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Author Topic: Mosaicplasty on MFC and Patella plus microfracture on 9th July!  (Read 11825 times)

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Offline AndrewH

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #15 on: July 29, 2010, 08:23:01 PM »
Hi Marc & Lottie

I'm doing okay so far. Just back from a few days holiday down in York & Scarborough with the family. Crutching about was hard going but I got into the right frame of mind by thinking of it as a good work out!

My knee is still swollen at this point although it is going down. Its still very stiff and a bit sore when I bend it. Can't bend it really any further than 90 degrees so far. Don't have any pain at rest but have no strength in my quads to lift my leg upwards (eg like a straight leg lift). Spent my time away doing a lot of active bending though and trying to activate the quads.

The scar down my knee is healing nicely now and doesn't look as though it will be too noticeable.

The big point will come in 3 weeks when I start putting weight on the knee again and getting back to weight bearing. I virtually ditched the crutches in a day last year but won't be doing that this time. For a start I can't even do a straight leg lift yet whereas I could do that immediately last year. Going to make it a gradual progression this year.

I would have been a lot more confident of success with this op if it wasn't for the fact that I've had work doen now on the patella on 2 small lesions. That really does worry me. However I wasn't really having any problems or pain with the patella before the op so hopefully it will be okay.

Marc - I take it that you still have had no joy with your microfracture?

My surgeon told me that my microfracture last year had worked in that the lesion was fully covered over with new cartilage. He said it was fibrocartilage though and appeared a bit soft. It certainly wasn't giving me any real pain relief but I have wondered if I'd left it a few more months if things might have got better. But that was 13 months so I suppose I would have noticed more improvement by now. Plus if I hadn't gone ahead with it then the patella damage might have worsened.

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: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #16 on: August 06, 2010, 11:50:26 AM »
4 weeks post op now.

Swelling in the knee has come down quite a bit but still can't do a straight leg lift with my quads yet. Losing quite a bit of muscle. Still non weight bearing and getting around on the crutches is a great workout. It takes me 30 mins to crutch up the road to work in the morning when I get off the train and same again on the way home.

2 weeks to go now until I can start putting some weight on my knee. Seeing as I can't even lift my leg yet I think that's going to be difficult. Will see how things go over the next fortnight.
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 Lottiefox

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #17 on: August 06, 2010, 03:40:38 PM »
Hi Andrew

Good to read that the swelling is reducing, that must be helping the overal feel of the knee. You'll have an upper body like a gladiator with all the crutching about!!

Does the quad fire at all, but is lacking in strength? I'm wondering if your PT or anyone has tried any e-stim at the same time as you contract it to get it more responsive and try and trick it into a leg lift. I think your slow and steady approach will pay dividends this time around - all fingers and toes crossed!

Keep us posted

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline AndrewH

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #18 on: August 06, 2010, 05:27:47 PM »
Quads don't seem to fire at all. I've been doing loads and loads of static quad contractions but its just not happening.

Its a bit like trying to move you ears. No matter how hard you try or how hard you think about it, you just can't move your ears......  :D Well, that's my analogy anyway - but in reality, I can actually move my ears!  :D But you know what I mean.

I've been to physio twice now. The second time, the physio was trying to get me to do some quad work but I've decided against doing anything other than static quad contractions. From what I've read, quad work puts a lot of pressure on the patella and that's not what I need just now. I'm willing to accept some severe muscle atrophy just now in order to let everything heal up first. I'll deal with strengthening my quads later.
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: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #19 on: August 13, 2010, 06:53:21 PM »
5 weeks post op now. Looking foward to starting to put some weight on the knee next week.

Decided to try and drive today and managed it no bother. At least that gives me some freedom back. The knee is still swollen in comparison to the other knee and the skin all around the scar is still numb. Have been able to do some leg raises this week. I'll not say straight leg raises as I can't do them without a slight bend in my knee but at least it will start the strengthening of the quads. Don't want to put too much pressure on the patella though so will continue to go easy on them for the next week.

