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Author Topic: ACI/Osteotomy in 1.5 weeks and freaking out!  (Read 9900 times)

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Offline nchen13

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Re: ACI/Osteotomy in 1.5 weeks and freaking out!
« Reply #15 on: December 11, 2014, 04:46:09 PM »
Hey ozzy,

I feel that i'm in the same boat as you. Just wanted to get your opinion on your two surgeries.
First of all,

1. Was it worth it?. Doctors recommended that i have HTO and ACI or De Novo due to being bowl legged and previous menisectomy which has resulted in a couple of cartilage lesions

2. When did you know when to have the surgery? I'm asking this cause i have occasional pain and not constant

Thanks!

NiCk

Offline ozzie

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  • ACI & Fulkerson 6/25/13, ACI & Fulkerson 12/26/13
Re: ACI/Osteotomy in 1.5 weeks and freaking out!
« Reply #16 on: December 12, 2014, 12:14:03 AM »
Hi Nick,
 I had recently wondered about whether I would ever get any more inquiries from the Knee. Geeks site
After several months have gone by!
I had patella ACI AND Fulkerson osteotomy on both knees. I am 51 now, on the older end of spectrum for ACI's and I have done very well. I still am not supposed to jog-but soon.  I sometimes do a short distance jog during my walks. I have not completely gained back all my quad and glute strength, but I have not been as good about doing exercises as I should, so I'm trying to work on that.  The osteotomy is probably a big deal-but I have no idea how my recovery related to the osteotomy as opposed to the ACI each time. I do know it uncomfortable to sit on my knees, because there is a bit of protruding area that is where the osteotomy was-but it does not bother me other than that.

As far as my thoughts on your situation-one thing I do not know is how ACI SURGERY works with arthritis. My cartilage issues were due to wear from the position of my knee cap rubbing it off. The main thing is the ACI means an extended recovery (about a year or so for one knee)  so you have to really think it's the right surgery and that you are ready to be less active for awhile and at the same time commit to physical therapy.  On the other hand, waiting too long could lead to other conditions that could prohibit the. ACI, like kissing lesions or some sort of other deterioration. Also, perhaps the osteotomy can prevent more cartilage loss-although not sure if that is the case for you -It was the case for me and I wish I had had the. Fulkerson. 10 years before and maybe avoided the loss of cartilage and need for ACI.

I am happy I did these surgeries and I had a very successful outcome .  I have very high regard for my doctor, Scott Gillogly, and am confident in his opinions and in his skill. For. aci, I recommend going to a very experienced orthopedic surgeon with a top reputation..  Another thing I found helpful is that there is physical therapy in the orthopedist'a office. Not many physical therapists have learned about ACI, so if you have that surgery, it's helpful to go to someone who is familiar with the rehab for ACI and preferably has a good working relationship with the surgeon. My doctor sees me for follow up visits in the physical therapy room (he rounds I the. PT area once a week-I still see him every 6 weeks) and during that time he talks to me and with my physical therapist.  I'm not sure if that is typical for orthopedic surgeons or not.

Please feel free to ask me any questions about my experiences with these 2 surgeries. I wish you the best on these difficult decisions!
« Last Edit: December 12, 2014, 12:58:29 AM by ozzie »
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 nchen13

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Re: ACI/Osteotomy in 1.5 weeks and freaking out!
« Reply #17 on: December 15, 2014, 08:01:03 AM »
Thanks ozzy for the update. I'm just so deathly afraid to be in a cast and on crutches for 3 months in general. Your update gives me alot of hope. Especially if you are in your 50's (I'm currently 38). I've been to many orthapedic surgeons in LA and don't know who has that much experience in doing a HTO. How did you determine which doctor was best for you? Also, how long were suppose to be non-weight bearing?

Nick

Offline ForrestM

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Re: ACI/Osteotomy in 1.5 weeks and freaking out!
« Reply #18 on: December 17, 2014, 08:33:22 PM »
Hey Guys,

I just started trolling the ACI/osteotomy threads again since I'm having my surgery on December 22nd, and discovered that you all have a very recent thread going!

I really appreciate all the feedback you've provided on this site, Ozzy, it's been very helpful. I'm having an ACI, tibial tubercle osteotomy, and a medial patellofemoral ligament reconstruction done, so I may be able to provide some insight for Nick and others as I progress post-op.

Wish me luck!

Offline nchen13

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Re: ACI/Osteotomy in 1.5 weeks and freaking out!
« Reply #19 on: January 06, 2015, 04:28:11 PM »
Hey ForrestM

Just wondering how your operation went? What was your condition?

Nick

Offline ForrestM

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Re: ACI/Osteotomy in 1.5 weeks and freaking out!
« Reply #20 on: January 30, 2015, 02:23:57 PM »
Howdy Nick,

My apologies for the delayed response. I guess I should start out by saying I realized that I received a different kind of osteotomy then you have been prescribed. I got a Fulkerson Osteotomy, or a Tibia Tuburcle Osteotomy, rather than a HTO. I think this type is a little less intense then the one you would get. However, I did get the ACI and a MPFL reconstruction, so the recovery has been fun nonetheless.

So, I guess it may be beneficial to give a little background. I'm a 26 year old guy and have always been quite active. A long long time ago my knee started slipping out when taking a awkward step. It would only happen once every few years, and never put me down for too long, so I didn't seek much medical attention for it. That was until June of 2014 when I was playing ultimate and my knee completely gave out when going to dive. The next day I realized I did more damage than normal so I went to the doc.

Fast forward 5 months. After finally getting my knee scoped to see what was going on in my there after unsuccessful PT they found I had a chunk of cartilage missing. It was at that point I saw a more legitimate knee doctor (should have done that sooner but hindsight is 20-20). He recommended the 3 surgeries, so after much research I decided to go for it.

Post surgery:

There's no getting around it, this type of surgery blows. I spent the first night in the hospital but the nerve block wore off at about 1 am. I am not sure this is normal but from that point on I was in the worst pain imaginable. The nurse couldn't get a new prescription for me for some reason so I was going in and out of convulsions from the pain until about 6 am, when my doctor showed up and wrote a new prescription.

The first week was also quite painful and miserable, but after about 2 weeks it wasn't too terrible, in terms of pain. I got completely off of the hard pain pills at about 17 days. Now I take ibprofin throughout the day and will pop a oxycodone before going in to PT.

I was on 2 crutches for about 3.5 weeks. From there I started putting more and more weight on it throughout the day and walking on 1 crutch. Earlier this week, at about the 5 week mark, I started only using a cane.

I do about 1 1/2-2 hours of therapy a day. I just started being able to get a full revolution on a recumbent bike, but can't do it without contouring my ankle a bit to make it easier going around. Also stated doing leg strengthening exercises. In PT she can crank up my ROM to about 95 degress, but not without a heavy heavy dose of pain. I still have a fair amount of swelling in the knee, but hopefully that will go down soon.

It appears that I am progressing well. The doc and PT seem to be taking an aggressive approach to my rehab, which I appreciate. They say I'll be able to get back into whitewater kayaking at about 4 months, maybe getting to bike outside at that point, and possibly even doing a little jogging. My doctor has told me on multiple occasions he is confident I will be back to playing sports at a high level, so I find it encouraging.

Now that the worst is behind me I am very relieved. It's much too early to know if this will work, but I have a lot of confidence. It's tough keeping up with all the PT and appointments, but I knew what I was signing up for. I think that is extremely important with this sort of surgery. You gotta know beforehand that you are going to have to work your ass off to get back to normal.

I hope this helps someone out there!