Advertisement - Hide this advert





Author Topic: Osteochondral allograft  (Read 18777 times)

0 Members and 1 Guest are viewing this topic.

Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Osteochondral allograft
« on: August 28, 2013, 09:51:32 PM »
Hello all -

This is not my first rodeo on knee geeks, but it is my first time down the Osteochondral allograft road.
I had an Patella ACI back in Dec 2009 that took but now the medial tibial has fallen apart and since doc does not really think a PKR or TKR is the answer yet due to age and activity levels .. we are going with this approach. 

I am curious, how many of you out there have had both:  ACI and Allograph?   Post op pain about the same?   I am mentally dreading the long rehab for this surgery, doc said its very similar to my ACI rehab.  So, I am starting to get mentally geared up as I went on the donor list today. 
How long have most of you had to wait for the donor tissue?

I think I have a pretty good concept of what to expect post surgery regarding pain and rehab, its the pre (waiting) that is a challenge this time around.  How much time has everyone had once donor selected and surgery was performed?

Well ... any insight or experiences and suggestions anyone is willing to share would be greatly appreciated it.   


Offline xclaxmom

  • Regular Poster
  • ***
  • Posts: 62
  • Liked: 2
Re: Osteochondral allograft
« Reply #1 on: August 30, 2013, 01:26:50 AM »
Hi. My daughter is having allograft surgery on Wednesday so I don't know how compare the pain level or rehab with an aci  surgery.  I can say that it took 4 weeks for insurance approval and another 4 weeks  to find a match.  Good luck.

Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Re: Osteochondral allograft
« Reply #2 on: August 30, 2013, 01:47:04 PM »
Ya, i had to fight with insurance too .. the ACI was much harder to get approved cuz when I had that procedure it was more of "experimental".   I took me about a month too for approval for the allograft cuz its on the same knee.  (I am sure my insurance company just wants me to get a new knee and be done with it all!)

Thanks for the info on how long for the match ... I assumed based on what my doc said 30-45 days for match.  I am trying to prepare but dont want to get to anxious as it may be a longer wait. 
once they called with the match, how quickly was surgery scheduled?

Good luck to your daughter!! If you dont mind, keep me posted on her recovery and rehab.
How old is she?  Where is her defect on the knee?

Best of luck!

Offline xclaxmom

  • Regular Poster
  • ***
  • Posts: 62
  • Liked: 2
Re: Osteochondral allograft
« Reply #3 on: August 30, 2013, 04:16:32 PM »
My daughter is 16. She had microfracture and a lateral release by a local pediatric surgeon. The microfracture failed. Her defect is on the outer part of her trochlea. Not sure how or when it originally happened, probably OCD or sports. We were given a heads up that graft was available and being sent to testing, then about another week for surgery. 
We weren't sure if insurance would even approve it because original ortho harvested for aci and did that whole thing but they did.

Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Re: Osteochondral allograft
« Reply #4 on: September 06, 2013, 09:47:52 PM »
Well ... here I go again is my theme for today!

Got a match already ... doc office called today.  So, surgery is Tuesday afternoon!   While I wanted surgery soon, next Tuesday (9.10) was not quite what I had planned.  How does one get their life in order for non-weight bearing for 6 weeks in 3 days? 

You would assume by me going through this before with my ACI surgery, I would be all calm and ready for this.  I must admit, NOT!!!   

I dont even know where to start .. gotta get work/employer up to speed .. prep the house and living conditions, rearrange appointments and fun stuff I had planned.   OH ya, find my crutches!  ha!!!

the goal of this journey, pain free walking.. right!!   keep focus on the goal!  ;-p

wish me luck .. I will drop in post surgery and share some of the experience for anyone who wants to read about it.

Offline xclaxmom

  • Regular Poster
  • ***
  • Posts: 62
  • Liked: 2
Re: Osteochondral allograft
« Reply #5 on: September 07, 2013, 04:20:36 PM »
Good for you. That was fast. With your surgery being so close to my daughters it will be nice to compare the two recoveries.
Were you told how long you were going to be in the hospital?  Probably similar to your ACI surgery.  Good luck with your surgery. I'll be checking to see how your doing.

Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Re: Osteochondral allograft
« Reply #6 on: September 08, 2013, 02:26:45 PM »
Yes, surgery is coming fast.  I was very surprised to hear a match was found so darn quickly.

I am in the hospital 23 hours (love insurance rules) ... so I will be home by Wednesday morning.

Yes the compare will be good, however I am 44 .. she has age and youthful parts on her side with recovery!  ;-)

Hope her recovery is going well, so far!  She is the CPM machine and for how long each day?
How is her pain tolerance?

Offline xclaxmom

  • Regular Poster
  • ***
  • Posts: 62
  • Liked: 2
Re: Osteochondral allograft
« Reply #7 on: September 08, 2013, 03:03:52 PM »
Lol. Hers was supposed to be the 23 hr. observation too, but her block was just starting to wear off at the 23 hr. mark.  She was starting to hurt some, and we had a 5 hr. drive home so they kept her the night. I think it was a good decision because she felt comfortable in the morning. 

