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Author Topic: Possible failed femoral osteochondral allograft - what to do next?  (Read 4988 times)

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Offline ToeKneeArmAss

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Hi - glad I found this board. I'm 10 months post-surgery, still in pain, can't run.  Wondering what to do next. Here's the back-story:

55 years old - have played in a men's baseball league for past 20 years. It's my passion.

Had an autograft/mosaicplasty on my right medial distal femoral condyle (did I get that right?) in 2001 and it's been great.

Had severe pain in left knee, same place last year - Dr. said injury was too large for autograft so opted for allograft (surgery was 4/22/2014 - one 20 mm graft and one 6 mm one).

Was very diligent about no weight bearing, CPM, etc. - did physical therapy starting about 4 months post-surgery.

Was still in a lot of pain in November, and couldn't run. Dr. did an MRI that revealed that the bone wasn't knitting the way he had hoped. Took me off PT and have been using an Exogen ultrasound for the past month or so.

Really not noticing any improvement.  Last appointment (Dec), Dr. said we just needed to keep waiting as the only other option was a total knee replacement. Next appointment is later this month.

Am desperate to do anything that might possibly return me to the ball field.  Really - anything.

Is re-doing the allograft an option?  I've read that sometimes the grafts don't take if they aren't fresh enough. Has anyone heard of anyone getting a second allograft done in the same location and it working out for them?

Any other ideas?  Again, I'm desperate and most grateful for any suggestions.

Thanks

Offline WeenietheWarriorPrinces

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #1 on: March 12, 2015, 03:14:21 AM »
Sorry you are having such a rough time. I have heard of people having a second allograft proceedure done. If the  donor bone is "too old" it can cause it to fail. I recommend talking with your surgeon and then getting a second opinion. I have read several testimonies of people feeling like the proceedure is a failure until 12-18 months post surgery. So there is still hope it may be a success! Good luck!
Weenie the Warrior Princess
Left knee:
6/2012 Arthroscope w/ debridment, and plica removal
3/2013 Microfracture of MFC & patella and lateral release
6/2014 Microfracture MFC (same spot as last time, was damaged in a car accident)(infection week after & ultimately a failed surgery)
11/2014 OATS(autograft) MFC

Offline ToeKneeArmAss

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #2 on: March 12, 2015, 12:59:07 PM »
WtWP - very much appreciate your insights. Thanks for taking the time to reply.

Your input is consistent with the advice I've received from my doctors. Wait and see seems to be the right path.

Offline WeenietheWarriorPrinces

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #3 on: May 17, 2015, 03:29:31 AM »
TKAA how ya feeling? Any improvements? Fingers crossed you are feeling much better!
Left knee:
6/2012 Arthroscope w/ debridment, and plica removal
3/2013 Microfracture of MFC & patella and lateral release
6/2014 Microfracture MFC (same spot as last time, was damaged in a car accident)(infection week after & ultimately a failed surgery)
11/2014 OATS(autograft) MFC

Offline ToeKneeArmAss

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #4 on: May 17, 2015, 04:33:15 AM »
Thanks for checking in WtWP!

I'm having arthroscopic on Tuesday. MRI/CAT scan showed possible 'ridge' forming around the interface between the graft and the receptor site.  Hoping my ortho can shave it down and give me some relief.

Appreciate your concern. Will let you know how it goes.

Offline ToeKneeArmAss

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #5 on: June 21, 2015, 08:43:06 PM »
An update. Had arthroscopy one month ago. No noticable improvement.

Surgeon says that the allograft appears to be in good shape and solidly implanted. But I still have intolerable pain in a certain part of my range of motion. Walking is ok as long as not for long distances (100-200 metres is tine but further starts to ache).

My surgeon continues to advise patience. But I'm now 14 months post-op and haven't experienced anything that I consider progress in 8-9 months.

Am starting to consider a partial knee replacement but have two concerns. One is that the depth of the receptor site for my allograft will make me unsuitable. The other is that it will guarantee that I will never play baseball again.

Grateful for any thoughts.

Offline WeenietheWarriorPrinces

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #6 on: July 23, 2015, 03:49:19 AM »
TKAA I'm so sorry, this was totally what I did NOT want to hear. Can you get a second opinion with all your records including surgery report? At my last apt my OS said that healing from an OATS can take up to two years! Hopefully this is your case and this will just click and you feel better!
As far as the PKR, I have know people who have had one and still returned to their previous activities. It took some time to heal but still possible! Hang in there!
Weenie
Left knee:
6/2012 Arthroscope w/ debridment, and plica removal
3/2013 Microfracture of MFC & patella and lateral release
6/2014 Microfracture MFC (same spot as last time, was damaged in a car accident)(infection week after & ultimately a failed surgery)
11/2014 OATS(autograft) MFC

Offline ToeKneeArmAss

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Re: Possible failed femoral osteochondral allograft - what to do next?
« Reply #7 on: July 24, 2015, 05:52:34 AM »
It so kind of you to keep checking in, Weenie.

I've never seen any suggestions of a two-year recovery from an OATS.  If I only felt the slightest improvement I might feel more optimistic that more time is the answer.

In the meantime I'm researching good doctors for a second opinion/alternative course of treatment.  Will post again when there's a new development.















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