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Author Topic: MACI and Fulkerson Osteotomy March 15th 2013  (Read 6387 times)

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Offline DebbieCJ

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MACI and Fulkerson Osteotomy March 15th 2013
« on: March 03, 2013, 08:33:28 PM »
Hi all,
This is my first post. The op, on my left knee (patella has 2cm x 2cm bald patch!), has been scheduled since August and now with only a couple of weeks to go, I'm getting nervous.
I've tried to find out as much as I can about the procedures and the rehab, but have not found anything that covers both at the same time!
The blogs on here have been very useful for each individual procedure, can anyone help with info covering the impact of both together?
Thanks!
Debbie
« Last Edit: May 05, 2013, 06:45:01 PM by The KNEEguru »
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline vickster

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #1 on: March 03, 2013, 08:41:08 PM »
There are a few diaries around the place, e.g. Sune's here

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=60875.0

Also, some of the US posters have had de novo and an osteotomy if you have a look around the post op diaries and cartilage repair sections

Good luck with the surgery :)
« Last Edit: May 05, 2013, 06:45:47 PM by The KNEEguru »
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 DebbieCJ

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #2 on: March 03, 2013, 10:56:54 PM »
Thanks Vickster!
Still finding my way around the site.
« Last Edit: May 05, 2013, 06:46:17 PM by The KNEEguru »
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline vickster

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #3 on: March 04, 2013, 08:20:42 AM »
No worries

Here's one of the de Novo, TTT diaries  http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=60611.0

This is a very useful site about ACI rehav which you may find interesting too

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

« Last Edit: May 05, 2013, 06:48:05 PM by The KNEEguru »
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 Mistyd

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #4 on: March 04, 2013, 04:21:06 PM »
I should be having mine this month too  ;)  Have 2 large spots known in the trochlear groove and patella.  I think the main line of thought is BE RELIGIOUS ABOUT THE REHAB AND GO SLOWLY!  Rehab is extremely important for this (and any) surgery recovery.  Not overdoing and yet not shirking from (recovery) pain during exercises is important too.  It takes so long for the cells to mature and harden you don't want to deviate from your planned rehab.

Good luck!  I plan on reading your diary (should you do one)  :)  I started one explaining where I currently stand; right now I am awaiting a phone call for surgery date.  I can't wait as my knee is very painful, locking about every stride, and I can feel the constant grinding...no fun!

God Bless,

Misty
« Last Edit: May 05, 2013, 06:47:08 PM by The KNEEguru »
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 DebbieCJ

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #5 on: March 13, 2013, 12:05:40 AM »
Thanks for the comments, Misty and Vickster.
The rehab link was very useful - most user friendly and easy to understand that I've read.
Only 3 days to go now and very nervous - trying to ensure house is straight, work covered, teenagers taken care of. Not sleeping well!!
I'm concerned about some of the practicalities of managing in a leg brace after surgery - moving around the house, getting in and out of bed, showering, travelling in the car etc.
Anyone have helpful tips on what made everyday activities easier to manage?
My physio has been great - proper hand holding!
 
Deb
« Last Edit: May 05, 2013, 06:47:36 PM by The KNEEguru »
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy - done!
« Reply #6 on: March 18, 2013, 10:37:06 AM »
Blimey!
So, I had the surgery last Friday morning and came home from hospital yesterday (Sunday) - had I not been feeling so sick due to anaesthetic and morphine then I'd have been home on Saturday afternoon.

Everything went well and as planned and I'm not feeling too bad. My pain is being managed with paracetamol and ibuprofen 4 times a day, with 2 40mg tramadol tablets at bed time. I'm wearing a 'range of movement' brace, set at locked straight most of the time, although I have been told that I can 'unlock' it if my leg is raised and fully supported. I'm also using an ice pack every 3 hours or so to help with the swelling.

I'm spending 90% of my time sitting or lying with my leg raised above my hip level. The most pain I get at present is on first standing after a period of time sitting - the weight of the brace and the pressure on the Osteotomy site is very painful, but it doesn't last for long once I'm moving around.

