It totally sucks! I'm sick of the brace and CPM also, especially the brace. I don't even wear it like I know I should; it's so heavy and cumbersome. I'm going to try to think positive like you that this will all payoff. GOOD LUCK! Let us know how everything is going.
Mar 16, 2010 ACI/HTO Surgery
May 26, 2009 Microfracture Surgery/ACI Harvest
2003 Medial Meniscal Tear Repair

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #4 on: April 01, 2010, 03:42:50 PM »
Post Op appt yesterday when geat.  Doc says the incision looks great, but stitches need to stay in for one more week.  They are very happy with the amount of swelling.

I tried to get out of the brace for sleeping, but they still prefer I leave it on.  I don't want to, but right now I'm willing to do anything to help ensure this implant takes.

Got to see some cool/bloody pics of the procedure. If I get really bored, I might try and scan some to upload.  They were pretty gross but cool at the same time.

Also had the first PT appt also.  No real suprises there.  Quad Sets, Straight Leg Raises, and Heal Slides.  My ROM is about 80 deg already which is good.   The only problem is with the Leg Raises.  I just can't do them unassisted yet.  Just too much swelling I can't contact the muscle enough to get a good lift.  So for now I have an exercise band around my heal that I pull to give a little help. Hopefully I can get this resolved in week or so.

I'm also itching to start driving again.  I threw my right leg over to the passenger side the other day and took a quick spin around the neighbor hood using my left foot to work the pedals.  It went pretty well and with a little more practice i think I'll be good to drive to my own appts.  The need to be driven every where by my wife has been the biggest strain so far.

One week down, 7 to go!
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Rennschnecke

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Re: ACI done, time for Rehab
« Reply #5 on: April 01, 2010, 06:13:08 PM »
Sounds like you're doing really well!

I hope it keeps on this way and you'll be zipping around again in no time.

 :)
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 kralldaddy

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Re: ACI done, time for Rehab
« Reply #6 on: April 09, 2010, 07:55:13 PM »
well 18 days post op day, had my second follow up with the PA.  Stitches removed and all is looking well.  Been cleared to unlock the brace and actually sit in the front seat of the car.  My wife will enjoy not feeling like my my driver.  I've also gotten the offical green light to drive using my right leg.  No more swinging it over to the passenger side.  If all goes as planned weight bearing in 4 more weeks!
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #7 on: April 21, 2010, 06:42:11 PM »
Four weeks post op as of yesterday.  Knee feels pretty good.  There is really no pain.  Have religously used the CPM 6+ hours a days and wear the brace when out of the house.  I have the CPM for 2 more weeks but am going back to work fulll time next week, so 6 hours is going to be tough if I can't sleep in it.

Went to PT today and had good results.  Was able to do a full revolution on the exercise bike with zero resistance.  Was acutally workingout next to NBA player Michael Redd who tore his ACL in January.  I guess it must be a good place if NBA players are going there.  Actually going to take few weeks off of PT since I really can't do anything new till I can put some weight on it.  The PT agreed and gave me list of exercises to progress on and to call if I have issues or questiosn.  No need to pay someone to watch me do things I can do at home or the gym.

Other than that, nver little news.  Hoping to bget cleared for minimal PWB in 2 more weeks.  The leg is so week and skinny compared to my good leg.  It didn't help that I wasn't totally recovered from the last NWB after the menicus repair.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #8 on: May 12, 2010, 08:31:19 PM »
Ding, Dong the CPM is gone!! 

After  6 weeks the CPM has been gone for a week and I don't miss it one bit.  Had my 7 week post op today.  all is progressing as the OS would like, but he's only clearing me for PWB for the next 2 wks.  I'm alittle bummed by that but I got to admit I'd really be pushing it to walk right now.  My quad is terribily weak right now.  He also wants me to keep the brace on for my own protection of hurting myself or the graft.  I will totally admit I've only been about 1/2 compliant with that order.  I sit 90% of my day so wearing the brace is just an annoyance.  What's going happen I fall out of my desk chair while reaching for my mouse?  I wear it out and about when I don't know the terrian or there might be steps or other things to trip on.

I think we'll have  ceremony to burn the Crutches and Brace when I finally get to quit them for good.

ROM is not back to 100% but not too far off.  Pain is pretty much not an issue. Swelling is minimal.  Only major issue right now is I stained my back reaching for things when I was being lazy on the crutches.  That has been no fun, but seems to be getting back to normal.

