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Author Topic: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15  (Read 23349 times)

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Offline dal_knee

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #15 on: September 23, 2015, 07:56:13 PM »
Hi willrunagain,

Do you know the most effective way to get the swelling down noticeably is to elevate above your heart (the higher the better) while icing.  Just fyi.   
2007 - partial medial meniscectomy
2010 - full thickness chondral defect & adjacent subchondral edema MFC.   Direct result of stupid partial mensicectomy from 2007.
2014 - Subchondroplasty, chondroplasty, unauthorized 2nd partial medial meniscectomy.
2015 - partial failure of subchondroplasty.

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #16 on: October 06, 2015, 03:00:11 PM »
Week 4 Post Op Update:

I hit the 4 week mark today! The knee is ever improving.  I gained another 17 degrees of flexion since week 2.  This currently puts me at 112 degrees.  Only 18 degrees to go to achieve the flexion of my good knee.

The swelling is also down another 1.5 cm since week 2.  I can walk moderate distances (50m) without pain.  However, my therapist advised me to keep using the crutches for at least another week so I don't walk often.

Strength is coming along too.  I am doing lots of SLRs.  I can do over 30 at a time now.  I try to do as many as I can every day to keep the quad from atrophying.  My next Dr. follow up is on the 14th.  I am hopeful he will release me from the crutches and leg brace at that time.

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #17 on: October 15, 2015, 03:57:58 PM »
Post op week 5. (Days 36 & 37)

I can't believe it's already been 5 weeks since my knee was sliced open :o.  Things have been going very smoothly.  I had my follow up with Dr. Farr's PA (Megan) yesterday and got some good news!  The X-Ray showed good bone healing which means the cartilage is likely tagging along. 

I was also told the patella is sitting right where it should be.  This is a good indicator that very minimal scar tissue has developed.  The last check was to see how the patella felt when pushed and manipulated in the trochlear groove.  To my delight, Megan told me it felt pretty darn smooth.  I'm hoping that means the cartilage is hardening! 

Last but not least, they released me from the straight leg brace!  Can't wait to get that damn thing off my leg.  Although I must say it has been a great conversation starter with the ladies.  Got a few phone numbers and even a date out of it! That's about all I will miss it for though haha.  Anyhow, my goal is to slowly transition towards walking like a normal person over  the next 2 weeks.

Offline jjackish

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #18 on: October 18, 2015, 03:30:46 AM »
Good stuff!!  Keep us updated.

also, getting my post count up....

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #19 on: October 27, 2015, 06:32:12 PM »
Post op Week 7 (Day 49)

I am now walking unassisted!  No brace and no crutch.  Walking is feeling more and more comfortable with each day that passes.  I have returned to an almost completely normal gait.  I have a very slight limp, but it is not even noticeable to an outsider's eye.

Started on the stationary bike at week 5.  I can comfortably do up to 20 minutes at a time with moderate intensity.  The bike is very therapeutic for my knee.  It really helps loosen it up and keeps it from feeling stiff.  I also started leg press with very low weight this week.

At the moment, I am very close to full flexion on the operated knee.  The swelling in my knee has been cut in half since week 2 (down from 3.5cm to 1.75cm).  All signs are pointing in the right direction!  Staying diligent with your physical therapy is the key!

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #20 on: November 17, 2015, 07:36:39 PM »
Post op Week 10

Things continue to progress.  I have regained full extension in my knee which is big for me.  I can touch my heel to my butt once again.  I am now doing the stationary bike 5 times/week for 30 minutes at moderate intensity.  At PT, they have me doing single leg press with my right leg at 40lbs with high repetitions.  My knee feels pretty good on leg press.  There's just some minor soreness at and around the incision site.  Yesterday, I walked 1.25 miles in 20 minutes around my neighborhood and my knee felt pretty darn good! Only a little soreness in the beginning which went away after about a quarter mile.

My next follow-up with Dr. Farr is mid-December.  I will get an MRI right before I see him, so he can evaluate the cartiform graft.  I'm hoping to get approval for outdoor cycling (weather permitting) and golf at this follow-up.  I will update on the MRI findings next month.  Wish me luck! If anyone has further questions, I'd be glad to answer.

Offline Torao

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #21 on: November 19, 2015, 02:52:48 AM »
Congrats on the progress. It's hard to keep with it, especially given the long stretches where not much changes.


Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #22 on: December 19, 2015, 03:09:44 PM »
I had my 14 week follow up with my OS yesterday. I got an MRI right before seeing him. We both took a look at it together. The cartiform implant is looking real good. It is already just as thick as the rest of my healthy patella cartilage.  Dr. Farr also told me it is well integrated to my subchondral bone. It is also showing early signs of integration with the neighboring healthy cartilage.

As far as symptoms, I'm doing very well. I'm already biking outdoors for 12 mile rides. I've even walked up to 2 miles at a time with no problems whatsoever. I am still not allowed to do squats or stairs until the 6 month mark. Even though I feel like I could do stairs just fine if I wanted to, but it's all about protecting the maturing cartilage at this time. One big improvement I've seen is when I lift and straighten my leg from a seated position. Before surgery this was extremely painful and cause an audible clicking noise. Now I have no more pain or clicking noise when I do this!
 
