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Author Topic: MACI patella done. On the rehab road.  (Read 9203 times)

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Offline Thabo

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MACI patella done. On the rehab road.
« on: March 11, 2011, 09:46:12 PM »
After a multiple other surgeries over the past 5 years I now at last had MACI done on the R patella 5 hours ago. In a full extension locked brace and will be in hosp for 2 days. The brace would be on for a week and then the physio starts. I dont really have much pain - had some tramadol and oxycodone and during the surgery I had a femoral block.
At this time the pain certainly does not even compare to the pain of a HTO !

I have gained a lot of insight and hope from the post on this forum and hope that logging my experience would be use full to someone els.

It was a 2x2cm grade 4 area on the patella that was patched. The opposing trochlea had some wear but my surgeon did not feel worried by this and looked satisfied when I saw him after the surgery. Hopefully it would all go well and then I can have the L knee done in 6-12 months.
I would be happy to answer any questions.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

cdubb

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Re: MACI patella done. On the rehab road.
« Reply #1 on: March 12, 2011, 01:52:02 AM »
Good luck in your rehab!  I am just over 4 months post patella ACI (MACI isn't yet FDA approved in the US) along with a tibial tuburcle osteotomy to realign my kneecap. My defect was also 2 x 2.   I'm doing fairly well at this point and actually found that the initial post op pain (even with the TT) wasn't as bad as I thought.  It does always amaze me how long that others are kept after this procedure in the hospital.  I was discharged home an hour after waking up and I didn't have a femoral block either.   The Norco and Oxycontin worked just fine. 

I'm in the stage where I wonder when I may be ready for my right knee.  At 4 months post op, I'm not there yet and still have significant quad atrophy and I don't think that the left can take the extra load.  I figure by about 12 months post op, I'll be ready. My doc says he won't do it any earlier than 6 months...so the approvals would need to get in place now if I wanted to do that...just not there yet though.

Hope your next few days go well!

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #2 on: March 12, 2011, 03:12:00 AM »
Thanks for the well wishes.

I am glad to hear that someone with a similar lesion is progressing well. I was also thinking about doing my other knee in about 12 months. That should be easier as its only a 1x1cm patella lesion. Interesting to hear about the MACI not being FDA approved. My surgeon does both and felt MACI would work better in my case. This in the UK, London.
Yes I agree that this is not a really a painful surgery-the microfracture and HTO in 2009 felt a lot worse.

Could you tell me if you are using a stationary bike for rehab and how that feels on both your knees?- the untreated one particularly. My physio seems to be keen on that, but I have mainly been using a crosstrainer(elliptical machine) until now.

Hope you reach your goals as well.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

cdubb

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Re: MACI patella done. On the rehab road.
« Reply #3 on: March 12, 2011, 10:03:23 PM »
I don't know why MACI isn't approved here yet, but just ACI is.  There are a lot of regulatory controls here that really slow FDA approvals for new treatments and drugs down.  People here are very litigious, so I think it's a way of making sure things are safe and effective before they can be used.

I am using a stationary bike for my rehab.  I actually purchased one to have in our house when I was about 10 weeks post op.  In rehab, I wasn't able to make a full revolution until about 6-7 weeks post op.  I'd have to check my post op diary to be sure, but prior to making a full revolution, it still used it to work on ROM.  No resistance was allowed though until 12 weeks.  I wasn't given the okay to do elliptical until my last post op, which was at 17 weeks, but I think I probably would have been cleared by 12 weeks to try elliptical had I had a visit earlier.  As for how they bike feels, I can tell a difference between my treated and untreated knees.  My treated knee glides much smoother and tracks much better than my untreated knee.  Both are still crunch and are snappy, but was was told that is normal as the graft fills and hardens and at this stage it is still quite soft.  I actually still do track slightly laterally also on my ACI/AMZ (TT) knee, which I am a little concerned about, but my docs says that should improve as my quad returns. 

I had my right knee scoped the same day as my left knee ACI/AMZ to assess that defect to develop a plan since the right was actually my historically worse knee until the left tanked rapidly.  That defect measured 1.5 x 1.5 at the scope; however, my defect at the time of my ACI/AMZ by the time all the damaged cartilage was removed, it was 2 x 2.   I also had a large spur that had to be ground down when my ACI was done.

Post op, I actually found my worst pain was about 10 days out when I developed some nerve/burning type pain in my foot. My Dr. said it was from blood tracking down the lining of my periosteum from the osteotomy. 

Why did you have an HTO before if you have a patella defect? I would think a TTO would be done, which is what I had done.  I thought the HTO's were more for more for condylar defects, but I could be wrong. It's just what I've seen through these boards being done. Trochlea and patella defects have TTO's and condylar have HTO's.

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #4 on: March 13, 2011, 01:24:03 PM »
Thanks. The info about the stationary bike is useful. I will definitely get one once I am discharged tomorrow. Sounds like I would be putting the elliptical machine away until I am much further recovered.
Interesting to hear about the crepitations in your knee when you cycle- please give me an update when that settles.

It is now day 2 post-op and the pain and swelling is not bad at all. I have been out on crutches last night and will do the same later today, as well as practice doing stairs.

Re the HTO- My original pain 5 years ago was a weightbearing pain in the medial side of my R knee. Nothing was seen during arthroscopy, or on MRI to explain this and it was not until I went to the Steadman Clinic in Vail that a varus R knee was diagnosed. A subsequent 5 degree HTO done in South Africa worked very well and I was lucky not to have been left with any condyle damage.


Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #5 on: March 14, 2011, 01:32:42 PM »
Day 3 and I have been discharged. The pain is not bad and I should manage on paracetamol and Tramadol. Also doing for doing short periods of ice for the swelling but luckily I have not had much swelling. My dressing was changed 2 days ago and the wound looked good. The staples is due to come out in 12 days.
I am managing well on my old crutches and have no problems with stairs.
The plan is now to stay on crutches for 4 weeks with only touchtoe weight bearing. I am starting physio in a week and will be aiming for 90 degree flexion before my consultant appointment in 4 weeks.
To help me along I am going to get a stationary bike and do pedal-movements on no resistance. I am sure that it would be quite some time before I can manage a revolution as I need 110 degrees for that.

Much of this diary is to remind my of my goals and limitations but I hope it is useful to someone else. Any questions, feel free to ask.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

cdubb

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Re: MACI patella done. On the rehab road.
« Reply #6 on: March 15, 2011, 01:35:27 AM »
Sounds like you're doing great! 

As for the crunching and snapping under my kneecap.  I don't notice so much when biking on my treated knee. I do on my untreated knee still when biking.  It's more if I attempt an open chain activity llike a short or long arc quad.  I do not actually do these are part of my PT, as only closed chain permitted, but to assess tracking my doc had me do one and my pt also did.  I do get some snapping even on closed chain stuff if there is a slight bend to my knee or when I'm doing dips on a whopping 2 inch high box...even then I still struggle with dips.

What my doc had me do to kep from getting stiff was to try to achieve 90 degrees a couple times per day from about 5-6 days post op. I was told to let it hang off the edge of the bed and use my other leg to lower and raise it and then just sit with it dangling for 30 seconds or so. I was told to do that 3 x's per day.  At my initial post op at 9 days out, I was already dangling to about 90.  I wasn't allowed to go beyond 90 until week 6.

So....you went to Steadman in Vail, had a HTO in South Africa and live in UK?? You're quite the world traveler!! Great that you didn't have any condyle damage and they caught the varus deformity prior to damage being done!

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #7 on: March 15, 2011, 06:50:11 PM »
Glad to hear your treated knee does not cause many problems when you cycle- cycling is really one activity I would love to get back to. I hope you would be able to do that as well once your other knee has been done.

