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Author Topic: Sune's Oct 18/2012 MACI and fulkerson  (Read 23726 times)

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Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #30 on: January 03, 2013, 11:57:51 AM »
11 weeks

Just wanted to publish a small update on the day of my 11 weeks anniversary since surgery. I've just come home from a physiotherapy session, including aqua therapy. Things are moving steadily, but slowly, forward. My range of motion is now 120°, which I think is satisfactory, especially since this was a problem initially. I have lost the crutches, but still try not to walk too much as I walk slowly and get sore after a while. I still get pain under the kneecap when I try to put on load in a bent position, so I've been told by my OS to avoid that for three or four more weeks. Just hope I haven't damaged anything so far...  ??? I definitely have avoided excessive loading, but I have loaded it sufficiently to feel a little bit of pain under the kneecap now and then. It's hard to avoid though.

Currently my exercise regimen consists of
-Quad sets
-forward and sideways SLR lying down
-SLR in four directions with resistance
-3 min. stationary bike without resistance
-balancing on one leg
-various exercises standing up with straight legs, a cloth under one (the healthy side) or both feet.

If I do too much, it will hurt during the next day, but always gone again the day after that. I try to adjust intensity to avoid pain into the next day.

Sune
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #31 on: January 16, 2013, 03:28:52 PM »
Hi

Wonder if anyone can provide me any comforting/reassurance?
My knee is progressing nicely, I believe, but then yesterday I had to do a bit more walking than usual, in connection with air travel (though not much, asked for assistance at the airports!). I also sat in an airplane seat for about 5 hours in total - and then today I noticed I had bruises on the back of my knee (streaks of blue/purple, like subcutaneous blood extravasation)!!!  :o It does feel a bit more sore, especially on the back side, but within the limits of what I have tried before.
What is the cause? Have I damaged anything? I don't see how I could have, I haven't done anything else unusual.
I am a bit worried... :(
Anyone tried anything similar, or have any other input?
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline randomlife

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #32 on: January 17, 2013, 04:17:01 AM »
Hi sune,

My response is totally unhelpful because I've not experienced anything quite like you describe. Just wanted to let you know I'm sending good vibes your way!

Cheers,
lk
03/10: Lateral tibial plateau fx
05/11: Chondroplasty of lateral tibial plateau and patella w/ extensive synovectomy
02/12: Grade III lesions on patella, new Grade II fissure on medial femoral condyle
09/12: DeNovo and Elmslie-Trillat TTT
01/14: Hardware removal and arthroscopy

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #33 on: January 17, 2013, 06:10:48 AM »
Thanks. I am thinking it could just be swelling from flying and having my legs down and stationary several hours - the increased pressure in the operated area might have caused a little bleeding in the scar tissue etc (probably some fragile blood vessels there) ... there is no blood supply to the cartilage, and I can't see how I could have damaged anything. (I think I see a little bit also behind the unoperated knee) Still, strange! Going to try and call my pt again today.
Sune
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #34 on: February 03, 2013, 12:55:19 PM »
15 weeks update

Hi folks. It's been a long time since my last update, so I figured now would be a good time…

I think things are going really well. A few weeks ago, I panicked a bit because of sudden bruising behind my knee. However, it hasn't changed any of my symptoms or lowered my limits, and neither my surgeon nor tissue therapist thought it was anything to worry about. We weren't really able to offer an explanation either, so I guess it's just one of those things that will never know what really happened. I saw my doc last week, and he was generally quite pleased with my knee. He did an ultrasound and said everything looked quite good.

So go to formal physiotherapy once a week, and aqua therapy twice a week in addition. I also exercise at home twice a day. Normally, I don't have any pain in my knee, but I do get sore if I overdo my exercises. I have a very good feeling about my knee… Already, certain things that would cause pain before, no longer cause any pain (such as walking naturally… Previously I would have to make my left knee a bit more stiff in order to avoid an angle that hurt).

My rate of recovery may be slower than others, but everyone is different and I have lesions in three different locations, so my doc has asked me to take it easy (although he also said that I should get some muscle on my leg…). I agree, and I'd rather go a little bit too slowly and avoid damaging the grafts.
Now I'm up to 10 min. on the stationary bicycle… That is a similar level that I was able to do presurgery without getting a sore knee. My walking distance limit is also about the same by now as before surgery. I'm still avoiding stairs, both up and down, although I can do a step up, and more so if I can use my arms to help a bit. I've also tried the elliptical/cross trainer, and a little bit on the stair master, but my knee didn't feel quite ready for the latter yet.
So I'm keeping a good attitude - and I'm feeling optimistic that the day will come where I can get a good aerobic exercise on the bike and walk as much as I like! Maybe skiing, and  even more sports!!!  :D :D :D
All the best,
Sune
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline jco

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #35 on: February 11, 2013, 01:58:50 PM »
hello sune  3 days out of denovo implant  just reading your post helps to hear others recovery ups and downs .Brings encouragement to go through what is ahead of me .Hope knee continues to do well and improves mobility.
11/25/11right knee debridement  meniscus repair                                       11 /11/12mri defect rightknee cap                
2/8/13 arthroscopic patellofemoral debridement excision of suprapatellar plica denovo cartilage implantation to patella

Offline Mistyd

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #36 on: February 12, 2013, 05:09:31 PM »
Hey Sune,

I hope all is going well with you and your recovery! I am sure there are plenty of up and down days, but hopefully, more up days are being strung together ;) 

How is your pain 3 months out?  Have you noticed the strength and ROM returning at a steady pace, or just randomly noticing something here and there?

