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Author Topic: New Member, I am having ACI in mid October, Help!  (Read 27686 times)

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Offline mlashmar

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Re: New Member, I am having ACI in mid October, Help!
« Reply #30 on: October 13, 2010, 06:26:41 PM »
Best of luck for the op, the op itself is not to bad, so try not to worry about it too much.

Make sure you have plenty of films etc ready for your return home and try and make sure you have plenty of people dropping in to see you, it can get very boring after a while! 

One suggestion would be to ask your physio for contact details so that you can chat through any problems / concerns you have once you're home; there are so many aches and pains, ups and downs it may stop you worrying at times.
Left knee
Full thickness defect (20mm x 20mm), Trochlea
Arthroscopy x 3 (1997 - 2006 NHS) - lose body removal, lavage and debridement
Microfracture 2008 Spire Southampton - diagnosis of trochlea defect
MACI Stanmore 2010

Offline Youthist

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Re: New Member, I am having ACI in mid October, Help!
« Reply #31 on: October 14, 2010, 12:35:17 PM »
Cheers Melissa and Mlashmar. I will definitely post on here once I have recovered and let you know how it went / is going.

And yes Melissa - it will be great to have others going through the recovery at the same time....hopefully this board will prevent us from all going nuts....!


Offline Youthist

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Re: New Member, I am having ACI in mid October, Help!
« Reply #32 on: October 14, 2010, 03:59:58 PM »
Actually a thought has come to me, I would like to get peoples suggestions.

I know that "elevate the knee" is going to be a huge thing that I am going to have to be doing a lot post op. I would like to get peoples opinions on what sort of elevation has worked and can they "get away with" in terms of comfort levels etc?

Like - do i need to lay on my back with it up? Or can you get away with sitting up pretty straight but just have some cushions etc and keep it relatively raised but not having to lay down all the time?

I guess my question to everyone is "What elevate the knee strategies did you use / What worked for you / what was the most comfortable but still provided success?"

cheers!
tony

Offline Rennschnecke

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Re: New Member, I am having ACI in mid October, Help!
« Reply #33 on: October 14, 2010, 04:36:08 PM »
Tony,

By elevation I think most physios mean get the knee above the heart and the ankle above the knee to promote drainage of swelling.  In reality, your time for doing this will be limited by other activities, e.g. CPM, icing etc.  It may be possible to ice and elevate if your ice system allows this, but sometimes they slip or are uncomfortable.

You may wish to just elevate to hip level, but this won't help swelling as effectively.  When the time comes you will have to see what is sufficient for you, but keep in mind that everyone is different and differences may also occur for any one person for different surgeries.

For example, I have recently had a scope and at 4 weeks post-op my knee is still very swollen (no problem with scaring a sick note out of my GP today with it).  I have been elevating above the heart twice a day or more when possible and also overnight since Day 2.  Yet, I was much less swollen after my ACL reconstruction and was able to run by Week 5.

BTW I was not elevating it high up post-MACI and I was perfectly OK, but I ended up with extensive adhesions forming from the swelling.  However, you may do the same and be perfectly fine – no adhesions.

Best to check with your OS and PT what they'd like you to try for.

Good luck for you op!
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 mlashmar

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Re: New Member, I am having ACI in mid October, Help!
« Reply #34 on: October 15, 2010, 09:15:11 AM »
Hi

I didn't elevate at all, it was more about finding a position that was comfortable for my knee, which I treated as a priority.  I controlled swelling through ice (aircast system) and anti-inflamatories, the former is an absolute god send, but it is worth making sure there is a ready supply of ice and it can be refilled as appropriate (say mid afternoon). 

My knee is still swollen, but this is normal (according to surgeon and physio), but I am pretty much comfortable most of the time.  I had problems with adhesions, but this was due to a slow start to range of movement exercises rather than swelling management.

As Renn says, chat with your physio or surgeon, but my experience has taught me not to stress too much, if you are cautious, conscientious and work hard, you'll be fine.  No regime will be perfect, you will just tailor the advice to what is best for you without putting the op at risk.
Left knee
Full thickness defect (20mm x 20mm), Trochlea
Arthroscopy x 3 (1997 - 2006 NHS) - lose body removal, lavage and debridement
Microfracture 2008 Spire Southampton - diagnosis of trochlea defect
MACI Stanmore 2010

Offline KartBoy

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Re: New Member, I am having ACI in mid October, Help!
« Reply #35 on: October 16, 2010, 12:12:47 PM »
I know the theory is knee above heart but I got by ok using a stool and cushion in front of chair, I also wore anti-thrombosis stocking for most of the first five weeks (I had two which I alternated). You need to move the foot to help pump the fluid around and ice the knee twice a day but other than that swelling came down ok. You will get funny nerve sensations and twinges while your non-weight bearing but that is normal, your muscles arn't working and don't know what to do but its nothing to be concerned about.

I had a good supply of tea & coffee from wife and house guests which meant I was up quite a few times during the day to go to the toliet and once I was partial weight bearing at four weeks this helped to bring the swelling down to almost nothing. You must however do the physio exercises by the book, for me that is still four times a day, icing after second and final set. The physio has been really good but they can tell if your holding up your end of the bargin and will be more supportive and helpful if you do.

I actually found that the swelling and stiffness after the harvesting operation to be harder to deal with than after the operation itself but that may be because when they harvest cartilage they also do some cleaning up at the graft site in preparation but not certain.

Best of luck, Andrew
« Last Edit: October 16, 2010, 12:14:35 PM by KartBoy »
7th Mar 08 - Pedestrian hit by car
10th Mar 08 - TPF (Plate + 6 screws)
12th Mar 08 - TPF Revision
Feb 09: Hardware removed + scope
Jun 10: ACI Stage I
Aug 10: ACI II (Stanmore)
Oct  11 - MRI + Scope (In pain)
Aug 12 - MRI + Scope (In more pain)
Sep 12 - TKR ruled out :(

Offline Youthist

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Re: New Member, I am having ACI in mid October, Help!
« Reply #36 on: October 16, 2010, 02:09:24 PM »
Hi All

So, had the op at 0800am today, so about 6 hours ago now. On a morphine drip right now, and that little button is coming in handy!  Was in agony when I first came round.

 Observations so far for those that have the op coming up:

- I am able to a straight leg raise at the moment, so pleased with that
- the cast / sling / contraption is not as bulky or uncomfortable as I thought it was going to be at the moment. Lightweight, and seems pretty easy to get on and off.
- The best news of all - Skinner has informed the Physio that I can PWB immediately. Pre-op I was being told it would probably be 3-4 weeks of NWB, so i am extremely please with that.  So he is going to come and chat to me later, but PWB right from the off has really given me a boost.

Thats about it for now, just sitting up in bed kinda feeling a bit pleased that its out of the way and I can start the  (hopefully successful) road to recovery. Long way to go though.




Offline KartBoy

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Re: New Member, I am having ACI in mid October, Help!
« Reply #37 on: October 16, 2010, 02:17:36 PM »
:-) PWB is good news, just make sure they define partial!, the new braces are much better but be careful about leg raises as you need to look after that cartilage graft. The muscles will waste a bit but they come back easily enough.

All the best, Andrew
7th Mar 08 - Pedestrian hit by car
10th Mar 08 - TPF (Plate + 6 screws)
12th Mar 08 - TPF Revision
Feb 09: Hardware removed + scope
Jun 10: ACI Stage I
Aug 10: ACI II (Stanmore)
Oct  11 - MRI + Scope (In pain)
Aug 12 - MRI + Scope (In more pain)
Sep 12 - TKR ruled out :(

Offline Youthist

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Re: New Member, I am having ACI in mid October, Help!
« Reply #38 on: October 16, 2010, 02:30:55 PM »
:-) PWB is good news, just make sure they define partial!, the new braces are much better but be careful about leg raises as you need to look after that cartilage graft. The muscles will waste a bit but they come back easily enough.

All the best, Andrew

Cheers Andrew.  I am very glad I found this forum to hear from people going through this / about to go through this, it really is helping me.
Cheers again,
Tony

cdubb

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Re: New Member, I am having ACI in mid October, Help!
« Reply #39 on: October 16, 2010, 04:13:27 PM »
Youthist,
Best of luck in your recovery. Glad it all went well. I'll be right behind you with my ACI/AMZ on Nov. 3rd. 

