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Author Topic: MACI & ACI - What are your knee's like post op and post initial rehan?  (Read 6765 times)

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Offline vegeta_goddess

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Hi guys and gals!

I'm just wondering if we could share some post MACI and ACI experiences? I'm at around 4 months now and I'm doing really great - I had full extension of the knee at around 5 weeks post op, got off my crutches at 6 weeks and have been progressing steadily ever since. My muscles have come back well and my knee seems to be doing quite good.

I do have a few problems though - my knee catches and make those loud snapping clicking sounds (yeah, you know them!) quite often. I sometimes get the feeling like something is 'caught' inside my knee. There is a really painful pinching feeling that I'm thinking could just be scar tissue getting caught? I do have quite a bit of knee soreness - especially around where the graft would have been (left leg, left femoral chond.). I can touch my knee fine but if I press on it it does hurt - not a lot - about as much as bruise would hurt. I also find my knee gives way on me a lot more than it used to.

I'm wondering how much of this is normal. Am I doing well? Should I be concerned? What were your experiences like post the intiial rehab phase? Do you have pain? I know a lot of people must be like me - scouring the forums for info about this stuff!

My knee generally feels very strong - however it does feel worse than it did before I had the surgery. The giving way, the cracking and popping, the pinching and the soreness all really concern me. They aren't bad...but they aren't normal for me.  My OS isn't the most talkative I'm not sure if this is normal or not. I also see him once in a blue moon!

I'd love to read more experiences!

Offline Catsmum

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Hi there,

I am just coming up to a year since my MACI surgery (lateral femoral condyle). The clicking and popping you describe was part of my experience too.

I have recently started up physio classes again after a period without any physio. This class is fairly intensive and after 6 weeks I have realised that the clicking has almost gone. My feeling was that it is a tracking issue and with increased muscle strength things have improved. In my case this took almost 1 year.

Low grade pain is still a feature for me. Not really bad, but located in the area of the graft (lateral knee). This pain is worse after physio. I have managed to recently wean myself off co-codamol but still need to take occasional diclofenac. I guess for me the pain is the bit I am still unsure about. Is this normal? I am trying to start running but not yet terribly successfully. I have been discharged from clinic on the grounds that I was doing reasonably well so am not able to ask there. Some folk on this forum seem to have had follow up
MRI scans but I have not been offered this. I am not sure how we can know how well our grafts have taken but for now I am trying to get back to normal activities including running

Best wishes for your recovery


Offline AARON14

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hi to both of you

i had an a.c.i + an osteotomy (t.t.o ) . i was wondering if both of you , had an osteotomy as well . my defect was very large , on the pattela , and i am 4 months out . i feel my patella tendon catching up , especially when laying in bed on my stomach , and pulling my leg back to my but . i got to do it slow , other wise it would catch and might not let it go all the way from this point and it would hurt a lot ! if i do it slowly , it still pop , but the pain would not be as bad . my knee still feel " strange " all along , leave what i can or can not do yet . it just doesn't feel well . i wonder what going to happen when i want to run and jump and lunge and go back to normal high activity . my os told me that i wouldn't need an m.r.i .i am only biking a little at the stationary bike , and doing straight leg raises , and some squats but not to deep . i am allowed to leg press and curl , but it still doesn't mean that it is free of pain for me .  i am really worried and don't know what is the future for me , and if at any point i would go back to my regular active life , painless !  i had a full range of motion , a month after my surgery , and my knee still make this crazy noises of crunching when walking .

i would love to hear both of you

thanks !

Offline vegeta_goddess

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Re: MACI & ACI - What are your knee's like post op and post initial rehan?
« Reply #3 on: October 16, 2012, 01:10:30 PM »
Hi again!

I'm 10 months post op now and thought I would update a little bit! I don't get that painful catching feeling in my knee anymore (yay!) but it still clicks and pops frequently - especially in the morning when I first get up and if I walk up stairs. I'm pretty sure it's the act of straightening my knee from a resting position that causes the popping.

My physio and OS aren't sure if it's my patella tracking incorrectly or if the graph has overgrown. No way to tell without an MRI - a cost which I'm trying to avoid!

