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Author Topic: MACI and Fulkerson Osteotomy March 15th 2013  (Read 6286 times)

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Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy - 4 weeks post op
« Reply #15 on: April 12, 2013, 12:11:13 PM »
Hi again,
Am now 4 weeks post op and saw the physio again today.
I can bend my knee to 100 degrees and can fully weight bear wearing my brace, which is now set to 30 degrees flexion instead of locked straight for walking - it feels strange and my injured leg feels very weak.

I've been told to carry on with the same exercises - heel slides, static quads, calf pumps - for the next two weeks, at which point I should be able to take the brace off permanently and also start straight leg raises as the Fulkerson should have healed sufficiently.

Due to the amount of fluid in my knee, and the resulting 'tight' feeling i get when bending, I'm also going to start using a heat pack and massage the area around the scar more vigorously to stimulate nerves and healing.

I'm still not sleeping well - just not comfortable but am napping in the day!

Debbie

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

Offline JessJess28

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #16 on: April 12, 2013, 07:27:08 PM »
Sorry you are not sleeping well  :(. I feel your pain. At least you get to nap  ;). Sorry you feel weak in the brace locked at 30. My OS says immoblizer for full 6 weeks. I'm getting nervous I'll be too weak if I don't get out of it sooner. I wonder why my OS won't let me use a ROM brace before the 6 weeks. I know they all have their own protocols though. Think it would be rude to ask why I can't use one?

Glad your ROM is improving! Hope your swelling goes down soon. Im a few weeks behind you post op so enjoy reading other Fulkerson diaries.
« Last Edit: May 05, 2013, 06:52:31 PM by The KNEEguru »
History of Dislocations
12/08 Scope
3/2013 TTO, Lateral Release, Medial Reefing, Grade III Patella lesion.
11/2013 TTO L knee, LR, Medial Reefing, R knee screw removal

Offline DebbieCJ

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #17 on: April 12, 2013, 08:38:03 PM »
Thanks for your post.
I don't think it would be rude at all to ask about a ROM brace - it helps with your understanding of what your OS is expecting of you and should ease any concerns you have about your progress.

We all have unique knees and we all heal at different rates too, but it is nice to get a feel of what is 'normal'!
« Last Edit: May 05, 2013, 06:52:57 PM by The KNEEguru »
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 #18 on: April 13, 2013, 04:06:35 PM »
Depending on where the graft is located usually depends on how much ROM you are able to do early on. I believe trochea and patella patients are able to PWB but not have much ROM (if any) early on, but those with femur/chondyle (brain went blank!  :olol...outside edges of knee ..need more coffee,lol) are able to bend early but no weight bearing for a longer period of time.

Hang tight Debbie, remember this is a looooong road to recovery.  I know it must be a royal pain in the patutee (a$$) to not be able to sleep at night.  Thankfully, you are able to sneak some napping in to try to catch up on some ZZZ's.  You might let your doc know too about the lack of sleep you are having, maybe he can prescribe something for a short time to help you get back on track to a normal sleeping habit (and during that time, your knee will continue to heal allowing you better positions, less pain, more mobility, etc).

God Bless,

Misty
« Last Edit: May 05, 2013, 06:54:40 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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Re: MACI and Fulkerson Osteotomy - 6 weeks post op
« Reply #19 on: April 29, 2013, 05:28:12 PM »
Hi all,
I'm now 6 weeks post op and progressing well.

Had my 6 week review with my consultant last week - I no longer have to wear my ROM brace and can walk with one crutch instead of 2!

I've added straight leg raises into my exercise schedule (quite difficult to do as quads are weak, the muscles shake after a couple of seconds!) and now use an exercise ball to 'roll' my knee from approx 30 degrees to 110-120 degrees (consultant describes it as being like rolling a lawn to achieve a smooth surface on my cartilage implant). I am restricted to close chain exercises only until 12 weeks.

My physio is going to get me on an exercise bike this week and once I can achieve a 120 degree bend regularly (my knee is quite fat and tight with fluid / fibrous gunk) I will also add 500 revolutions 3 times a day into my exercises.

I had an X-ray taken to ensure the Osteotomy is healing well - I have attached a couple of images. The screws are 48 mm long - huge!