I've been told to take it easy for the first week or so, although I have been supporting my own weight, in the brace, since the physio got me up and about in hospital. The advice before surgery was conflicting! I'm doing very simple closed chain (foot supported by a surface) exercises - heel slides, using my hand as support for the knee joint, calf pumping (pulling your toes towards your head then pointing them) and static quads (tightening your thigh muscle and pushing the back of the knee on to the bed). None of these cause any pain, although the bending of the knee during heel slides is uncomfortable due to the amount of fluid around the knee joint.

I'm dozing in the day as I'm not used to sleeping on my back and the knee brace doesn't give you much choice. I've been told that I should only have to wear it during the night for a couple of weeks.

I've made an appointment with my nurse to have stitches 'snipped' next Monday - they are soluble so don't need pulling out.

A couple of things I wasn't aware of:
I have to give myself an anti-blood clotting injection in my tummy every evening for the first week (never done anything like this before and a bit weird, not really painful though)
I had a nerve block in my groin before surgery and mentioned to my surgeon that some of the area around my knee was still numb yesterday. Due to the amount of cutting he needed to do for both procedures and the tissue and nerves that are damaged, the numb area could last for up to a year.

Having spoken at length to the physio regarding some of the practicalities of moving around, such as sitting on the loo (not comfortable at all unless at a funny angle), getting on and off the bed and in and out of a chair, there seems to be no way that I am going to be able to have a shower or a bath! I can't get the brace wet, but can't stand up without it or get in the bath with it on. So, top to toe soapy washes with hair wash over the bath is how it will be for the next few weeks.

Debbie x
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy
« Reply #7 on: March 18, 2013, 10:39:50 AM »
P.s. and my husband is washing my feet!
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline kimb

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #8 on: March 18, 2013, 06:21:07 PM »
Did they show you (or maybe you already figured it out on your own) how to use a band/tie/towel or your other leg to be able to lift and lower the injured leg up and down, so you can more easily get in and out of bed and such? It's much easier than having someone do it for you or trying to support your leg with your hands.
 
Good luck with your healing, I hope it goes smoothly and quickly! Nothing is better than being able to shower and sleep normally! I had such horrible back pain from sleeping on my back with my legs up. It didn't matter how I supported my legs or my upper body. My back hurt worse than my knee for the first many days!
« Last Edit: May 05, 2013, 06:49:02 PM by The KNEEguru »

Offline DebbieCJ

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #9 on: March 18, 2013, 06:42:25 PM »
Thanks for your reply!
Yes, I was shown how to use my other leg to support my injured leg - it makes moving a lot easier, especially getting in and out of bed.
My mum has bought me a support pillow (triangular shaped) and this seems quite comfortable so far. Early days!
« Last Edit: May 05, 2013, 06:49:35 PM by The KNEEguru »
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy - 6 days post op
« Reply #10 on: March 21, 2013, 12:55:44 PM »
Hi again,
Just a quick update.
Am now 6 days post op and doing regular exercises as described previously.
My knee is still very swollen - I am icing the area after exercising. The calf pumps are fine, static quads seem tricky in that I'm having difficulty actually tensing my quad muscles. I assume this is down to the level of cutting that was done?
I am supporting my knee with my hand when I do heel slides and can get to about 40 degrees - however, it feels as though there is a solid lump inside my knee, nearer the back than the front on the outer edge. I also have a huge amount of bruising on the back of my knee.
I am doing all the exercises without the brace on which is a relief for a short period of time.
The pain is not too bad, although I relented and had an additional tramadol tablet yesterday afternoon - the bone feels sore, particularly when standing after sitting for a period of time. The weight of the brace doesn't help!
I'm sleeping on a support pillow to try and help with back ache.
Overall I don't feel too bad and it is probably as I expected - I'm still dozing in the day due to disturbed sleeping at night.