Have a Great Day!

God Bless,

Misty
Living for the Audience of ONE: Jesus Christ

'95 -knee injury
5-'04 -knee scope cleaned up grade III tears
12-'12-knee scope cleaned up tears
2-'13-harvested cartilage for upcoming ACI
...awaiting ACI

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #37 on: February 16, 2013, 12:34:30 PM »
Hey Misty,
I usually do not have any pain, except if I overdo something. I still avoid some activities like going up stairs without handrail support. Too much exercises will cause a little soreness afterwards and the next day, but it's not bad.
My ROM is almost maximal, and my quad strength is what I am focussing on now. It is slow progress!
Especially since I am still being careful to avoid pain, as advised by my OS.
Sune
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #38 on: March 26, 2013, 12:00:47 PM »
Hi all.

It's been a while since I've updated, so I figured now is about time. It slightly more than five months since my surgery.

Unfortunately, I had a setback approximately 2 weeks ago, and it's giving me a great deal of worry. Up until then, everything was going really well, and I was very optimistic about everything, looking forward to a new and much more active life. Then I followed my physiotherapists advice of being more conscious about using both of my legs when getting up and sitting down on chairs. So I did that for one full day, in addition to my normal activities and training. It didn't hurt while doing it, but the next day I was sore in the knee, and haven't been able to get back to my previous shape since then. It's like a burning stinging sensation, and while I can get it to disappear if I skip my training and don't walk too much, it only takes a small fraction of the training I did before to bring back the pain, which always comes the next day. When I do the different exercises, it's not really that it hurts while doing it, so from that perspective it's much like before the setback, but there is a delayed reaction the next day. I don't have any visible swelling, or locking, or anything. Sometimes, the injured knee feels a bit warmer than the other.

I'm really worried that I might have damaged the grafts, my mood is really down, and I loose a lot of sleep over it. And it's not making it any better that I feel a lot of anger/resentment towards myself as well as the physiotherapist  >:(. I'm well aware that this is not very constructive, and probably very unfair. I'm angry at the physiotherapist because she suggested it, despite having told repeatedly that we must be very careful in my case with me having three grafts, and despite having told her that I tried already to sit and rise normally from a chair a few times, and it's more or less always caused some problems afterwards. I sometimes feel that she hasn't gone through the trouble of properly researching cartilage implantation, and just treats me more or less as a generic knee patient (it may be unrealistic to expect otherwise). Also, I feel that we haven't really built up to this kind of loading of the knee… At least not down to that angle. I'm angry at myself for not trusting myself more, and being more careful. I could've just try to sit and rise normally a handful of times during the day, instead of more or less every single time, just to test the reaction.

Well, it's not very constructive, but I can't help it at the moment. Working on it though…

An MRI examination was already scheduled before the setback, it's going to be on April 15. My doctors appointment will be two weeks later, so unfortunately I have to wait one-month… I'll try to write to him and see if I can make it happen a bit or earlier, it's a bit long to wait.

Hope everyone else is doing well!
Sune
« Last Edit: March 26, 2013, 01:53:44 PM by sune »
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline Mistyd

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #39 on: March 26, 2013, 03:08:18 PM »
Hi Sune,

I am sorry about the 'setback' (more on that in a bit).  I can understand how frightening it must be not knowing if the grafts are ok.  I think the mental/emotional side of this type of surgery is possibly the most difficult (from what I've read. I'm on the other corner..awaiting the MACI but insurance is the hold up >:()) so many up's and down's and fears.  Still, at 5 months, while the grafts are still very tender they should be on the course to firming up (not jelly and not marshmellowy, soft plasticy  ::)). 

I know you know this:  Post surgical knee pain has many types of pains, pinches, pulls, bruning, clicking, clunking, etc.  Perhaps you have torn some scar tissue, OR, the scar tissue is still adhered and that s the pinching.  Nerves regrowing can cause all sorts of weird sensations.  You could drive yourself mad wondering when ultimately, it won't do any good.... just make you sick and miserable.  You have been very studious about your rehab.  Your anger (while it may or may not be justified (remember you don't know any damage has been done, so your anger could me a moot point ;)) is understandable even if it is just directed in the loooong rehab this surgery puts you (us) through.  It is an emotional roller coaster for sure!!!  It is a difficult surgery to rehab from, time and patience are the ultimate in ensuring your physical (and mental) health.  Hanger in there Sune!!!