Can now shower pretty much unaided (although hubby still washes feet) which is great. I should be able to attempt driving in a week or so - I have an automatic car so no issues with gears / emergency stop, it's just being able to get in and out of the car without twisting my knee and being able to sit comfortably, which is still tricky.

All in all it's going well - slow and steady. Both the consultant and physio are really pleased.

Debbie

« Last Edit: May 03, 2013, 09:39:29 AM by DebbieCJ »
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 - 7 weeks post op
« Reply #20 on: May 03, 2013, 08:03:16 PM »
Hi all,
Just a quick update.
Saw the physio today, am now able to use an exercise bike and do one-legged balancing whilst standing on a cushion!
I have some pain on the outside of my knee, where the lateral release was done, so the physio has massaged the ITB and all around the outside of the knee. It has helped and I need to try and do it myself before using the bike.
I've also been wary of walking in a way that puts pressure on the cartilage implant - I've been 'dragging' my leg and not bending it enough. The physio has told me to exaggerate lifting my leg, as the action of simply walking does not put force through the kneecap that will do any damage - the thigh muscle is doing the work to lift my leg and gravity is enabling the bending. It feels weird but seems to be working.
Am going to try driving at the weekend - a chance at freedom!

Debbie
« Last Edit: May 04, 2013, 10:09:38 AM by DebbieCJ »
2008 steroid injections, Bilateral arthroscopy
2012 bilateral arthroscopy, cartilage biopsy
2013 MACI (patella), Fulkerson and lateral release march 15th

Offline JessJess28

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MACI and Fulkerson Osteotomy March 15th 2013
« Reply #21 on: May 04, 2013, 06:19:08 PM »
Good luck trying to drive! Aaack! I didn't even think about that stuff for when I am cleared to drive. I can't bend my knee past maybe 80 degrees so not sure I can even try to drive once I get this brace off. Keep us posted with your progress. I had my Fulkerson about 2 weeks after you so it's nice to see how others ahead of me are recovering. Have a good weekend!

jess
« Last Edit: May 05, 2013, 06:53:58 PM by The KNEEguru, Reason: Title amended on main thread at request ot the OP. »
History of Dislocations
12/08 Scope
3/2013 TTO, Lateral Release, Medial Reefing, Grade III Patella lesion.
11/2013 TTO L knee, LR, Medial Reefing, R knee screw removal

Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy March 15th 2013
« Reply #22 on: May 05, 2013, 08:29:10 PM »
Thanks Jess.
I can bend my knee to about 120 degrees now, but am still very nervous of trying to drive. May give it a go tomorrow.
Knee has been really quite sore today, very achy when walking, sitting, exercising. Am taking a couple of paracetamol twice a day to try and help.
I caught the heel of my foot on a step coming down stairs yesterday and felt as though my knee 'jolted', causing a sharp pain. I hope I've done no damage and just need to rest it for a day or so.

Debbie
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 March 15th 2013
« Reply #23 on: May 07, 2013, 10:52:13 PM »
I drove my car today!
No problem at all, am relieved to be mobile again.
Have also purchased an exercise bike and have done a couple of 10 minute sessions today, approx 300 revolutions in each session.
I'm so unfit!
I need to build up to 3 x 500 revolutions per day, as well as continuing with straight leg raises and balance exercises.
I've stopped taking all painkillers now - the Osteotomy site aches occasionally and my thigh muscles also ache after exercise so I am continuing to use ice.
My progress since removing the leg brace has increased dramatically - I think the next couple of months will be more of a slog, as I need to continue with more of the same to really build upon my early success!

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

Offline JessJess28

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Re: MACI and Fulkerson Osteotomy March 15th 2013
« Reply #24 on: May 08, 2013, 07:08:52 PM »
Yay! So glad you drove! Sounds like you are doing well.

I have a couple questions for you if you don't mind? Is your osteotomy site still puffy? I'll be 6 weeks post-op on Friday and mine is still puffy. Also, did you find you needed something for pain after physio/therapy? Want to make sure I ask about this stuff when I go in next week and get my script for therapy. I can't bend very much now without a lot of pain so I am nervous. Thanks in advance for answering.