Sounds like hanging the leg down is a good idea- I will discuss it with my physio when I remove the brace next week. At the moment I am just lounging around in the brace and tightening my quads for exercise.

Yes I really had to travel all over the world to get a diagnosis and treatment. Apart from Vail I had also been to Boulder and San Francisco for treatment and assessment. I can only hope that a further 2 years from now it would all have been worth it !
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

cdubb

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Re: MACI patella done. On the rehab road.
« Reply #8 on: March 15, 2011, 11:44:50 PM »
Quad sets and ankle pumps are really all you can probably do at this time.  I also had a CPM to be in 6 hours/day, but it was only set at about 40 degrees.  I've seen that often in the UK, CPM's aren't utilized as often as they are here in the US for ACI and MACI.  It's strange, I'm really just over 4 months out and decently restricted still, but thinking about those early post op days seems like ages ago already....  Definitely not ready to do it again yet...perhaps by the end of the year... although, that leave me on crutches in ice and snow again (gotta love Chicago winters).

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #9 on: March 22, 2011, 07:42:58 PM »
Well at least we have the summer coming up- I spent the morning sitting in the sun. You are right- I would not enjoy the snow on crutches. We had a few days of ice last winter and I just decided to stay in- not worth the risk of slipping on crutches.
Yesterday was my first day out of the brace and I saw my physio for the first time post-op.  Feeling a bit unsure without the brace but coping ok. Without any pain I was able to get about 15 degrees flexion yesterday and over the next 3 week I will be working towards getting 90 degrees. Apart from that I am doing the usual VMO static exercises and very gentle core muscle work. Very boring! However at least I don't have to do CPM- I had my share of that with the microfracture and it still failed miserably!
Also changed my dressing today and had a look at the wound. Its looks like its healing well but it certainly is an impressive length with 20 staples- they are coming out in 2 days.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #10 on: March 31, 2011, 04:36:25 PM »
My staples are out and the wound looks fine- no problems there. Unfortunately I have had a bit of a setback in that I developed a lot of opposite side hippain. I have discussed this with my hipsurgeon and physiotherapist who explained that this is likely due to the uneven weight distribution and altered gait. Being on crutches and touchtoe weight bearing does throw your balance out!
I have been having a lot of hip pain over about 6 days but it is now a bit better since I have been resting more and really working on the hip/buttock muscles. Unfortunately this has set my MACI rehab back and I have not moved beyond 45 deg flexion. Hopefully I can improve on that in the coming week or two. Apart from that I have few problems with the knee and although it is still swollen, it is looking a lot better.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Rennschnecke

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Re: MACI patella done. On the rehab road.
« Reply #11 on: April 11, 2011, 12:13:55 PM »
I know it's highly inconvenient, but have you thought of loaning a wheelchair from the Red Cross?  It would save on your hip pain and allow you to focus on your knee.

I'm also paranoid about scar tissue and arthrofibrosis so I'd really recommend getting the swelling down by whatever means you can, whether you plug yourself into the Cryocuff (Aircast or whatever) and elevate constantly or whatever.  If you do this and do heel slides down the wall you may get past the 45 degree flexion.  Really hope you do.

Glad your knee feels good otherwise and long may it behave like that!
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 Thabo

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Re: MACI patella done. On the rehab road.
« Reply #12 on: April 12, 2011, 11:31:14 AM »
Thanks for your advice  Rennschnecke. Good to see that you are in a stable situation despite the setbacks you have had.

 I have managed to find a Zimmerframe. However I soon gave up on that idea!! It is way too slow to get about with it, even in the house. Luckily the hippain has improved a lot since I have been consciously contracting my gluts when weightbearing.

Re the flexion- I have also been using heel slides against a wall as well as lying on my back with a flexed hip and letting gravity flex my knee.

I did manage 90 degrees flexion over the past week and my consultant seemed happy with my progress when I saw him yesterday.
My next follow-up appointment is in 3 month- by then my consultant wants full flexion... So lots of work ahead.
I am on crutches for another 2 week and then weightbearing as tolerated.
The swelling has mostly subsided and the scar looks fine.
« Last Edit: April 12, 2011, 11:40:48 AM by Thabo »
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline CR_UK

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Re: MACI patella done. On the rehab road.
« Reply #13 on: April 12, 2011, 01:11:22 PM »
Hi Thabo
Good thing you have picked up on your glutes at this stage. I also had hip pain on my good side at your stage and it only recently settled.
My recovery has been very slow but I'm getting there . I developed various soft tissue problems as I started walking about 2- 3 weeks ago (hamstring tendinitis, then patellar tendon tendinitis, and some ITB problems all due to muscle imbalance, in the main though because my gluteus is completely wasted on the operated side and this was'nt noticed by my physio as she always only sees me in the water and assumed that glutes were working when they had just switched off completely, and the quads and hamstrings were trying to do all the work. Since I have started working on that, I have made rapid progress, although I still need NSAID's but at a lower dose.
Are you from SA by any chance. I lived there for most of my life but moved to UK in 1993.
Hope you continue to recover well!

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #14 on: April 13, 2011, 02:22:26 PM »
Hi CR
Yes I saw that working on glutes was useful for you as well ! Good to see it worked so well.
I also try to keep my trunk and upper body muscles as strong as possible by doing  weights.  I have managed to totally avoid Nsaids for the past 2 years- just too paranoid about the effects on regeneration.
I am from SA- have been here for many years though.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #15 on: April 17, 2011, 04:12:13 PM »
It is now 5 weeks following surgery and I am steadily progressing. Currently I am able to do short periods on a stationary bike- no resistance. The knee is still stiff but I am able to get 110 degrees of flexion- this is as much as I was able to do before the surgery. Now the challenge is to flex it even further and I will be working on that in the next 3 months. The swelling has mostly subsided and it is only slightly swollen- I expect this to subside in the next few weeks. It feels as if my other knee is now going to be the limiting factor on the stationary bike...
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

cdubb

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Re: MACI patella done. On the rehab road.
« Reply #16 on: April 22, 2011, 05:48:01 AM »
Hey Thabo,
Glad to hear you're progressing right along.  I am actually finding as I am doing more, my knee I haven't yet had repaired is my more limiting factor also.  The past couple weeks have been rough for my non repaired knee.  Still not in a position to do anything with it for several months, but it's frustrating. 

Keep plugging away at the rehab.  While my repaired knee isn't perfect by any means, I am less than 6 months post op and many people say that months 18-24 is when they see the greatest improvement.

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #17 on: April 23, 2011, 12:34:38 AM »
Thanks cdubb. Always good to get positive news.

I have unfortunately had a bit of a setback in that I started getting some retropatellar clicking with heelslides and the stationary bike. I had a word with my MACI physio who told me to take it easy for a few days and let it settle. It is now feeling better but I still have some painless clicking. Will just have to see how it goes in the next few days. I have increased icing and reduced activity.
Hope for the best.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #18 on: April 27, 2011, 11:30:56 PM »
The knee has settled down and I am now back to where I was before the setback. I have about 90 degrees flexion so would need to work on it. Saw my physio yesterday and she was satisfied and has given me more intense exercises. Thus very small squats against a wall, balance work, rocking on toes etc. I am also working towards coming off the crutches and have been into town today. Did a fair amount of walking but used the support of both crutches. I really felt it in my R quads by the end! The knee is looking OK tonight and I am going to continue increasing weightbearing tomorrow. Still continuing to ice but I only need it once a day at night.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #19 on: May 10, 2011, 11:27:47 PM »
Progressing OK. I have returned to work yesterday and the knee is really not giving me much trouble at all. No swelling or increased heat at the end of the day although I continue to ice it at night. I have decided to go ahead with Hyperbaric Oxygen as I figure I need all the help I can get!!
I am now able to do stationary bike with no resistance and do it after work for about 15 minutes. It seems like the long and slow process of recovery have now really begun and I just have to keep motivating myself to continue regular physio,
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline JulianUK

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Re: MACI patella done. On the rehab road.
« Reply #20 on: June 02, 2011, 09:35:33 PM »
Hi Thabo,

Thanks for your kind words and that you are glad I check back from time to time.