She was taking Percocet, but yesterday she took only 2 ibruprofen 2x all day. She said it hurt some but it was really not bad.  Hopefully yours will be the same.

Offline Heidi Ductable

  • MICROgeek (<20 posts)
  • *
  • Posts: 19
  • Liked: 3
Re: Osteochondral allograft
« Reply #8 on: September 09, 2013, 05:30:22 PM »
Good luck tomorrow, Thornburg.
I'm 3 1/2 weeks post-op and had an osteochondral allograft done in NYC.

In terms of prep... here are a few things I wished someone had told me in advance.
(1) You'll definitely want to buy a shower seat...if nothing else than to rest on it while you lift your feet over the tub and into the shower.
(2) I had no idea I was supposed to be on the CPM for up to 4 hours/day, and on the GameREady ice machine for 2-3 hours/day. All those hours KILL productivity, in case you were hoping to get any work done during the first three weeks post-op. You have to be flat on your back for the CPM, so it's hard to read, and using a laptop is sort of out of the question.
(3) If your doc has you use the GameReady ice machine, you're going to need (a) a TON of ice, so you might want to go out and buy several bags now and (b) make sure you have someone to help you load it and carry it over to a chair at least twice a day, since this will be impossible with both hands on your crutches.

As for pain... I didn't have anything but the allograft done... but it was really not bad. I stopped taking percocets after 2-3 days and have taken nothing since (except 1 low-dose aspirin a day to prevent thrombosis or whatever it does).

The biggest thing, I thought, was the huge time drain with the machines. But there's no getting around it, so just do it.

For anyone else... I'm wondering if you had trouble doing a straight leg lift with the operative leg after 3 weeks. I know I don't atrophy that fast, and I was doing them in the gym before the op, so... what gives?


Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Re: Osteochondral allograft
« Reply #9 on: September 09, 2013, 09:14:08 PM »
Hi Heidi -

thanks for the info .. yes, I have a shower seat .. I know all about the CPM machine and how it fills hours in your day.  The post op protocol for this surgery is extremely close to my ACI a had a few years ago.  I was just not sure of pain .. close to or worse or better.   From what I am hearing, might be better!   

My previous ACI surgery, I could not do a leg lift for a very long time.  Actually had to get a machine to use at home to engage the quad so I could eventually do one ... that was hell getting to point, if I may be so blunt.

I have been doing leg lifts several times a day getting ready plus what I call "surgery training" to build my quad as much as I could .. it will be the last thing I do before they knock me out too ... hopefully my brain will talk to my quad a few days down the road and say, lets do this!  LOL
Since surgery came up fast, my prep was not as far along as I would have liked.

I did not have a gameday ice machine .. dont think the plan is to have one again either .. but I have a cryo-cuff that i have learned to love over the years.

what degree have you bent your knee to yet without the CPM?   have you started PT Yet?  are you allowed to ride a stationary bike or water therapy at the gym yet?

I'll talk to you all on Wed!  thanks for the well wishes

thornburg99

Offline Heidi Ductable

  • MICROgeek (<20 posts)
  • *
  • Posts: 19
  • Liked: 3
Re: Osteochondral allograft
« Reply #10 on: September 09, 2013, 11:51:31 PM »
Hi Thorn,

My tissue match came quickly, too. I had about 2 biz days to get ready. Oh well.

I haven't started PT yet. I think it begins 6 weeks post-op. I got up to 115 degrees flex on the CPM before I sent it back at the 3-week mark. Without it... I can do at least 90 because I'm trying to sit normally at my desk right now-- maybe a bit more than that because I've been on the recumbent bike for the past 3 days. (The first revolution has been impossible every time, but eventually you'll find a way make it happen, even if it means 1000 tries and hugging your leg with both arms to help it get around initially.) The funny thing is that even though I was able to pedal for 45 minutes on my second day of biking, I still haven't been able to produce enough power yet to actually get the bike's program display lights to go on --but I'm still non-weightbearing, so... maybe that can be my next mini-milestone.)  No pool stuff yet. Actually, if the doc prescribes water therapy, I have no idea what I'll do. My gym doesn't have a pool. In NYC, not many do. Also, my options are limited because I don't own a car, so my legs are my wheels and I can only travel as far as my crutch muscles will take me right now.)

All the best tomorrow in the OR. And remember to savor your last shower!

Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Re: Osteochondral allograft
« Reply #11 on: September 11, 2013, 09:57:04 PM »
Hi Heidi and xclaxmom

I am home and its 24 hours post op .. I am in a TON OF PAIN!   OMG, i fee like my knee got hit by a bus!!!  I mean to tell ya, it just throbs too!  Once the full leg nerve block wore off, all hell broke loose regarding pain!

I am taking pain pills every 6 hours and have another type of pain pill for break-thru pain too ... taking those every 2-4 hours.   I almost want to say my pain is worse or maybe just very different from my ACI.  Where the plugs are .. very intense pain.  They said the next 3 days are gonna be bad and to stay the course with my pain meds regardless of how I feel.   Saturday, I can see if I want to back off on the meds or not.

Surgery was a success, at least technically per doc.   He plugged my medial defect area with 2 plugs, microfracture my trochlea and then found a brand new spot on the lateral side .. so he plugged that too.  The new spot, the cartilage was just falling off like old wallpaper.  He said, if we did not fix that while he was in there, I would be telling him that hurt very soon.   It was on the way to shredding off and bone being exposed.  (I have awful cartilage apparently)  Docs assistant, in short says .. your knee is a hot mess!  ;-p
I dont know the size of my defects, but will get that at my next appointment and share.

I am in the CPM machine at 35 flexion .. oh how I hate this machine!  I am non weight bearing for 6 weeks and no stairs or inclines for 4 months.  I get my staples out on the 20th and will talk next steps in rehab then.   My first goal, a leg lift .. gonna try this weekend.

How many areas did you gals have fixed .. more than one plug?  any microfracture too?  the doc seemed to hit my entire knee with something, maybe that's why it hurts to darn bad!

how are you both doing?  xclaxmom - your daughter is about a week ahead of me .. how is she managing now?   Heidi - you are way ahead of us ... so your over the worst pain, right?

I will check in later in the week and share how I am progressing.  I will post pics if you gals are interested in seeing.  I just need to scan to the computer, I have hard copies doc gave me.

hope you both are doing well .. more later!

Offline xclaxmom

  • Regular Poster
  • ***
  • Posts: 62
  • Liked: 2
Re: Osteochondral allograft
« Reply #12 on: September 11, 2013, 11:01:49 PM »
Glad to hear surgery went well, sorry about all the pain. It does get better though. I would have to agree that at the 24 hr. mark was the worst pain wise. Then day 3-4 my daughter kicked the meds completely.
Sounds like your whole knee got a little work. I'm sure that hurts a lot more than just her nickel size plug. Take care.

Offline Heidi Ductable

  • MICROgeek (<20 posts)
  • *
  • Posts: 19
  • Liked: 3
Re: Osteochondral allograft
« Reply #13 on: September 13, 2013, 12:34:32 AM »
Hi Thornburg,

I'm so sorry to hear that you've been put through the ringer. I definitely think the pain is compounded by the multitude of procedures you had. Also, the number of plugs. (I was fortunate to only require one plug, nothing else, and I hesitate to say it whileyou're ailing, but was only on percocets for 2 days.) It will only get better.  Can't hurt much worse, right? 
 
The most important thing is that the operation was a success, and it's a REALLY good thing that you had donor tissue on hand so they could repair everything from the same match.

Just hang in there. As much as you hate the CPM... it does make the days go by faster.  And if you have some friends or family around, don't hesitate to surround yourself with their help.

Now, if you can do a leg lift in the first week post-op, I will be simultaneously impressed and jealous!! Let us know!  Either way, you're motivating me to try harder.

Meanwhile, I saw the doc today (4 weeks post-op). He said I can move from the recumbent bike to the upright bike now. So I tried the upright today and while I was able to crank out 45 minutes on the recumbent yesterday -- just enough to get the program lights to stay on-- I could only do 20 revolutions on the upright bike. He also said that after 6 weeks on crutches, expect to spend another 7-10 days on crutches while transitioning to full weight-bearing. I didn't see that coming.

I have a feeling that once you get over the hump with the pain, you'll sort of like aiming for these small milestones -- and, as you know from past knee surgery, there will be plenty. Progress is nice, even if it's just 1-5 degrees on the CPM. It'll happen. Hang in there. I hope you're able to get some sleep soon.

All the best

Offline thornburg

  • Regular Poster
  • ***
  • Posts: 57
  • Liked: 2
Re: Osteochondral allograft
« Reply #14 on: September 14, 2013, 11:28:19 PM »
5 days post op ... (Saturday night)

Pain is much much better .. have not taken a pain pill all day!  However, I still cannot do a straight leg raise .. so frustrating. I keep trying and my leg just lays there!  ha!
I can so my side and inner lifts ... just the quad wont wake up!   Calling the Doc monday morning to see what they want me to do about the quad.
Sleeping is better now too .. coming off all the pain meds has to go to help my overall mood too. 

Had a few breakdowns cuz I get frustrated I cant do stuff on my own .. but in the same breath I knew those would happen too.  Showering and keeping the knee dry is a pain in the butt .. I am over that again already!!

CPM machine ... been living in the machine and up to 55 degrees tonight so far .. hoping to hit close to 60 by the time I head to bed.  I try to up the degrees every few hours.

Not much else to report, its all going the way I expected .. i'll drop back in after I call on monday for what he wants to do with the quad / leg lift.

I will say, each knee surgery gets harder to recover, I hope I dont ever have to do this again!

Let me know how everyone is doing too .. keeps me positive that it will get better!

take care!















support