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Author Topic: Alternatives to carticel  (Read 3546 times)

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Offline Eva519

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Alternatives to carticel
« on: October 16, 2012, 04:20:37 AM »
This is my first time posting so I hope I'm in the right section.  I'm a 51 yr. old female and had arthroscopic surgery 2 months ago...the os was suspicious of meniscal tear.  They could not do an MRI to diagnose because I have a spinal cord neurostimulator implanted in my spine.  After surgery, he informed me that the meniscus was fine but he discovered "an articular cartilage defect, full thickness which ultimately after chondroplasty was found to represent a defect, anterior top posterior, approx. 2 cm. medial to
lateral approx. 1.8 cm."  I'm quoting this from the surgical report. ( BTW, I did not have much pain prior to this (just swelling) but after the debridement, my knee has hurt constantly.)  He stated that I would be a candidate for ACI and that his partner does this procedure.  Ten days later, at my sugical follow up I was passed over to his partner who explained the carticel procedure and offered no other alternative procedures. A week or so later I was informed that the insurance co. denied this procedure.  The medical assistant said the next step would be a peer to peer conference between the surgeon and insurance co. to try to get approval.  It has been 3 more weeks and no peer to peer has happened despite my regular phone calls.  My knee is in such shape that I can barely walk and some days I can't walk at all.  I've done research on other procedures...microfracture, OATS.  Does anyone have any input about the success of these other procedures versus carticel.  I'm beginning to feel desperate here.  I own a business and the 9 to 12 month recovery from ACI would pose a difficulty in keeping my business going.  I'm getting the feeling from the os and his staff that my case is fairly low on the totem pole and whatever procedure we do, it would be financially beneficial to do it before year's end due to insurance, etc.  I would appreciate hearing from anyone who has had any of these procedures and how their recovery was and if it was successful.  And how long is it with any of these procedures before I could get around on crutches?  Thanks so much.

Offline Whibs

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Re: Alternatives to carticel
« Reply #1 on: October 16, 2012, 10:54:15 AM »

I have been waiting to have this operation since April this year, but I am in the same situation as you my medical insurance company (BUPA) wont fund the procedure, they are saying that it is a trail that has ended and that is why they won’t fund it.  My consultant and I have been in consistent communication with the insurance company but they won’t budge.  My consultant has been kind enough to offer this procedure through NHS, so at the present time I am on the waiting list to have this done at the Royal Orthopedic Hospital in London.  My argument with BUPA is that if NHS are still doing this operation then they should.  I have heard good results from this operation as long as you follow the doctor’s orders and do all the necessary exercises, my consultant did say it is a long recovery period and to expect to have 3 months off work and the first 6 weeks is non weight bearning.  Good luck in getting your approval.

Offline Overdidit

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Re: Alternatives to carticel
« Reply #2 on: October 16, 2012, 05:03:07 PM »
The OATS procedure is roughly the same recovery time.  Have you tried an unloader brace?  Donjoy unloader brace might buy you time until the insurance agrees.  They cost roughly $850 and you need a perscription.  My insurance company paid for mine.  I was supposed to have the Carticel surgery but my harvested cells died twice which is why I have the OATS Allograph which is with a cadaver.

Offline Flyinglion

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Re: Alternatives to carticel
« Reply #3 on: October 16, 2012, 09:11:21 PM »
Not sure if you are in the US. If you are, Denovo NT (allograft) may be an option worth looking into.
I am almost 5 months from a Denovo/TTO/Lateral Release on my right knee. Orgionally, I had scheduled the ACI procedure for last December but backed out because I did some research,  talked with some Denovo NT patients,  and finally came to the conclusion Denovo would be a better option.
It is still pretty early in my recovery but (knock on wood) I think I made the correct decision given my situation.
February 2011 - Injured right knee playing indoor soccer
April 2011 - MRI showed patella & trochlea grade 4 kissing defects
June 2011 - Right Knee Scope/ACI Biopsy
November 2011 - Synvisc Injections
May 31, 2012  - Denovo NT Patella & Trochela, Lateral Release/TTO/MPFL Reconstruction