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Author Topic: Was supposed to do ACI surgery tomorrow but the chondrocyte preparataion failed  (Read 9925 times)

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Offline sjunkerg

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I am now at 2.5 weeks post surgery and doing much better. After tapering down the dilaudid over the last week, I took my last half dilaudid pill last night. The horrible neausea and dizziness I was suffering from during the first 10 days is now largely gone.

On the CPM my OS is being quite aggressive and my progress has been great. I was at 45 deg within 12 hours of the op. 75 at 48 hours and 100 after 7 days. I maxed out the CPM after 10 days at 120 deg and have been there ever since. Down to 8 hours per day on the CPM now.

The swelling has gone down quite a bit as well by now.

Offline sjunkerg

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I am now at 7.5 weeks and doing much better. While I have not yet been allowed to ditch my brace and crutches, I can walk around at home without much trouble, drive a car etc. I went back to work at 4.5 weeks and don't have much problems with swelling at the end of the day so most things are good. Using the CPM, I got to 120 degrees within 10 days of the surgery but my ROM outside of the CPM has been at 115 for the last month. I am now off the CPM for 10 days and it would have been nice to have gotten a bit further by now.

My normal routine is 2 90 minute PT sessions per week and about one hour each night with my own exercises which includes isometrics, ROM exercises, patella and fatpad mobility as well as 15 min on the stationary bike with no resistance.

Offline Jamey1215

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Hi Sjunkerg,

It sounds like you are doing well after the surgery.  Any regrets?  I recently got approval for the ACI and TTT and am scheduled for surgery 2/23/12.  I spoke to Genzyme today to make sure all was well and there was a little miscommunication between the doctors office and genzyme.  Apparently they did not know my selected sugery date!  For some reason I felt compelled to call today to make sure all was well.  I am a bit OCD!  Luckily I did because although they had all the approvals, they had not put the orders into the lab to start the cell growth and they need 15 days.  I hope all goes well with the growth because I have mentally prepared for 2/23 surgery. 

You mentioned you could drive.  I am having my left knee done.  Any issues with that?  Also, I plan to go back to work after two weeks.  I really can't get much more time off than that.  Realistic at all?  I have always bounced back from surgery pretty quickly but my most involved surgery was just the realignment on my right knee many years ago, no ACI. 

Jamey
« Last Edit: February 09, 2012, 01:01:33 AM by Jamey1215 »

Offline sjunkerg

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No regrets here. Life sure changes when you have this surgery since it is a big procedure that disrupts your everyday life for quite some time.

As far as driving goes, having the procedure done on your left knee will allow you to return to driving quicker than on your right. I had excellent help at home and did not have to do any driving until 7 or 8 weeks after the surgery so by that time it really was not an issue and I was more than ready.

On how quickly you can return to work I would say that it differs a lot by person. My best recommendation would be to read a number of diaries on line (this board included) from people who have had the surgery before you. I was able to return at 4.5 weeks which was the right time for me. Before the surgery I was advised that I would need to take 1 - 3 months off after the procedure. 2 weeks is extremely aggressive. I have only read of one patient that has pulled that off. This is very different from an arthroscopic procedure. At the two week mark, you will likely still be on narcotic pain killers and thus not be able to drive. You will likely also have problems getting into a car on your own (I certainly needed help at that stage). The osteotomy is still going to be extremely sensitive and you will not be able to stand for long periods due to swelling and pain etc.

My state at 2 weeks after the surgery was one where there was no way I would be able to work no matter how much I wanted to. The drugs were affecting me quite a bit and I would only sit up for a couple of hours at a time. At that time I was also doing 8 hours per day in the CPM machine and did something like 2 hours in the CPM, 1 hour break throughout the day. Doing the CPM continuously for several hours was very hard. I still needed some amount of help at home for getting food etc. Each person obviously react differently to the surgery but that's where I was at 2 weeks and my recovery has been pretty straight forward so far. I think you need to prepare yourself for being out much longer than 2 weeks unfortunately.

Hope this helps.

Offline OCD in Portland

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Hey Jamey1215,

I got ACI with a femoral bone graft done on my right knee last February and my left knee last December and I am so happy I had the opportunity to get ACI.  I was nervous about getting my left knee done less than a year after my right, but for insurance deductible reasons really wanted to do them both in the same year, and my right knee has help up amazingly through my 10 weeks on crutches following surgery.  And the 10 weeks was due to my bone graft, and is much longer than most ACI procedures.