I'm sure it's somewhere up here on the thread, but where is your lesion?


Offline Youthist

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Re: New Member, I am having ACI in mid October, Help!
« Reply #40 on: October 16, 2010, 04:34:30 PM »
It is a lesion of the medial femoral condyle. Grade 4 2cm * 2cm.

Good luck with yours too!

cdubb

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Re: New Member, I am having ACI in mid October, Help!
« Reply #41 on: October 16, 2010, 04:51:50 PM »
Thanks! I'm a central patellar grade 4 - 1.5 cm x 1.5 cm. Since it's patellar, I'm also have the anteromedialization done as well...in all honestly...that part scares me more than the ACI even though the ACI is an overall longer recovery!  There is something about cutting, realigning and screwing down bone that just seems well....painful!

Offline markld

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Re: New Member, I am having ACI in mid October, Help!
« Reply #42 on: October 16, 2010, 07:32:30 PM »
Why dont you forget the ACI procedure and request a Denovo NT procedure. It is new and proving to be better and have a faster recovery than ACI. Don't listen to me, do the research and find out for yourself. All the top cartilage Dr's in the country are now performing them.
April 2008 microfracture left knee trochlea
Jan 2009 ACI harvest from right knee
Mar 2009 ACI right knee trochlea
July 2009 Aci left knee
Nov 2009 left knee scope to check graft

cdubb

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Re: New Member, I am having ACI in mid October, Help!
« Reply #43 on: October 16, 2010, 07:58:40 PM »
My doc is one of the top cartilage restoration docs in the country.  I'm w/ Dr. Brian Cole out of Chicago.  I know he does Denovo, but I don't know how he decides who he does Denovo on and who he uses traditional ACI on.  As Genzyme is already growing my cells, nothing that can be done at this point.  It is a good question to ask though. At the time of the ACI biospy I hadn't heard of Denovo and it's only been in the past couple weeks that I've read about it actually being done. It was my impression before that it was only being done as part of clinical trials.  I may need to have something done with my right, which is being scoped when my left ACI/AMZ is being done, so it may be an option for that one.

Offline Youthist

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Re: New Member, I am having ACI in mid October, Help!
« Reply #44 on: October 17, 2010, 03:00:50 AM »
Hi All

So, had the op at 0800am today, so about 6 hours ago now. On a morphine drip right now, and that little button is coming in handy!  Was in agony when I first came round.

 Observations so far for those that have the op coming up:

- I am able to a straight leg raise at the moment, so pleased with that
- the cast / sling / contraption is not as bulky or uncomfortable as I thought it was going to be at the moment. Lightweight, and seems pretty easy to get on and off.
- The best news of all - Skinner has informed the Physio that I can PWB immediately. Pre-op I was being told it would probably be 3-4 weeks of NWB, so i am extremely please with that.  So he is going to come and chat to me later, but PWB right from the off has really given me a boost.

Thats about it for now, just sitting up in bed kinda feeling a bit pleased that its out of the way and I can start the  (hopefully successful) road to recovery. Long way to go though.


So its 0300AM here in the UK, so I guess thats about 19 hours post op now.  Update on what has been going on:
- I was moved off the morphine drip and onto some other painkiller drip in the afternoon (still morphine based however). It was giving me a few unpleasant side effects when dozing / closing my eyes (slightly hallucinagenic imagery, but not pleasant ones) so they moved me onto something else.
- Every 5 mins you can press the button and get zapped with the painkiller. And if you dont, your leg soon starts to let you know about it - very painful
- I started in the last 2 hours or so to get very itchy all over my body, its a side effect of the painkillers. They have given me about 15 mins ago some anti-histamine to try to get rid of that. Its driving me up the wall, hence my need to get on the laptop / do "something" to take my mind off it!
- I had done less pain killers / been holding off on pressing that button, because of the itching - catch 22 !
- I have decided that the pain is definitely worse than the itching :-)

thats about it for right now. Overall, not too bad, in extreme summary. But not the greatest day of my life either.















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