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Author Topic: Denovo NT for lateral femoral condyle cartilage defect  (Read 7877 times)

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Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #15 on: April 26, 2016, 05:46:56 AM »
Thank you razuzin, I hope you are right!

Day 4 after surgery.

The little pain I have continued to subside today. I am not noticing any pain when my leg is resting horizontally or even when using the CPM machine. I feel pain only when the leg is either hanging vertically or when I am doing the active exercises my doctor prescribed. For the last two days, I've been taking just one tablet of painkiller a day (before bed); I feel good enough about the pain today that I decided to stop doing taking the painkiller completely.

My doctor's instructions specified that a big bandaid was sufficient to cover the incision; I tried that yesterday, but switched to a gauze pad and ace wrap today. The bandaid seemed too flimsy for task and was peeling off due to the knee flexing. The wrap has the added benefit of making icing easier/comfortable by protecting the skin from direct contact with the icepacks (with the bandaid, I had to use a t-shirt as a protective layer).

I tried to work from home today. I was able to deal with email and call into meetings while on the CPM machine, but had trouble doing actual work. Part of the problem was my CPM machine setup - I was sitting on the floor, which, even with a cushion, was uncomfortable. I put the CPM machine on the sofa, and that seems to work better, although I still have to balance my laptop on the thigh of my healthy leg.

Finally, a couple of friends from work brought me a nice frozen treat, which was a very pleasant surprise.  :)

P.S. I will probably lessen the frequency of my posts as my recovery continues, otherwise they would become very repetitive. However, I will definitely report on my first post-op doctor's appointment next Wednesday.
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #16 on: April 29, 2016, 02:22:22 AM »
Day 7 after surgery.

I feel like my knee keeps making progress, but at a slower pace than before. My minor post-op pain and swelling are now localized to the left side of my knee.

I am getting better at altering my daily routine to minimize the impact of CPM, active exercises, and icing. For example, I figured out that I can make phone calls or call into work meetings while doing the active exercises.

I've started to go out of my apartment to run errands. I actually feel quite lucky, because several circumstances are lining up just right to make my life on crutches easier:
  • My apartment building has an elevator, which is quite rare in the suburbs.
  • Not only does my car have power seats, which are really helpful for getting in and out, it also has a neat feature that automatically moves the seat back once I open the door to get out of the car.
  • The local grocery store has online ordering and drive-thru pickup, which makes grocery shopping a breeze.

I am bit worried about how much longer I will need to do 6 hours of CPM a day, since I hope to start going to the office next week. I might just have to get a second CPM machine for work.

Overall, though, I am pretty happy with my recovery so far.
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #17 on: May 06, 2016, 02:22:50 AM »
Two weeks after surgery.

Yesterday I had the first post-op appointment with my doctor. He was pleased with how the incision healed up and the overall recovery so far.

I got a chance to read my surgery report, and there were a few interesting items:
  • my cartilage defect was 2.0cm by 1.4cm, grade 4a,
  • the defect extended to the trochlea; before, I thought it was confined to the lateral femoral condyle,
  • before the graft, my doctor did a lateral release. I searched for this procedure online, and it seems to have a bad rap on this forum. The doctor says the purpose of the release is to reduce the pressure on the graft.

Before the doctor's appointment a physical therapist measured how much I could bend the knee (125 degrees). The knee was actually a little swollen because the appointment was in the morning and I didn't have time to ice the knee and keep it elevated before heading out the door. As I am typing this a day later, there's a lot less swelling.

I plan to start going to work full time next week (this week I've been only coming in for a couple of hours a day, for important meetings). I still have to do the CPM machine, so I decided to use it at work during the week and bring it home for the weekend. A coworker who lives in the same building has graciously agreed to help me carry the machine to and from the car on Monday morning and Friday evening. My doctor did acknowledge that the benefits of CPM machine are small, but we both felt that I should continue doing it in order to maximize the chances of success.

I've scheduled a couple of physical therapy sessions, but their efficacy will be limited as I will still be on crutches. Looking forward to walking without them in around 4 weeks!
« Last Edit: May 06, 2016, 04:16:54 AM by 01 »
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #18 on: May 12, 2016, 10:39:28 PM »
Three weeks after surgery.