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 and4400

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #20 on: August 24, 2010, 11:28:45 PM »
Andrew just wondered how you are doing, how's the weight bearing going? I'm going to the doctor tomorrow so I'll update my progress then. Andy
osteochondritis dissecans† RT. knee
Debridement Oct 06
Bone grafts 3x3cm defect MFC(harvest ACI)Dec 06
Scope Apr 07
ACI done July 07
Scope May 08,Scope Dec09
surgery #8 Oats(MFC) Open wedge HTO July 10'

Offline AndrewH

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #21 on: August 25, 2010, 08:15:18 PM »
Started weight bearing again, still using 2 crutches, last Thursday. That was a day short of 6 weeks. Since then I've been alternating between weight bearing with 2 crutches and 1 crutch and have also taken a few short walks in the house and office without any crutches in the past couple of days.

Went to see the surgeon yesterday but didn't get really much out of that. Going back to see him in another 6 weeks.

Pain in different places in my knee. Sort at the front of my knee, I think basically coming from the scar / wound. One side of the scar feels numb while the other side feels a bit sore. Surgeon says this is normal. Gives a sort of tight feeling when I bend my knee when walking. Its also irritating when rubbing against my trousers when walking.

My quad is also a bit sore just above the patella but is becoming less so ever day. I have been strengthening my quads with leg raises (not yet completely straight). Surgeon told me I can now start using ankle weights and also to heat my knee up before exercising (eg with a hot water bottle).

As for pain from the grafts on the mfc and patella, microfracture on the patella and donor sites? Who knows. Its early days. When I type all that out I realise what a mess my knee is in now! On my side however is that the lesions are relatively small. My surgeon also tells me that he's only ever had one patient who's had any problems after he's done mosaicplasty. From my reading it seems that the surgeon doing a good job is critical and I have complete confidence in my surgeon. He even described the work he did on me as "beautiful"!  :o

I'll give updates on how my knee progresses over the next few weeks / months. At this point I'm hopeful and confident that all is going to turn out okay. I'm now approaching almost 2 years since I initially injured my knee and having a normal feeling in my right knee is something that I can't remember!
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 kevin3004

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #22 on: August 26, 2010, 09:07:15 AM »
Started weight bearing again, still using 2 crutches, last Thursday. That was a day short of 6 weeks. Since then I've been alternating between weight bearing with 2 crutches and 1 crutch and have also taken a few short walks in the house and office without any crutches in the past couple of days.

Went to see the surgeon yesterday but didn't get really much out of that. Going back to see him in another 6 weeks.

Pain in different places in my knee. Sort at the front of my knee, I think basically coming from the scar / wound. One side of the scar feels numb while the other side feels a bit sore. Surgeon says this is normal. Gives a sort of tight feeling when I bend my knee when walking. Its also irritating when rubbing against my trousers when walking.

My quad is also a bit sore just above the patella but is becoming less so ever day. I have been strengthening my quads with leg raises (not yet completely straight). Surgeon told me I can now start using ankle weights and also to heat my knee up before exercising (eg with a hot water bottle).

As for pain from the grafts on the mfc and patella, microfracture on the patella and donor sites? Who knows. Its early days. When I type all that out I realise what a mess my knee is in now! On my side however is that the lesions are relatively small. My surgeon also tells me that he's only ever had one patient who's had any problems after he's done mosaicplasty. From my reading it seems that the surgeon doing a good job is critical and I have complete confidence in my surgeon. He even described the work he did on me as "beautiful"! :o





I'll give updates on how my knee progresses over the next few weeks / months. At this point I'm hopeful and confident that all is going to turn out okay. I'm now approaching almost 2 years since I initially injured my knee and having a normal feeling in my right knee is something that I can't remember!
Hi Andrew good to hear youíre weight bearing and Iím sure things will work out for you and your surgeon seems very positive. Are you now driving?
Get those ankle weights on and take it steady and keep posting.
Cheers
Kevin

Offline AndrewH

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Re: Mosaicplaty on MFC and Patella plus microfracture on 9th July!
« Reply #23 on: September 12, 2010, 04:23:41 PM »
That's just over 9 weeks post op now. Weight bearing is going well so far. Knee is still a bit numb and sore around the scar but its getting better.