Debbie
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline ozzie

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  • ACI & Fulkerson 6/25/13, ACI & Fulkerson 12/26/13
MACI and Fulkerson Osteotomy March 15th 2013
« Reply #11 on: April 05, 2013, 10:30:27 PM »
Hi Debbie,

I noticed you had a similar surgery as I am planning and also noticed you had not posted for awhile. How are you doing?  I hope you have progressed well.  I am planning ACI patella and Fulkerson on April 30 in Atlanta....curious about how Fulkerson has affected your recovery. 
You are probably not needing ice regularly, so this may not be timely suggestion for you, but when I read your posts. I was surprised that you did not have an ice machine.  I found the one I used (Game Ready) so helpful after the arthroscopy I had last month. 

« Last Edit: May 05, 2013, 06:50:26 PM by The KNEEguru »
ACI patella and trochlea & Fulkerson on Dec. 26, 2013-Dr. Scott Gillogly
ACI patella surgery and Fulkerson with Dr. Gillogly June 25, 2013
Extensive cartilage damage in both knees due to misalignment of patellas

Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy - 3 weeks post op
« Reply #12 on: April 07, 2013, 05:31:45 PM »
Hi Ozzie,
Thanks for your post!

I'm now 3 weeks and 2 days post op.
I've seen my physio and has my first post op review with my consultant (2 days ago). He's really pleased with my progress!

I'm doing the same exercises - all closed chain, 10 heel slides, 50 calf pumps, 2x10 static quads, all 5 times a day. I can bend my knee to 90 degrees, and can support my weight, wearing the brace in a straight locked position, on my injured leg.
I am not able to do any straight leg raises due to the Osteotomy healing.
The consultant is really pleased that I have taken things so slowly - a nervous patient (of doing any damage to the implant) is better at rehab, apparently!

I am still icing the knee after exercise - the cryo cuff that was given to me at the hospital works really well. I am now down to one paracetamol and one ibuprofen tablet twice a day.

As of two days ago, I no longer have to wear the brace at night - it's much more comfortable, but I'm still not sleeping well. If I need to get out of bed I have to put the brace back on and as it's still uncomfortable to bend my knee ( lots of fluid around the joint) I'm still sleeping mostly on my back.

My consultant says that at the end of next week (week 4 post op) I should be able to walk with the brace set at 30 degrees flex, then by the of week 6 post op I can take the brace off completely. My next follow up session will be at the end of week 6 and he wants to take an X-ray at that point, presumably to check that the bone is healing properly.

I've read a number of blogs whereby the Fulkerson goes hand in hand with a 'lateral release' and apparently I've had this too!

Why do they never tell you everything?

It explains why the left side of my leg is so tender and bruised and has so much fluid in it!

I'm also now rubbing bio-oil into the scar twice day and had my first shower in 3 weeks yesterday! Bliss! It was really tricky though and involved my husband ensuring I didn't fall over whilst i was supporting all my weight on my uninjured leg.

I'm technically back to work tomorrow - lucky that I can work from home and intend to do so until I can drive again. I'm still sitting with my leg raised and supported all the time.

I hope this has been of help - good luck with your op.

Debbie



2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline Mistyd

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #13 on: April 09, 2013, 03:39:43 PM »
Hi Debbie,

I am glad you are doing so well  :)  It is a long haul in recovery, lots of up's and down's (so I've heard).  As to the Dr. not telling you 'everything they did in surgery', the paper you sign before surgery lists the possibles of what could be done during surgery.  You may not have noticed that that was listed (if it wasn't...they could be in big trouble).

I pray you continued success in healing and getting back to a normal and productive (fun) life again ;)


God Bless,

Misty
« Last Edit: May 05, 2013, 06:51:22 PM by The KNEEguru »
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 DebbieCJ

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #14 on: April 09, 2013, 11:36:04 PM »
Thanks Misty.
I can't believe it's already nearly four weeks since the surgery, but most days seem to go slowly! Very frustrating not being mobile and relying on others for basic activities when I don't feel unwell and am not really in pain!

As you say, it's a long haul and it will hopefully lead to a much better quality of life so I just need to get on with it.

Debbie
« Last Edit: May 05, 2013, 06:51:48 PM by The KNEEguru »
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th















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