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Author Topic: Denovo NT: Cartilage repair for defect behind patella, left knee.  (Read 12121 times)

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Offline 2iron-knee

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Hello All,

I have just had surgery on 1/28/14.
I will be writing a diary on my recovery. I will try to update regularly and answer questions you may have.

Background:
Male,
24yo
Left knee, first knee surgery

I hurt myself while hiking/bushwalking. I'm not sure how I tear up my articular cartilage behind my left knee patella, but I suspect a fall in July, 2013. I started having significant knee pain in September, 2013. On October, I was diagnosed with the tear through a MRI. My first OS opinion was to have surgery. My second OS opinion was to do physical therapy first, I tried for 2.5 months but PT did not helped me significantly. I was having problems walking more than 2 blocks. I decided on Denovo NT to repair my torn cartilage.

Day 1 (day of surgery):
Surgery lasted approximately 2 hours.
I checked in the hospital around 7 AM and by 2:30 PM I was already home.
Pain was virtually non-existent probably due to anesthesia left overs, I was given a knee brace to use all the time.

Day 2:
Pain was minimum, I started CPM machine. My doc wants me to do 0-30 degrees for 6-8 hours per day. I'm taking the prescribed vicodin on regular schedule.

Day 3:
Pain is severe! The anesthesia finally wore off and even with Vicodin, I'm in a lot of pain. Doc said that I can put some weight on the foot of the affected knee, but I'm using the crutches all the time. I'm still doing CPM, up to 34 degrees now.

Day 4:
More pain, I asked the doc if I could double my dosage of Vicodin and he agreed. I'm starting to put some weight on the affected knee/foot. My quads are not responding at all. I can't raise my leg on its own, I use the right leg to lift the left leg. I'm on CPM, up to 44 degrees now. I'm a lot of problems sleeping through out the night. For now, that's all. I will update as necessary.

« Last Edit: February 26, 2014, 06:21:16 AM by 2iron-knee »

Offline MDAL

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #1 on: February 01, 2014, 01:08:55 PM »
That pain should finish soon, but you will keep having inflammation for a long while more until it turns residual.

I had 3 surgeries to the same knee, including 1 full open joint.

For now just be very careful, I find it hard to believe he put you CPM so soon, since the Denovo Procedure is something so fragile to hold in the early stages. Specially in the patella which rubs hard into femur.

Well, keep us posted. I am curious to see how the results turn.


Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #2 on: February 02, 2014, 04:15:32 AM »
Thanks for the feedback.

Day 5:
Pain is starting to go down a notch. I'm taking Vicodin every 6 hours as oppose to 3 hrs. I'm still in a lot of discomfort especially while wearing the knee brace. It it's tight it hurts, if it's lose it hurts. The only true pain free zone for now is the CPM machine. I'm up to 49 degrees now. I accidentantly put too much weight on the affected knee/foot while wearing the brace today and it started hurting more. I'm icing as I write this. The doc said I could put weight on it but today was too much. Lesson learned.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #3 on: February 03, 2014, 05:52:58 AM »
Day 6:
I'm still in pain but it is slowly going down. I hardly have any inflammation. I ice my knee right after doing CPM. I've broken down the CPM sessions to 4 chunks of 2 hours each. I like being in that machine because I hardly feel any pain while exercising. The brace is very uncomfortable. I start work tomorrow ( from home). Fiding a comfortable position to have my computer to do my job will be difficult. I'm at 54 degrees now in the CPM. We'll see how tomorrow goes.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #4 on: February 05, 2014, 05:25:04 AM »
Day 7:
Pain continues to go down. Still doing CPM 8 hrs a day. Finding a good position to work on my computer was difficult. If anyone goes through a similar scenario, I suggest you buy yourself one of those mobile hospital tables for food.

Day 8:
I still can't sleep through out the night. As soon as my pain med wears off I wake up.
Pain is no longer severe but still there. I'm up to 65 degrees in the CPM. The doc said that my goal is to reach 110 degrees in 3 weeks so I'm slowly increasing it by 5 degrees per day. My leg muscles have started to twitch I assume it's proof that pretty soon they'll wake up. At least my ITB seems to be partially working as I can move my leg sideways.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #5 on: February 06, 2014, 04:36:56 AM »
Day 9:
I visited my doctor today. They removed the thread of the stitches, apparently the remaining staples will be absorbed by my body which is something I had never heard of. My pain levels continue to decrease, I am officially out of the Oxycodone. The doc gave me a lesser pain med, acetaminophen/Tylenol. The doc wants me to continue CPM only, no PT for me yet.