Thought about trying Juven to help with building some muscle with the PT.  Has anyone else out there tried this?   http://www.juven.com/  It seems a little more credible than the stuff from the Health Food Store or GNC.  The stuffs expensive so I'm wondering if anyone else has tried it?

Kralldaddy

3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Rennschnecke

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Re: ACI done, time for Rehab
« Reply #9 on: May 13, 2010, 03:37:37 PM »
Not sure about the stuff or how it works.  I guess you need to check out whether it works by enhancing the recovery from training, i.e. normally you get stronger from training by stress the tissues and the recovery makes you stronger.  If this stuff works this way you may see only limited results.

But I admit, I speaking from nothing like solid ground beneath me ... ;)
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 kralldaddy

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Re: ACI done, time for Rehab
« Reply #10 on: June 01, 2010, 06:22:59 PM »
Wel now 10 weeks post op and had a question for the experienced ACI and MACI folks out there.  I'm now walking normally no crutches or brace needed, the knee still feels not normal.  There really isn't pain and it definately feels different than pre op and my other knee.  Just wondering if this is similar to other folks experiences?  I just have this huge fear of messing up something with the graft and making all of the time, effort, and money a waste.  I'm follow OS/PT's orders.  Minimal walking and steps only when I have too.  What kinds of distances were you doing at this stage of your rehab?
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #11 on: June 17, 2010, 01:45:41 PM »
 Wow, it has been 3 months since my ACI surgery. Had a followup with my OS yesterday. So far all is going as planned.  My ROM is almost back to 100%  which is nice since it hasn't been that good since I torn the meniscus back in Aug which started all of this.  Pain if farily minimal if any at all. 

The strenght of the quad is my main issue now.  Two stints of NWB and almost a year of favoring have taken its toll.  I guess it's good I'm weak,  it helps remind me not to over do it.   Going to PT once a week and that seems to be progressing well, slow, but well.

I do have a couple small issues.  I have an adhesion at one of the port spots.  Its not painful or a problem durning normal activity, but causes some pain during PT.  I'm going to try and massge it out and see if that helps. 

There is also still some swelling.  It's not hindering any progress yet, but but if it's not better in 4 weeks, they're going to drain it.  I'm going to get back to icing it more often to see if that helps.  Also the exercise bike seems to help, so I might up the frequency on that some.

Hope all are doing well.

Kralldaddy
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #12 on: July 23, 2010, 06:40:19 PM »
Well it's been four months.  Had a appt with my OS this week and he's extremely happey with progress.  Swelling is minimal, I still see/feel it but its not enough to drain.  Got cleared to do some work on teh Elipitical now, about 10 min at a time a couple times a week.  That's been a welcome change to the exercise routine.  I asked about light runnig or jogging, but he's holding that off till the 8-9 month mark.  The muscle still gets tired fairly easy, but is only noticiable when going down steps.  Other than that normal daily activities are almost back to normal.  Still seeing PT about once a week and won't go back to the OS for four months.

I had a little scare after flying a couple weeks ago and had some pain issues, but I think it was just sitting cramped for so long.  I'm 6'6" tall and planes just weren't meant for people that tall.  I'm definatly going to try and get better seats on future flights (exit row or bulkhead)  That DVT stuff is scary.

So in my opinion this has been a success so far.  It's just a slow long process. 

Hope all are well.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline SevenofNine

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Re: ACI done, time for Rehab
« Reply #13 on: July 24, 2010, 04:57:03 AM »
Hi Kralldaddy,
sounds like you're doing great :D you will love the cross trainer / elliptical - I started on this at about 3 months post & now do 20 mins each nite with a low resistance for the second 10 mins. I haven't flown since my surgery but have a trip booked in August though it's only an hour each way & I haven't been blessed with your height :)

Thanks for posting updates - it's really good to follow others progress & share the hiccups along the way.

Cheers,
7of9
May 22 2013 RK LR & medial capsular plication, debridement, meniscus repair
Feb 3 2010 LK MACI
Nov 4 2009 LK scope - meniscus repair, debridement,      biopsy for MACI

Offline Rennschnecke

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Re: ACI done, time for Rehab
« Reply #14 on: July 26, 2010, 06:52:51 PM »
Well done, Kralldaddy!

I think you're a great encouragement to everyone out there.  Hope it carries on being so smooth for you!