My initial impression is that the pain on the MFC that has been giving me problems for approaching 2 years now feels less painful. Its early days just now so don't want to jump the gun but even at this early stage I'm able to walk about without a limp. There are noticeable improvements every day. Haven't really noticed any patella issues other than the pain at the scar on the oustide of my knee. In fact the worst pain so far has been the scar rubbing against my trousers when walking about althoyugh that has diminished as the days go on. Am able to walk up and down stairs okay and although I haven't walked any great distances, I have done a couple of trips round the supermarket so far.

As I said, early days at the moment but compared to how I felt at this stage last year after microfracture, I'm a lot more confident that I'm going to have a positive outcome this time around.
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 Lottiefox

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Re: Mosaicplasty on MFC and Patella plus microfracture on 9th July!
« Reply #24 on: September 12, 2010, 10:57:42 PM »
Andrew

I shall say this quietly....so not to tempt fate....but things sound good!  ;D

Slow progress is the way to go, and having been through failed MFC repair I think you're well placed to recognise if the OATS is helping more. I have all fingers and toes crossed that things go well this time. I've just had a visco supplement jab in my problem left knee (Euflexxa) - my areas of damage are varied and diffuse and I'm just not sure if any of the cartilage repairs are going to help long term......the OS who jabbed me seems to think it will be bionic parts for me but says that could be 2, 5, 10 or 20 years on....so whilst I am pretty functional and pain free (so long as no running!) I'll keep plodding along..

Good to hear your update, keep us posted and take care

Lottie  :)
Bilateral patella OA since 2009, no surgeries.
Euflexxa working well x3 to current
Right forefoot CRPS post fusion surgery 2011
Refusing to let the ailing parts stop me....

Offline AndrewH

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Re: Mosaicplasty on MFC and Patella plus microfracture on 9th July!
« Reply #25 on: October 10, 2010, 12:22:57 PM »
3 months post surgery update

The knee feels a million miles away from being normal yet. The skin around the long scar down my knee still has some numbness and pain, although is very slowly getting better. It irritates when rubbing against trousers when walking about.

Have more or less regained full ROM, just feels a bit tight when pulling my knee right back. Am able to walk about okay but I do still feel some of the same pain in the same area on the MFC that I was having pre surgery. I don't think its as bad as before and I think its getting better. Its hard to tell though because of the general achiness in the knee from the actual surgery and the numbness and soreness on the skin.

Am rehabing my doing 20 mins on the bike most days with low resistance and doing straight leg raises with weights every second day. Also using a small cycling machine in the house for short spells every day to keep my knee moving. Muscle is coming back. Have been doing lots of upper body work in order to help keep my weight down. My weight actually went up a bit after I stopped using the crutches, probably because I did so much walking about on the crutches and it was a great work out. Weight has come back down over the past couple of weeks. Am still within the normal weight range on the BMI scale by almost half a stone but would like to lose up to another half a stone to ease the pressure on my knee.

Its still early days. Its hard to get timelines on recovery for this op but as most studies look at results at a year or after, I know that is the timescale I am facing. I found a good study recently of 8 patients which looked at results at 6 months - which is the earliest I have found in any study. There were significant improvements for all 8 at 6 months with some fully recovered at that point and significant progress again after 12 months for the rest. I'm only half way to the 6 month mark and a quarter of the way to 12 months so am being realistic in what to expect.

I've had worked done on 3 different lesions on the knee so I knew it was going to be a difficult recovery. Still feeling confident.
« Last Edit: October 10, 2010, 12:32:05 PM by AndrewH »
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