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Author Topic: MACI post op help!  (Read 4048 times)

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Offline vegeta_goddess

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MACI post op help!
« on: December 23, 2011, 07:42:05 AM »
I had my MACI surgery 2 weeks ago and everything went really well - even though it's only been 2 weeks the swelling has completely gone down and my incisions are mending beautifully. I was even able to get my knee bending at 90 degrees at one week without much pain as my doctor and physio asked.

Unfortunately a few nights ago I slipped and put full weight onto my bad knee - it really, really hurt. Since that night I haven't had any swelling but I am having a lot of pain when I bend my knee - especially down the back of my knee. I'm hoping I've only bruised something, but can anyone tell me how bad it is that I put my full weight on my knee for that one second? I fell onto it quite hard and I really hope I haven't messed everything up.

Unfortunately my doctor is away for Christmas and won't be back until the 29th of December. Any help is greatly appreciated - I'd especially love to hear from you if you accidentally put weight on your knee when you were still in the NWB stage.

Offline JulianUK

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Re: MACI post op help!
« Reply #1 on: December 24, 2011, 10:10:22 PM »
Hi,

I did this a couple of times with both of my knees and I totally understand what is going through your mind. As long as you didn't laterally rotate the knee and it wasn't in a bent position you should be ok.
It took me months to believe that the grafts were ok and I hadn't damaged them.

You should be ok but run it by your OS whem he is back.

Hope this helps,

Jules
Julian

Offline sophie_123

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Re: MACI post op help!
« Reply #2 on: December 27, 2011, 04:50:04 PM »
Hi I'm 3 weeks post-op now after a MACI and I too am so worried I'll have damaged the graft! I'm worried my physio excercises are going to damage the graft and I'd like to know what exercises I should be doing now. Also I am having trouble lifting my leg up. I sit with my legs out in front of me and my leg just doesn't lift up no matter how hard I try. Is this normal?

Thanks!

Offline Vickster

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Re: MACI post op help!
« Reply #3 on: December 27, 2011, 05:00:22 PM »
Not had a MACI, but did some research when it was on the cards (wasn't deemed suitable for repair at the time) - you need to work with an experienced physio but these are links to the rehab protocols that have been/are used in the UK.  Depends where in the knee joint the MACI was done too

http://www.active-trial.org.uk/ACTIVESite/RehabPhysios.htm

http://www.kneeclinic.info/download/CKC_GNHFT_ACI_RehabGuide_101106.pdf

http://kent.academia.edu/KarenHambly/Papers/632658/Autologous_chondrocyte_implantation_postoperative_care_and_rehabilitation (pretty technical)

What country are you in?  Are you in a brace, when do you expect to be off crutches etc

I am sure someone who has had the procedure can help further

Good luck :)
« Last Edit: December 27, 2011, 05:02:09 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline vegeta_goddess

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Re: MACI post op help!
« Reply #4 on: December 28, 2011, 07:24:32 AM »
Sophie, I know just how you feel! It's been almost 3 weeks since my MACI and I still haven't seen a physio aside from the one who I saw in the hospital. My OS has told me to hold off on seeing one until he sees me first.

I'm doing the exercises that the physio at the hospital gave me three times a day - and it seems to be helping me with my range of movement, but like you I can't lift my leg up. Well, I can lift my leg if I don't straighten my leg, but if I straighten it I can't get it to lift. I think it's because my knee cap can't lock in properly - if that makes sense. I think this is pretty normal.

I wouldn't normally be worried about putting a bit of weight on my knee, but I just feel on my leg so hard. I can't imagine having to go through this again!

I see my OS tomorrow, so I'll post an update when I hear from him!

Offline sophie_123

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Re: MACI post op help!
« Reply #5 on: December 29, 2011, 09:47:42 AM »
I think part of it with me is that I'm so scared to lock in my knee cap that I've lost the ability to do it now :( my MACI was under my knee cap so I'm worried about damaging it! I've still got a brace on limiting my bend to 30 degrees and its going to be on at least another 2 weeks till I see my consultant again. I'm glad to hear it seems pretty normal to have these worries and troubles as its put my mind at rest :)

Offline Rennschnecke

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Re: MACI post op help!
« Reply #6 on: January 01, 2012, 11:55:53 PM »
After MACI people differ as to their ability to perform a straight leg raise (SLR).  This is due to a variety of factors, not least of which is your conditioning pre-op and pain levels.  If you can't do an SLR then just stay with the quad sets.  They both do the same thing which is strengthen your quads.  When you can do an SLR you can usually drop quad sets.

FWIW, people find that one day they can't then suddenly they can.  So no need to worry much about this.

I saw physios early on and one of them just told me to go away until 6 weeks post-op as there isn't a lot to do apart from early post-op exercises that you're given at the hospital.  Just ice, elevate and mobilise within your allowed range until you are reviewed by your OS.

Hope all goes well with recovery!
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 vegeta_goddess

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Re: MACI post op help!
« Reply #7 on: January 02, 2012, 03:34:38 PM »
Well I saw my OS and my physio and they say I'm doing very well - it took a couple of tries but I can now do straight leg raises - although it hurts quite a bit. Once my muscles worked out how to do everything again I was able to do SLR quite easily from a lying down position.

Offline fatsarge

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Re: MACI post op help!
« Reply #8 on: March 21, 2012, 09:04:51 AM »
I have just read your post and it has stopped me stressing. Like you I have had a MACI on my patella. I am 7 days post op still in full extension and I fell last night putting full weight through the bad leg. The pain through the knee cap was horrendous! It even brought tears to my eyes. My first thought was that I tore the graft off. It feels so fragile now and I am scared to get out of bed. I am also unable to do straight leg raises, the pain is similar to what I felt last night when I fell.

I take it these grafts are tougher than I think? I am glad you are progessing.
It would be great to hear how you are progressing.

Offline Vickster

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Re: MACI post op help!
« Reply #9 on: March 21, 2012, 08:30:39 PM »
This link tells you what the consistency of the MACI grafts are like at certain stages

http://www.kneeclinic.info/download/CKC_GNHFT_ACI_RehabGuide_101106.pdf
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline vegeta_goddess

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Re: MACI post op help!
« Reply #10 on: April 17, 2012, 01:20:18 PM »
Hello everyone! I thought I would briefly update you all! I had my op in December 8th so I'm now...4 months post op. Roughly!

I'm doing great and even got off my crutches early - which was an unexpected bonus! 6 weeks on crutches was more than enough for me! It took a few days to really move without stiffness, but my knee felt much better when I started using it again. I must say though, I had a lot of foot and ankle pain when I started walking again - most likely because I babied my leg after I fell on it in week 2!

It took several scans and doctor visits where I was told things from 'osteonecrosis' to 'complex regional pain syndrome'...thankfully it wound up just being really bad joint stiffness and inflammation though!

I am a bit lazy with my exercises, but I'm generally going good. I have most of the muscle back in my leg and my knee is now strong and I can walk up the many flights of stairs at my workplace without worry.

I do however have a lot of pain around my kneecap still. Under my kneecap and above where the graft went on (roughly) is still sore to the touch and my knee does make cracking sounds and give way on me sometimes...which is never used to do. I have one more visit with my OS soon so I'll try to get a MRI or a CT scan done on the knee to make sure everything is going tip top.

But I feel okay!















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