Take care!  :D
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 kralldaddy

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Re: ACI done, time for Rehab
« Reply #15 on: December 20, 2010, 10:03:24 PM »
Well it has been almost 9 months since my ACI procedure, so I thought was time for an update.  The Quad muscle is still quite a bit weaker than my other leg, PT measured that at about 50% difference, I agree.  Steps and squats still seem more difficult on that side.  I can use the eliptical trainer daily with no issues or pain, and just got clearance to do a run walk program on the treadmill up to two days a week.  I don't have "Pain" when i run, but definatly doesn't feel like my "good" knee.  There's no pain or swelling afterwards, it just feels strange. 

Anyone have this experience when you returned to running/activity?  I don't know if its due to the muscle weakness or the fact that there is still nerve damage/numbness on the outside of the knee.  Either way, I'm happy things are starting to progress, I was getting a little depressed I'd never run again.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Rennschnecke

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Re: ACI done, time for Rehab
« Reply #16 on: December 21, 2010, 04:22:15 PM »
You're bound to feel weak if this is your first return to anything like running.  Your body will adapt over time till it evens out.  9 months is till quite early days in recovery and I know some people took nearly 2 years to return to running.

At this point you still need to take care on how you go forward.  If you train carefully you'll notice a big difference at the end of the next 3 months.

Best wishes
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 kralldaddy

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Re: ACI done, time for Rehab
« Reply #17 on: January 25, 2011, 09:51:13 PM »
10 month update.

I've since backed off the run walk routine and things have gotten better.  Had my 10 month check with my OS and he's still happy with progress.  The pain I experienced with the run walk he guesses was due to the muscle weekness I still have on the surgry side compared to the non surgery side.  I keep reminding myself they said 12-18 months recovery.  Just concentrating on building strength for the next few months before I try a shorter walk run program again.  I just fear damaging the graft, but need to push to build some muscle back.



Hope all are well.

Kralldaddy
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Room 101

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Re: ACI done, time for Rehab
« Reply #18 on: January 31, 2011, 10:52:18 PM »
Hi Kralldaddy.  It seems as if all is going well for you.  Congrats on making it this far.  I am 2 years and 2 months post right now.  I had        3cmx2cm patella lesion ACI repair along with AMZ 10 months prior to that.  I was blown away that you were starting run/walk at 9 months!!  That is so outstanding.  I know you backed off of it, but it's still great that you felt that good.  I was definitely not that quick (and not allowed to be).  At 11 months we hiked 3/4 mile to the Hawaii volcano and back.  It wasn't up or down hill, but more across very uneven terrain (lava with big cracks and crevices).  I remember at my 1 year follow-up I told my doc about it.  He was surprised I did it with no pain and said he would have told me not to do such a thing had I mentioned it beforehand, hahaha...

To be honest, even now I feel like I have some strength differences, but I almost feel like it is really a muscle balance issue where the leg with the AMZ is straight now and the other is still bowlegged.  I definitely notice differences in balance, etc.  I don't run for any distance and I just started cross country skiing this winter.  That's how I do my cardio.  I don't want to screw this whole thing up.  Too much time has been put into it, and I am so grateful for what I can do today that I couldn't do a year ago.


Good luck to you, and I hope your success continues.

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 gryff

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Re: ACI done, time for Rehab
« Reply #19 on: February 27, 2011, 09:39:06 PM »
Hi Kralldaddy,
I am in your shoes a year ago. I am having ACI soon by Dr. Flanigan as well. Did you have patella ACI or tibia/femoral ACI? Did you take a lot of time of work? How did you feel about a week out? Did they have to do any osteotomy with the ACI.
Thanks for any advice in advance.

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #20 on: March 08, 2011, 06:19:22 PM »
I had tibia/femoral ACI.  I took about a month and a half off work.  About a quarter of that was total off and the rest was working from home on the couch.  One week out the knee feel pretty terrible.  Really swollen and pretty painful.  Ice and CPM was my life for 8 weeks.  Towards the end I was back at work and sleeping in the CPM to get my 8 hours a day in.  I was  a total of 8 weeks NWB after the ACI and 4 weeks after the previous Meniscus repair.  So the strenght in my leg is shot.  No osteotomy for me, and I 'm glad, that can add a lot of complations and changes to the rehab.