I know waiting until the 15th must seem like an eternity... especially not knowing.  But try not to focus on the bad... re read others posts and be encouraged by the many pains they've had that ended up being nothing (and ignore those that were something ::)).  Take courage my friend, your hardwork will pay off!! ;D

God Bless,

Misty
Living for the Audience of ONE: Jesus Christ

'95 -knee injury
5-'04 -knee scope cleaned up grade III tears
12-'12-knee scope cleaned up tears
2-'13-harvested cartilage for upcoming ACI
...awaiting ACI

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #40 on: March 31, 2013, 08:13:51 AM »
Hi Misty.

Thank you very much for cheering me up… I do hope you're right that the implants have not been damaged, although at times I have difficulty believing it could be anything else with the symptoms I'm experiencing. But I try to keep my hopes up. I got the MRI exam moved forward, and I will get the results on April 15.

You're definitely right that it's an emotional roller coaster. I have three boys, and I don't think it's making it any easier for me. I want so bad to be there more for them, playing with them, and to go out more…
 Good luck with your insurance battle!

Sune
1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline Mistyd

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #41 on: April 12, 2013, 04:49:36 PM »
Hey Sune, just checking in to see how you are and what the results were for the MRI???  I am hoping and praying (literally) that all is well with the implant!  Hang in there!!!!


God Bless,

Misty
Living for the Audience of ONE: Jesus Christ

'95 -knee injury
5-'04 -knee scope cleaned up grade III tears
12-'12-knee scope cleaned up tears
2-'13-harvested cartilage for upcoming ACI
...awaiting ACI

Offline sune

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #42 on: April 15, 2013, 04:13:13 PM »
6 months post surgery

So today I saw my OS. He said my MRI looked good, the cartilage has filled nicely, looks smooth, and the bone beneath it also looks happy. I was extremely relieved to hear that, as I had almost expected to hear that the grafts had failed, given my recent bout of pain and problems. But he was not so concerned. He also did an ultrasound, and he could see some irritation around the knee, mainly the tendons on the lateral side. He didn't offer any explanation as to how that had arisen, but I guess it's due to the overloading that I have described previously. He said to focus on slow/heavy exercises, to build muscle, and I think I will also need to exercise only every other day or so to give the tissue time to recover.

So… I'm very happy! At least this is the best news I could get at this stage, I think. But of course it doesn't change the fact that I still have pain and several restrictions, but now I certainly got back a hope that this will disappear again, given careful rehabilitation. I really hope I learned my lesson… Better go too slow, than too fast, no matter how splendid things appear to be going!

Misty, a special thanks to you for cheering me up!!  :) :) :)

Hope every one else's doing good.
Sune

1999: Chondral lesion on medial patellar facet. Synovium changes, grade II degeneration of neighbouring cartilage. Debridement (shaving) and lavage.
2009: 2nd arthroscopy,  debridement (shaving) and lavage.
2010: steroid injections
2012: MACI (2 patella, 1 trochlea)+Fulkerson+Lateral release

Offline Mistyd

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #43 on: April 15, 2013, 04:51:22 PM »
Yay!!!  I am so happy that the graft sites are ok!! (thank you Lord!) I know these past weeks have been an emotional roller coaster for you (and not a fun one at that!). At least now, while you may still have pain - you don't have to be afraid of what that pain means (i.e. damaging the graft).  Thus, you can work through the pain (wisely and at your speed) without the emotional baggage that comes with the question "am I doing damage...and what if's".  Good news  ;D

Rehab is a loooong process on this surgery, but getting back to full and active strength and ROM is possible. Hold to that thought!  You are over so many of the hurdles that are present in this type of procedure (whew). 

God Bless (and protect your graft site, and bring the inflammation down in the tendon),

Misty

P.S.  You are most welcome friend  ;)
Living for the Audience of ONE: Jesus Christ

'95 -knee injury
5-'04 -knee scope cleaned up grade III tears
12-'12-knee scope cleaned up tears
2-'13-harvested cartilage for upcoming ACI
...awaiting ACI

Offline randomlife

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Re: Sune's Oct 18/2012 MACI and fulkerson
« Reply #44 on: April 22, 2013, 01:21:18 AM »
Fantastic news, Sune! Hope can go a long way to help you feel better. I'm glad that the graft looks good and that your surgeon isn't worried. I'm sure that takes a load off your mind. I hope that you continue to improve from this point forward!

Cheers,
lk
03/10: Lateral tibial plateau fx
05/11: Chondroplasty of lateral tibial plateau and patella w/ extensive synovectomy
02/12: Grade III lesions on patella, new Grade II fissure on medial femoral condyle
09/12: DeNovo and Elmslie-Trillat TTT
01/14: Hardware removal and arthroscopy