Patellar cartilage tear, considering ACI/Denovo ?

[poohray32]

Sorry all, I never knew my thread from November went thru..

So, it appears I'm the 3rd person on here that has had Cartiform surgery!!  I'm at 12 weeks recovery now.  My OS/Pt are extremely conservative and I appreciate that.. 

I'm finally starting to do more challenging exercises now.  The first phases of recovery are crazy limited because of the weight bearing issues and protecting the graft from forces and impact.

I'm now doing the elliptical everyday, 1 leg down presses on the biodex machine, seated squats and some balancing on one leg while throwing a tiny small med ball at the trampoline (these are my favorite!). PT had me try lunges but that hurt like hell ad put me back a week.

They've given me a portable tens unit/ivf machine for pain relief bc there are days where I still feel like crap.  That's too be expected bc this surgery was pretty invasive.  My knee still swells up considerably and is still warm to the touch but I'm SLOWLY getting better

[willrunagain]

Poohray - It is strange that your PT already had you doing lunges at only 12 weeks.  I had my cartiform surgery done by Dr. Farr and his rehab guidelines say NO SQUATS or LUNGES until 6 months in bold print.  He said I can bike as much as I want, but was adamant about me avoiding loading my knee too much before 6 months.

[ArmstrongK]

CanyonKing:  Did you have grade 4 patella cartilage lesion/defect?  Can you jog? 

And, what is ftg arthrosurface inlay? 

[poohray32]

Willrunagain - Yes, I agree I thought they were crazy. I haven't tried them since, even though they were modified and I barely descended they hurt like a m*$&!  I would love a copy of your rehab guideline sheet that would be so awesome. I can't find one anywhere online.  My doctor uses the same guidelines as the CARTICEL REHAB and gave me those handouts after surgery.

I can say that I am only going to PT once a week now, but I am in constant pain all day long now.  Probably from overworking it..

[poohray32]

ALSO Willrunagain and CanyonKing - do either one of you ever wear a knee brace or specific unloader brace???  At the end of SOME of my days I am in so much pain I start to limp ;(

[willrunagain]

Sorry all. I was about to post my rehab protocol and realized it is copyrighted.  I thought it was strange to have a copyright on a rehab protocol!?

[poohray32]

Willrunagain.  Its been 13 weeks since my Cartiform surgery.  Taking 2 weeks off of PT to rest my irritated knee per my therapist.  ---- surely due to LUNGES😡  I will still do some light exercises at home.  As for the bracing I had found a good bit of relief with the Donjoy Reaction Web bracing (after my mfx surgery on my trochlea and prior to the Cartiform surgery on my patella.)

How long did you go to physical therapy at an office?

[willrunagain]

Poohray - I only did physical therapy at a clinic for the first 3 months post surgery.  Now I go to the gym and do my PT exercises on my own.  I just don't feel like paying the $30 copay for every PT session when all my therapist does is give me one new exercise a week.  My sister has a doctorate of Physical Therapy, so I've just been having her guide me through my rehab protocol for free   

I may look into that knee brace.  Thanks for the suggestion.

[taylob]

Poohray32: Been a while since you've posted and I wanted to know how things are progressing regarding your Cartiform. I'm new, only just over 2 weeks, but eager to learn more. I did get that lunges aren't going to work at 3 months out, so that's good to know.

Anyway, wishing you the best!

[nkaufman]

...
Don't accept microfracture, it's unethical due to the subchondral bone damage it creates.

Another option would be Dr Saw in Malaysia or Dr Broyles in Baton Rouge, if affordable.    Dr Saw claims 95% matching to hyaline.

I thought Dr Broyles did micro-drilling. Is this different from micro-fracture?

Thanks,

[dal_knee]

It's similar to microfracture but uses holes that are spaced much closer and are deep enough to access the bone marrow space to generate a lot of bone bleeding. Can't believe it's taken this long for orthos to make an improvement to the microfracture technique. It's like they have no knowledge of the scientific method

[nkaufman]

It's similar to microfracture but uses holes that are spaced much closer and are deep enough to access the bone marrow space to generate a lot of bone bleeding. Can't believe it's taken this long for orthos to make an improvement to the microfracture technique. It's like they have no knowledge of the scientific method

The reason I ask is:

From Dr. Broyles website - "The Augmented Marrow Simulation procedure involves an outpatient microdrilling surgery"

From Arthrex/Cartiform - https://www.arthrex.com/resources/patient-education-brochure/0i_0rZOz8UWKGgFPYCmmTA/a-patients-guide-to-cartiform-treatment-options -
"A microfracture procedure, also known as a marrow stimulation technique, consists of removing the damaged cartilage until a border of healthy cartilage is found."

Hence was thinking that perhaps people use the terms interchangeably. Both the above talk about Marrow Simulation.

Thanks,