Hope you keep progressing well! Keep us posted :)

Jess
History of Dislocations
12/08 Scope
3/2013 TTO, Lateral Release, Medial Reefing, Grade III Patella lesion.
11/2013 TTO L knee, LR, Medial Reefing, R knee screw removal

Offline DebbieCJ

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Re: MACI and Fulkerson Osteotomy March 15th 2013
« Reply #25 on: May 08, 2013, 08:25:39 PM »
Thanks for your post Jess.

Don't mind the questions at all!

The Osteotomy site has never really been swollen and isn't puffy at all - it is very tender to touch however, and aches most of the time, and the site where the drain was put in is still very sore.

I've only just stopped taking painkillers (have only been taking paracetamol regularly for past couple of weeks,  morning and night). I don't find I need anything additionally after a physio session, but I still ice the area after a session and after each exercise session during the day. Both my surgeon and physio however have told me to take painkillers if I need them and not to worry about it - if the exercises hurt too much, I won't do them and recovery will be too slow!

It sounds as though your rehab protocol has been quite different to mine. And we all recover at different rates so you shouldn't worry too much about the level of bend you can achieve without pain - mine has improved a lot between 6 weeks and now. The level of pain also depends on the type of movement I make - 120 degrees on the bike sometimes is easier than 40 degrees walking!

I hope your physio goes well, and that you start seeing improvements soon.
Let me know!

Debbie
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 - 8 weeks and 4 days post op
« Reply #26 on: May 14, 2013, 05:11:07 PM »
Hi All,
I am now 8 weeks and 4 days post op.
All going ok, and I am now driving almost every day, albeit short distances.

At the end of last week my physio was concerned that I had fluid in my knee joint and wasn't sure if this was residual from the surgery or due to the new exercise regime on the bike. She's therefore scaled back my exercises! I am now doing 5 minutes twice a day on the bike, plus a 5 minute walk (still doing straight leg raises, calf pumps and static quads). It doesn't feel like much, but my knee has actually been really achy today so have not wanted to use the bike at all.
The most painful part of my knee is where the lateral release was done - it's extremely tender to touch.
I'm massaging my whole knee area once in the morning, and using bio oil on the scar.

Has anyone else had issues with the area where the lateral release was done, and any tips on making it less tender?

Thanks,

Debbie

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

Offline JessJess28

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Re: MACI and Fulkerson Osteotomy March 15th 2013
« Reply #27 on: May 14, 2013, 06:09:05 PM »
Debbie- Sounds like you are doing well! I too have tenderness on the lateral side of my knee where my lateral release was done. I also have pain down the lateral side of my leg. Not sure if it's from a nerve or just the lateral release though. I've been trying to massage the area to see if it helps. I will ask my Dr about it on Thursday.
History of Dislocations
12/08 Scope
3/2013 TTO, Lateral Release, Medial Reefing, Grade III Patella lesion.
11/2013 TTO L knee, LR, Medial Reefing, R knee screw removal

Offline sune

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Re: MACI and Fulkerson Osteotomy March 15th 2013
« Reply #28 on: May 21, 2013, 01:06:18 PM »
Hi Debbie.

I've also had some pain coming from the lateral side of my knee. It's never been so sore to touch, but it would become painful after exercising. I stepped down my training program quite a lot for almost 2 months, and I also used anti-inflammatory gel and two pills, and now it's much better. My training program is back up, but to avoid it triggering a new inflammation, I only train every other day.
I wish you a continued good recovery.

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 ozzie

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  • ACI & Fulkerson 6/25/13, ACI & Fulkerson 12/26/13
Re: MACI and Fulkerson Osteotomy March 15th 2013
« Reply #29 on: May 22, 2013, 05:19:59 AM »
Hi Debbie,  I have been following your progress and it sounds like you are going great!  I am hopefully having ACi and Fulkerson mid June. My insurance had denied payment for the lab cost (but not ACI and they had already paid for the initial "harvesting surgery) and we had to fight to get approval. So now it has been approved.  Thanks for posting updates. It is so helpful to read about your progress and ups and downs-helps me know what to expect and also to know I'm not the only one with the knee problems. (:
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















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