The hardest part is the total protection of the repair for the 8-10 weeks.  I hated that brace and crutches, but I followed the Drs orders and so far this seems to be a success.  I ran 2.5 miles yesterday and muscles were sore, but the knee felt pretty good. 
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Rennschnecke

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Re: ACI done, time for Rehab
« Reply #21 on: March 08, 2011, 06:29:18 PM »
MAGIC
[/shadow]
Hope it continues this way! :D
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 Melissa S

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Re: ACI done, time for Rehab
« Reply #22 on: March 09, 2011, 03:08:30 AM »
That is good to hear.  So, you are about a year out from surgery right?
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 kralldaddy

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Re: ACI done, time for Rehab
« Reply #23 on: March 09, 2011, 01:37:46 PM »
Yes, exactly 2wks shy of 1 year today.  Yesterday I actually shot a basketball for the first time in almost 2 years since the injury.  Jumping to shoot definalty felt weird but got better as i warmed up and no pain then or this AM.  This was encouraging because the ultimate goal was to return to sports like basketball and running. 
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline gryff

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Re: ACI done, time for Rehab
« Reply #24 on: March 12, 2011, 02:35:19 AM »
Thanks for your update. I really appreciate it. My surgery is soon and I am very scared. I wish I could say I could be mentally prepared for this but I am not sure that is possible. I just keep putting it out of my head. I was hoping to get back to work by 1-2 weeks (I work at a desk all day) but maybe that is unrealistic.... I know I can work from home, I just get cabin fever after a day or 2!

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #25 on: March 14, 2011, 01:02:11 PM »
The biggest reason I took so long was to get the CPM and Ice time in.  I agree working from home is awful boring.  Maybe you could do have days.  My other biggest issue was this was my right knee so I couldn't drive at first.  In fact with my leg locked straight in the brace, I couldn't even sit in the front seat of a car, I had to sit sideways in the back seat.

Its just important to have lots of help and support from someone.  You don't realize how much you can't do when your totally NWB and on crutches.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Flyinglion

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Re: ACI done, time for Rehab
« Reply #26 on: August 04, 2011, 06:19:58 PM »
Kralldaddy,

Came across your experiences while completating possible ACI surgery with Dr. Flaningan. Had right knee scope in June and still having some issues with stiffness due to fluid buildup.  Thinking about ACI for "kissing defects" patella and troclea along with patella realignment.
I was wondering if now you are able to do impact sports (soccer, running tennis) and also wondering where you did your PT in the
Columbus area?

Thanks!
February 2011 - Injured right knee playing indoor soccer
April 2011 - MRI showed patella & trochlea grade 4 kissing defects
June 2011 - Right Knee Scope/ACI Biopsy
November 2011 - Synvisc Injections
May 31, 2012 - Denovo NT Patella & Trochela, Lateral Release/TTO/MPFL Reconstruction

Offline kralldaddy

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Re: ACI done, time for Rehab
« Reply #27 on: October 14, 2011, 08:46:32 PM »
Sorry for the late reply, I've been off the board for a while.  I haven't total returned to all activities.  I do some running a couple miles a week right now) and lots and lots of  elliptical work still.  No basketball :'( yet.  Flanigan advised this would be the worst thing i could do with regards to protentially damaging the graft.  The knee for day to day activites  (walking, squating , stairs, yard work, playing with kids) feels good.  Heavier activity causes some minor discomfort.  Not nearly as bad as before the surgery, but there's still some ocasional pain and discomfort but noththing some rest and occasional OTC med can't help.  Still hoping to get back to hoops some day, but we just had a baby and I can't take that chance of gettng hurt right now.

As for PT, I did mine at the OSU rehab in teh same building as flanigan.  That why I felt he and my PT could work together closely on the plan.

Best of Luck.
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline kralldaddy

  • MINIgeek (20-50 posts)
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Re: ACI done, time for Rehab
« Reply #28 on: November 18, 2011, 07:48:57 PM »
Had my 20 month check up on Wednesday and the Dr. has cleared me for all activies as tolerable.  Yahoo, rehab is done!  The surgery leg is still alittle smaller than the non surgey side the strength seems to be the same.

I played one hour of recreational baskeball yesterday and besides feeling terribly out of shape, the knee held up fine.  In fact the not surgey knee had some pain but none on the ACI side.  I took a long time, but I think I can say the procedure worked!
3/10 ACI
11/09 Menicus Repair/ACI Biopsy

Offline Jwin138

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Re: ACI done, time for Rehab
« Reply #29 on: November 18, 2011, 08:12:32 PM »
Kralldaddy -

thanks for keeping us updated! I am glad to hear you are doing well! I have a chondral lesion under my patella and am getting a cartilage regeneration surgery in January. (denovo, not ACI)

hope you keep improving!
Jess















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