It's good to see your rehab is progressing ok. You will have setbacks and plateau's with your rehab. Don't dispair and don't push it too much to soon. It definitely pays to be the tortoise and not the hair in this race!

Keep up the good work.

regards,

Jules
Julian

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #21 on: June 11, 2011, 03:58:59 PM »
Thanks for the words of encouragement Jules.

I am now exactly 92 days post-op. Fully back at work. Keep in mind that it is office work but I still have to get up at least every 10 minutes. |The knee is holding up well and does not complain at the end of the day.
I still get weekly physio and am now getting between 110 and at times 120 degrees flexion.
At this stage it looks like a slow but sure road to recovery. Just hanging in there and awaiting my next consultan appointment in about 3 weeks.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #22 on: July 15, 2011, 12:08:42 AM »
Long time since the last update. I have been really busy at work. Saving up to do the other knee!

My R knee is doing reasonably well and I already feel better than before the surgery. Far from ideal though but it is now only 4 months. At a recent followup with my consultant I was able to flex to 120 degrees and he seemed happy with my progress. Told me that he would tell me in November if he would do the other knee. I am hopefull. I try to do physio when I can. Lots of flexion. Small shallow squats and stationary bike as well as coremuscle work.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11

Offline AARON14

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Re: MACI patella done. On the rehab road.
« Reply #23 on: September 16, 2011, 12:54:44 AM »
i currently live in the u.s and had my biopsy on 9/13 for the A.C.I . i know m.a.c.i. is not approved yet in the u.s.a because of the f.d.a . iam originally from israel , and from  what  i understand it is approved over there  .

does any body knows the differences ?

thanks - aaron

Offline petite knee

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Re: MACI patella done. On the rehab road.
« Reply #24 on: September 22, 2011, 11:50:01 PM »
Hi Aaron,
I found a scientific paper comparing ACI vs. MACI: http://web.jbjs.org.uk/cgi/content/abstract/87-B/5/640
It seems like there's no significant clinical difference between ACI and MACI at least according to this study. Generally the best predictor of success of any surgery is the surgeon's experience (how frequently they have performed the procedure, and therefore how skilled/comfortable they are with the procedure).
Hope this helps.
3/31/2008 ACLr
8/13/2010 Arthroscopic debridement, notchplasty, chondrolysis discovered
12/17/2010 Arthroscopic evaluation, chondroplasty (aka biopsy for ACI)
9/6/2011 ACI, HTO, TTO

Offline Thabo

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Re: MACI patella done. On the rehab road.
« Reply #25 on: November 30, 2011, 06:13:23 PM »
Update: My R knee is still doing well although progress is very slow. I still do stationary bike without any problems in the R knee and hoping to progress to the crosstrainer in the next week or so. I am now also getting ready for my first holiday away in 5 years ! I have been traveling in the past 5 years but always on the way to get another medical opinion abroad. Thus things are hopefully slowly changing. Saw my consultant this week and he is happy with my progress and has agreed to do the patella on my other knee in the early part of next year.
Overuse injury 2003.
Chondroplasty and medial synovectomy May 2006.
Now bilateral grade 3/4 chondromalacia.
Bilateral patelar microfracture 04/2009, R HTO 10/2009.
R hip impingement surgery 05/2010, L hip impingement surgery 09/2010
Stage 1 MACI  14/01/11
Stage 2 MACI R patella 11/03/11