I'm back at the gym regularly now and have intensive fitness sessions twice a week with a trainer (I found it hard to really put a great deal of muscle on by myself) and am back at all my usual sports, minus any of the impact sports. I find jogging to be quite uncomfortable - my gait just isn't right and I end up limping slightly.

In answer to your question - I just had the MACI procedure as my massive defect was on my femoral condyle. I found that my range of movement came back pretty fast - my knee often felt tight, but I worked really hard to get it moving straight away. I had no pain - just tightness. I did have problems doing straight leg raises - it took around two months for me to be able to do them properly. I also have a lot of nerve damage on my knee - most of my kneecap is numb and has no feeling.

But all in all, aside from the snapping & popping and the occasional feeling that my knee is 'out' I'm doing great.

Offline Room 101

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Re: MACI & ACI - What are your knee's like post op and post initial rehan?
« Reply #4 on: October 16, 2012, 05:22:35 PM »
Hi.  Sorry if I am impeding on your thread.  I have not been out here for quite some time.  Somewhere, someplace, I have a sort of diary from my initial AMZ/ACI in 2008.  I had a 3cm x 2cm defect on the patella.  I progressed thru the surgery and rehab very well.  My knee was *very* loud when bending it, but it didn't hurt.  My patella was tracking great.  I actually returned to recreational sport in 2010, with hopes of returning to competitive sport the next season.  I felt 20 years younger with my activity level and ability.  I ran down stairs and really had no issues.  I do have to admit though, that my knee was always a little tricky.  One day out of 20 might be a bad day for no real reason... but then I think the problem reared it's head and it all made sense.  One day, I was playing Frisbee with our dog in the yard.  I walked a few feet, bent over and POP.  Another injury.  I feared the graft was gone... but when they did the exploratory scope, the ACI site looked "pristine" and I had torn trochlea cartilage now.  So they did microfracture in May 2011.  I healed well from that and have noticed a dramatic improvement.  No daily pain and I can walk and work out hard at the gym.  I can xc ski and bike, but sport and impact are now out.  I can just tell it isn't as strong a seal as the ACI.  It feels different now.  Not unstable, but different.  So, the ACI was a great success, but I managed to hurt another part of my knee.  Ugh.  i will leave that be as long as I can because my right knee went south really fast, likely having to deal with all the stress from the left knee ops.

Move on to today.  My right knee ACI biopsy was done at the time of the left knee mfx.  I have had problems on both sides for years, but the left was always much worse.  Finally, in August this year, I had the dogs at agility and it went out on me for good, to the point of not walking.  So, September 5, 2012 I had AMZ/ACI on the right knee.  2.5cm x 2cm patella defect.  I am 5 weeks and 6 days out today.  Things have progressed pretty well, although I think a little slower than the last time.  That might not be fair as I had AMZ 10 months prior to ACI on the left side, so it was different.  At my OS visit last week, he took xrays, and he said it "looked exactly as he would want it to look at this stage", so I was feeling really great after that visit.  I am in the brace/CPM and on crutches still, although I would say I am bearing most weight thru my right leg now.  I was non weight bearing for 4 weeks.  I imagine the brace will go this week.  Perhaps tonight at PT.  Then the crutch weaning will begin.  I am looking forward to it.  I still get some pretty fierce pain behind the knee when I put too much weight thru it, and I cannot comfortable do an SLR.  I work out with a trainer (brace always on) twice per week, and I see my PT twice per week.  My quads are strong and have great control.  I just need to give some time to the kneecap I guess.  It's extremely frustrating.  I had kind of blocked that part out, hahahahaha ... one day at a time though, and hopefully the improvements will come.  If I could get the same success on this knee, I would be ecstatic!!  The real work is just beginning  :P

I know I will have more issues with the trochlea and mfx on lefty.  It has not liked being the weight bearer for 6 weeks, but I hope that, too, resolves upon more weight bearing and normal walking.

Cheers to all you brave souls going thru this right now.  It's comforting to know all these frustrations are normal.  I am very up & down because I feel pretty darn good one day and then have pain again another day.  I never dreamed this cycle of events would still be going on!  Everyone around me thinks I just love to have surgery, hahaha - If they only knew...

Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella