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Author Topic: OATS and Medial Meniscus Transplant for 32 year old active patient?  (Read 8376 times)

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Offline LateralMeniscusIssuesGuy

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Re: OATS and Medial Meniscus Transplant for 32 year old active patient?
« Reply #30 on: October 10, 2018, 08:15:27 AM »
Thank you for sharing your progress badleftknee.

For what it is worth, I recommend Functional Range Conditioning as an accompaniment to any rehab, it seems to be resulting in better quality of movement, and less pain for me.  Its all over the internet, and the pioneer is Dr Spina, again lots of youtube content.
Partial Lateral Meniscectomy (2/3 removed), pristine articular cartilage...2013
Return to impact sport, continual responsive swelling ever since
Mild pain onset..2016
Arthroscopy reveals grade 2/3 articular cartilage damage lateral compartment behind kneecap
What now? Allograft / brace / nothing?

Offline KneeIsBummed

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Re: OATS and Medial Meniscus Transplant for 32 year old active patient?
« Reply #31 on: April 25, 2020, 05:51:25 AM »
Hi badleftknee

Hope you're doing well a year plus out of the micro-fracture surgery - not sure if you'll ever read this but just wanted to try my luck

I'm in exactly the same boat as you (I think) - same cartilage wear and tear injury in the exact same spot along the medial femoral plane (remnants from an old ACL reconstruction surgery 9 years ago that was slightly botched). Essentially I decided to live with the ACL deficiency for years, until I decided to bite the bullet and just get another ACL reconstruction surgery done (with some meniscus repair too) but woke up with a nasty surprise - I had a micro fracture on the medial femoral plane because of pretty bad cartilage break down from over the years

So now I'm 8 weeks out of surgery, and generally doing OK walking around without any pain or crutches (in the house, under the Covid-19 lock down), even for prolonged periods of time isn't really hurting me which makes me feel good

The problem is, I can't load the knee (yet - hopefully soon to improve) while climbing stairs - there is sharp pain at the site of the micro fracture and I back off immediately after that, which seems to be what you went through for a while. Stepping down on it is even worse

I know 8 weeks out is extremely early in the process, and yes I know I'm impatient, but my knee is pretty much all I think about all the time. The mental aspect of this has been by far the most depressing - given the uncertainty of it all (I've made a mental note to not visit any more of these knee forums after finding some solace) - reading all these stories just makes me think of all of these distant possibilities that could happen to me and is terrible for my mental health

So I've scanned through lots of these threads and your situation seems to be the most similar to mine, which is why I'm reaching out here to see how you are doing a couple of years out? Are you back to normal activities, climbing up and down stairs, hiking, sports etc.? I think something like this would greatly give me confidence that one day (even if its a year away, I really don't care), I'll be back to relative normalcy

Thanks a lot mate

Offline badleftknee1

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Re: OATS and Medial Meniscus Transplant for 32 year old active patient?
« Reply #32 on: May 11, 2020, 05:33:41 PM »
Hey all,

Almost forgot about this site, ALMOST! Figured I would check in. Seems like at least one person out there is finding it useful!

So ya I'm 1.5+ years out at this point (have stopped counting really, think that's right). Things are going fairly well, though not perfect and I would be lying if I said that my life is "back to normal." I would say that my life now has gotten much better, and that I have found peace with my new activity level. Here's a summary of where I am at from different angles of activity:

Everyday life: So I no longer wake up and the first thing I think about is my knee. Overall I don't notice it at work, with short walks, bending/lifting as long as not over done.  It continues to feel slightly different in gait pattern from time to time, not to say its painful- hard to explain really but sometimes I just notice one leg is the left, and the other is the right..something I think most don't think about routinely. I have occasional twinges, but nothing that bothers me all that much. Stairs for the most part are fine, again sometimes gait feels slightly different. I can walk several miles without feeling the knee in any significant fashion. Overall, when I reflect, I feel super fortunate to be at a place where everyday life is not uncomfortable. The mental battle I faced day to day then was absolutely miserable from a quality of life standpoint.

Activity level: My new favorite activity is cycling. This includes road biking, peloton, and mountain biking- all at pretty good clips; keeping up with athletes at my level without injury. Ya, I ice afterwards and feel the knee if I'm really cranking up a hill, and try to have at least one day between hard rides but its been an absolute blast to get back at something that is challenging from an endurance standpoint and with some sense of comradery. I can do basic non-impact plyo workouts without too much difficulty, though I will say that when I isolate my left knee and do repeated single leg squats or the like it will become irritated- some of the irritation I can actually feel more anterior (patellofemoral) which I just think suggests some degree of generalized inflammation. I have definitely done higher impact plyo classes with skater jumps, single leg jumps, etc, but overall I still am fairly guarded with it and it will be sore the next AM- I still do it from time to time just to try and keep my strength up and test it, hoping one day it will actually be pain free. Hiking has also been very doable, though I haven't done much past 8 or so miles though that is with pretty good elevation gain and trying terrain- the knee tends to do fine though I do notice a slightly different step when ascending, particularly at mid range angles (steeper pitches actually more comfortable- think it is dependent on where cartilage deficits "kiss"). I should say that elliptical is fine at this point as well, no major issues there. I did also do some x country skiing (classic, not skate) this past winter and tolerated this reasonably well.

Impact sports: I have tried running off and on, mainly on a treadmill. I ran 2 miles at one point. I have to be honest and state that it doesn't feel good. There is definitely still a point in the stride that if hit right will cause a shot of pain. That is enough for me to want to back off, its simply not worth reverting back. My stride is off, because I am guarding it, which makes running difficult. I was always an 'OK' runner, so I am ok leaving this behind though some days there is nothing more I want then a quick 4 mile run to get a quick workout in. I will keep testing it on and off and let you know if it ever improves though mentally I have retired for now. I haven't tried any impact sports like soccer, basketball, etc....sports I have noticed most of my non-injured friends slowly quit any way in exchange for lower impact stuff (I'm 35 now), though many of them still run- would of course love to run the local 10k fundraiser race with them and my wife etc.

So all and all I think I'm in a decent place. I'm really hoping this holds up, I know Microfractures can fail eventually, then it would be time for PKR- hopefully a ways off. Part of me thinks the microfracture isn't really what helped me, and it was perhaps more a tincture or time and reduction of inflammation/marrow edema caused by repetitive bone on bone trauma when I was playing soccer several times per week when injury first came on. I don't think I would ever go for cartilage/meniscus replacement if it came to that- I just think my articular cartilage wear is too significant to find benefit.

For folks who can, give cycling a try. Its a tough mental transition eventually but it really helps you get that endurance fix out and as you get deeper into it, and as you get older, seems like there are plenty like minded (injured or not). It's drastically improved the quality of my life.

The one true passion of mine I am still waiting to test is downhill/alpine skiing. I think it may go ok, though I will probably be compensating and "skiing with one leg." If I can get out and enjoy who cares tho! I may get into more skinning to make it more of a cardiovascular sport then endure the repeat trauma that is a day of lift served down hill.

Happy to answer any more questions for folks- I was in your position at one point and wanted all the answers as well.

Best all, Jake