With the right knee I wasn't able to drive for 6 weeks when I started partial weight bearing, but again that was because of the bone graft.  With the left knee that I just did, I was driving in two weeks with no issues.  As for work, I only took a week off for the right knee, and two weeks for the left.  My right knee may have been a miracle surgery though as the pain basically went away 5 days after surgery.  With the left one I was in a lot of pain for the first week and a half (definitely glad I was off for two weeks), and a pretty good amount of pain for the first month. The hardest part about going back to work early is balancing CPM time with working.  You basically have to dedicate all free time to CPM and attempt to sleep in it, which I was never able to do.  I was definitely mentally overwhelmed during that time, and do not recommend trying that if you are still heavily medicated.  But regardless of how long you take off work, the results can be amazing, and long term if you miss a little more work than expected I think will be irrelevant. 

Finally, sjunkerg is totally right that help is needed.  In the beginning just getting your leg in and out of the CPM can be daunting, nevermind using the bathroom or cleaning yourself.  Take up any offers you can for food, transportation, cleaning, etc.  Hope your date stayed on the 23rd, it's an exciting opportunity.  I wish you the best of luck!

Offline Jamey1215

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Thanks for your reply.  I am happy to see that driving and returning to work after two weeks was not too big of an issue for you.  That is my current plan if all goes well.  I have always healed pretty quickly and this will be my 8th surgery, but only my second really big one.  I had a TTO on my right knee about 15 years ago and it was the best thing I ever did.  The first week or so was rough but after that it was pretty much downhill.  Training for marathons and triatholons along with fighting all of the injuries that come with that was not easy, but I survived that and the payoff in the end was amazing.  I am hoping this is the same.  I am pretty nervous with surgery just being days away now.  I even had a little panic attack last night and started doubting if I was doing the right thing.  I am giving up most of the horse show season and am hoping to be back in the saddle by the fall.  My surgeon said 6 months to be riding again was not unreasonable, I hope he was being honest.  I am hoping to catch next years triathlons and don't have any plans for long distance running again.  Not really worth it as that is how I ended up where I am now.

You had a bone graft done with both knees??
« Last Edit: February 21, 2012, 01:26:06 AM by Jamey1215 »

Offline sjunkerg

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Jamey,

I too used to do triathlons but have not run at all for the last three years while trying to figure out what was going on with my knee. I hope to return to the sport at some level in 2013. I am now 10.5 weeks out from ACI and finally dropped my crutches 10 days ago. Life is looking much better now. The first weeks will be intense but after that, life gets a lot easier. At 6 weeks when you get rid of the CPM, you start having some spare time again etc (assuming that you returned to work in less than six weeks).

A big portion of this surgery is mental and while it was physically challenging and I was not feeling that well at all in the beginning, I did not have a lot of anxiety about the procedure beforehand and it has been pretty smooth sailing after the first 10 days for me post-surgery.

Good luck with your surgery!

Offline Jamey1215

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Wow that seems like a lot of time on crutches.  Is that normal?  I thought I read 6-8 weeks.  Maybe I was wrong.  I have tried to educate myself a lot but at the same time feel that maybe ignorance may be bliss.  If I know too much I will chicken out and I don't really have any other options if I want to return to some athletics at some point.  Eventually I was told I will be a candidate for replacement if the wear and tear continues.  I just want to get this over with because right now I feel like I can't plan anything and am just stuck. 

Offline sjunkerg

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Yeah, I was a bit of a late bloomer. I think more commonly it is the 6-8 weeks that you quoted above. In my case, I dropped the crutches at 8 weeks for anything indoors and outdoors at 10 weeks. It gave me a little bit more protection and helped out with not giving myself a bad gait by starting too early. In the end, 7 vs 10 weeks did not affect me much practically as I only used them outdoors at that point.

I too did my ACI due to fear of a total knee replacement down the line. I actually did not have much pain before the surgery, even if there was some issues occasionally. The biggest thing you will find with the recovery is that it is quite slow and you have to hold yourself back a bit and not step things up too quickly. I am resigned to the fact that this will be a slow year. I do my exercises religiously every night but I am not trying to push it in any way.

Offline OCD in Portland

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Hey Jamey,

I had OCD and basically had two big holes in my femurs.  It's genetic and tends to mirror itself, hence why I did both knees.  The lesions were too big to just do ACI so my surgeon did the bone graft with the ACI.

I was on crutches for 16 weeks on my right knee, and am 14 weeks out on my left and am still on one crutch, but my bone grafts are the main reason for delayed weight bearing, and I got stress fractures in my foot on my first surgery when I tried walking which is why the crutches were extended out to 16 weeks instead of just 10.  Lesson learned, talk calcium pills if you are going to be on crutches that long. 

But trust me, after 4 weeks on crutches, you kinda do get used them.  They still suck, but it's not the agony that first couple weeks can be since your body is used to them, and you start to learn all the tricks to get things done.  I just keep telling myself what's one more week of crutches if I can run a mile in a year. 

Anyways, not sure if you got your surgery yet or not, but if you did, congrats on getting the worst part over with, and good luck on your recovery.  There are plenty of us here to bounce thoughts off while you are recovering, and make sure to do all your PT everyday as assigned, it really does help.















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