Offline randomlife

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #6 on: February 06, 2014, 10:53:50 PM »
Hey there! Sounds like you're making much positive progress! I'm about 17 months out from DeNovo under my right patella, and I've learned that patience, more than anything else, is key to this recovery.

I was on the CPM for 24 hours a day for the first ten days after surgery (I was only allowed up for exercises and to go to the bathroom). Then I was on the CPM for about 15-17 hours a day until I hit three weeks. My understanding is that this helped to shape the cartilage graft, in addition to helping the knee maintain some kind of ROM. Also, for the first 10 days, I wasn't supposed to engage my quads at all (harder to do than one might think!) because of how delicate the graft is at first. A recent scope showed that the graft has grown into some kind of cartilage cover (it's not totally smooth), and I have no exposed bone. So I think the CPM was a good thing, at least for me.

I hope your pain continues to decrease. Have you figured out a comfortable position for work? I used a lap desk for my computer, but one of those hospital tables should do the trick, too. Keep up the good work!

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 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #7 on: February 07, 2014, 02:13:44 AM »
Thanks for the feedback lk.
I did figure out a position using my futon and pillows.

Day 10:
Pain is much less now. I have started my first steps using the crutches. I'm still on CPM up to 75 degrees now. I have attached two pictures one is the MRI of my defect and the other one is me wearing this uncomfortable brace of mine using the CPM machine as a resting spot.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #8 on: February 08, 2014, 05:38:34 AM »
Day 11:
Pain continues to go down. I'm already attempting to walk with the crutches. My muscles are responding once again. I can't raise the weight of my leg with my quads yet. I'm taking Aleve/Naxproxen for inflammation and pain. I will try to stay away from the Opiods since one side effect of it is constipation. I'm up to 80 degrees in CPM.
« Last Edit: February 08, 2014, 05:41:17 AM by 2iron-knee »

Offline Meniscus Boy

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #9 on: February 09, 2014, 06:34:42 AM »
Hey there
My name is Kevin an I'm wondering how you're feeling after the Denovo NT?

It sounds like its probably the most advanced procedure available at this time.

Has anyone ever told you to seek out some prolo therapy in addition to the regular treatment to possibly enhance healing and final result?

Please let me know your email and perhaps I can email or call you to see how it's going

Wishing you the best

Meniscus boy

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #10 on: February 09, 2014, 05:20:31 PM »
@Kevin/Meniscus Boy: I'm feeling fine. I'm still recovering from surgery as you can read in this diary. I will try to update regularly so that others can read what progress is like. No one has ever said anything about prolo therapy. My doctor wants me to do physical therapy but later on. Thank you for your wishes, you can contact me in this diary, I will respond.

Day 12: Pain is very little now. I'm starting to take showers! The Medical Assistant said I can. Prior to taking showers I was using moist wipes (aka baby wipes).  Getting in the tub is challenging but the crutches are great help. I don't do it alone, my significant other helps me. A shower feels awesome! When the water touched the incision I felt a small burning sensation but nothing to cry about.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #11 on: February 10, 2014, 05:26:06 AM »
Day 13:
I'm starting to feel a burning sensation when doing CPM. I believe it's due to the cloth being stretched nonetheless it is annoying. I'm up to 90 degrees now, a milestone I think. Pain continues to go down. I walked without crutches today, only a few steps but it felt good.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #12 on: February 11, 2014, 03:55:48 AM »
Day 14: I have stopped taking pain medications. I'm drug free! I'm still doing CPM for a minimum of 6 hours a day. Up to 95 degrees now. Whenever I try to walk my entire left leg feels weak and unstable. Hopefully tomorrow will be a better day.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #13 on: February 13, 2014, 04:42:04 AM »
Day 15: Still doing CPM. I am officially two weeks post op. The doctor said that I leave the crutches behind. I have started to walk without them a few steps around the house. Pain comes and goes.

Day 16: Walking without crutches around the house turned out to be more challenging than I thought. I have not taken any pain meds in 3 days although there is some burning sensation that comes and goes. I'm up to 100 degrees in the CPM. I'm still wearing the knee brace all day with the two exceptions of while on CPM and while taking a shower.

Offline 2iron-knee

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Re: Denovo NT: Cartilage repair for defect behind patella, left knee.
« Reply #14 on: February 14, 2014, 05:18:05 AM »
Day 17:
My leg is definitely getting stronger. I still feel very unstable and weak whenever I walk. I'm following CPM schedule religiously. I'm up to 105 degrees now. I'm still working from home and I have not driven my car anywhere since surgery perhaps this weekend...















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