Lastly, my OS told me the 6 month mark is when patients really turn the corner in terms of symptom relief.

Offline dal_knee

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #23 on: December 19, 2015, 09:45:16 PM »
Hi willrunagain

Good news on the steady progress

For stairs , then you climb one leg at a time ?  Does it not aggravate the other knee cap??
2007 - partial medial meniscectomy
2010 - full thickness chondral defect & adjacent subchondral edema MFC.   Direct result of stupid partial mensicectomy from 2007.
2014 - Subchondroplasty, chondroplasty, unauthorized 2nd partial medial meniscectomy.
2015 - partial failure of subchondroplasty.

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #24 on: December 20, 2015, 03:52:50 PM »
I've been trying to avoid stairs all together. When there's no elevator available, I just make sure to lead with my left leg on every step. Basically just dragging my right leg along.

My left knee is very strong and has never had any issues (knock on wood).

Offline lrc

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #25 on: January 25, 2016, 02:53:13 AM »
Hi Willrunagain,

I appreciate all your posts and info about Cartiform vs. other treatment possibilities.   I have a couple questions but will first briefly describe why I'm asking.

1 month after a routine scoping surgery 2 years ago a piece of cartilage flaked off my patella.   Took 5 months and another scope to figure it out and during the 2nd surgery where the issue was discovered microfracture was performed at the defect site.  The microfracture didn't fix the issue (can't squat very far without sharp pain), not surprising given the location (patella) and my age (56 at the time).   

So now I have a "pothole" cartilage defect in my patella bout 12mm diameter.  Doesn't bother me very much during normal daily life,  but he big issue is skiing - I am an avid/expert skier and inability to squat = can't ski.   I really want to regain this important part of my life...

I'm trying to figure out next steps.  Cartiform certainly sounds interesting but surgeons here in Colorado don't have much knowledge about it and none have any experience.  The guidance I've received so far leans toward ACI, DeNovo, or PFJR,  along with feedback that my age (soon to be 58) makes any biologic solution (ACI, DeNovo, Cartiform, etc.) less recommended.

You had mentioned in one of your posts elsewhere in the forum knowing someone in their 50s who had a Cartiform procedure and who is now running again.    I'm curious if you could share whether the procedure was in the patella and roughly where in the "50s" that person was when the procedure was performed?  Answers will be helpful toward making a decision to seek some further consultation about Cartiform out-of-state.

Thanks much!

Best Regards,  LRC

Offline lrc

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #26 on: January 25, 2016, 02:55:19 AM »
... and I forgot to ask the most important question:   How is your recovery going?

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #27 on: January 25, 2016, 02:42:19 PM »
Hi LRC,

I am 4.5 months post surgery and doing fairly well in regards to ADL's.  I can also cycle 80+ miles a week without issue.  The recovery from cartiform typically takes a full year, so I am still relatively early in the recovery process.  I am still not allowed to squat or jog yet.

The lady I was talking about was in her early 50s.  She had the cartiform in her lateral femoral condyle, so that is a bit different than the patella.  My patella lesion was 3.25cm^2.  It sounds like your defect is much smaller.  My Doctor has said age isn't always a defining factor in choosing between biologics and metal/plastic.  He said if the rest of the knee is pristine and there's only one contained defect, biologics can be successful regardless of age.  However, PFJR is a faster recovery.  The downside is you can probably only do light skiing after a pjfr whereas a successful cartiform surgery could get you back to your old self and allow full return to prior activities.

Oh and one more thing. I saw this in the news a few weeks ago.  This was the first Doctor to perform cartiform in Colorado! You may be close to this surgeon http://www.thedenverchannel.com/thenow/1st-colorado-patient-gets-new-cartilage-graft-cartiform-technology-helps-rebuild-torn-knee-ligament

Offline willrunagain

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #28 on: January 25, 2016, 02:44:38 PM »
Disregard the fact they were talking about cartiform to rebuild an ACL haha. Stupid newscasters did not research Knee anatomy, but I assure you Dr. Vidal probably repaired this kids femoral condlye cartilage with the cartiform.

Offline lrc

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Re: My Cartiform Patella Implant/Cyst Removal Surgery 9/8/15
« Reply #29 on: January 25, 2016, 03:32:59 PM »
Thanks Willrunagain,

Great to hear you are doing well!

I appreciate the info and added insight.   Docs here seem to lean toward PFJR,  but the possibility of regaining full ability to ski is what has me interested in a biologic approach.  I'm struggling to find the right local doc to be a partner in finding the best path forward. 

I was aware of that one ACL procedure here in Colorado by Dr. Vidal - but am pretty sure nobody has done any cartilage repair with it yet.   I'd really like to consult with someone experienced with Cartiform (for cartilage repair) before making any next step decisions,  will probably have to make a trip out-of-state.

Thanks again!

LRC
















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