I am at the halfway point of my 6 weeks on crutches; only three weeks to go until weight bearing! I can hardly wait  :)

The knee continues to slowly improve; at a physical therapy appointment yesterday the PT measured my active flexion at 135 degrees. I still occasionally feel sharp pain when straightening the leg while doing active exercises, although the frequency and severity of the pain seems to be decreasing.

I wanted to mention a couple of products that made my life on crutches easier:
  • Roomba vacuum cleaner: self explanatory :)
  • adidas Capital sling backpack: you pretty much have to have a backpack to carry things around while on crutches. This particular backpack is easy to put on and take off while balancing with one crutch (it only has one strap) or while sitting down (the strap has a buckle).
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #19 on: June 02, 2016, 06:42:21 PM »
Six weeks after surgery.

The six weeks of only toe-touch weight bearing are over. Had an appointment with doctor's assistant yesterday and was cleared to start full weight bearing. For now, I am still using crutches to for support and balance as I walk, but I should be walking without them in about a week. Also, no more CPM machine  :)

The assistant told me I that I deserve a gold star for my range of motion :D. I think she measured 140 degrees active and 150 passive. There are still a few problems with the knee, but the assistant says they are totally normal:
  • sometimes there's a bit of pain when straightening the knee,
  • the knee does swell up a little if I keep the leg vertical for an extended period of time,
  • there's some tissue under the skin which has no feeling; it's likely due to nerve damage from incision.

Tomorrow I will have an MRI to check how the donor cartilage is doing.
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #20 on: June 09, 2016, 10:45:07 PM »
Seven weeks after surgery.

For the last week I've been learning to walk again, first with crutches and then with a cane. Today I am finally walking all on my own :)

I had an MRI on Friday, but it was an MRI for the Denovo NT study I am participating in, and my doctor is not supposed to look at it unless the radiologist notices an abnormality. So I guess this means the MRI was OK, since the radiologist hasn't sounded an alarm.

For the next week or two, I will be doing some low resistance exercises, including stationary bike and 30 degree body weight squats. It will take a few more months until I (hopefully) can do some light running.

Finally, now that I can walk, I decided to stop using my disabled parking permit. I hate giving up the convenience of never having to hunt for a parking spot, but I don't want to take up a spot away from people who really do have trouble walking.
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #21 on: June 25, 2016, 01:04:57 AM »
Two months after surgery.

I am doing great so far. Learned how to walk again pretty quickly, currently doing various strength, balance, and cardio exercises given by physical therapist to build back the strength in my leg after six weeks of crutches. Some exercise examples are 90 degree bodyweight squats, small resistance stationary bike, and balancing on one leg on a cushion.

The best news is that I am feeling the first improvement over my pre-surgery condition. Before the surgery, I felt a bit of pain in my knee when walking up the stairs; that pain seems to be gone now  :)
04/2016 Denovo NT on LFC/trochlea

Offline paladyr

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #22 on: August 16, 2016, 07:50:45 PM »
How are you feeling?

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #23 on: August 17, 2016, 01:20:37 AM »
Doing well, thanks for asking! Still walking and doing various low resistance exercises as prescribed by the physical therapist. Virtually no pain in the knee, but I am not pushing it too hard. I did stress the knee once when I went camping (walked 6 flat miles in two days) and I felt soreness for a few days. This scared me and I swore off any more such adventures.

Physical therapist says I will be starting higher resistance exercises in a couple of months  :)
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #24 on: September 30, 2016, 02:17:44 AM »
Five months after surgery

Went through a sports performance test with the doctor's physical therapist.

The test would determine whether I am good to some light running. Unfortunately I am not there yet; the test showed my operated on leg is 32% weaker than the other -- 25% was the threshold to beat.

The good news is that the test allowed me to overcome some mental blocks. Initially my brain refused to do some parts of the test; for example, the one legged squat. But gradually I eased into it. After the session I have realized how much my knee improved. I was doing quad extensions with a lot of resistance without pain -- something that would have been impossible before surgery.

The physical therapist changed my exercises to focus on the weak leg. Now I am mostly doing variations of one legged squats, quad extensions, and hamstring curls. The hope is that I will get the leg up to strength in about a month.

04/2016 Denovo NT on LFC/trochlea

Offline surfbum

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #25 on: January 11, 2017, 10:43:41 PM »
Why would you even want to start running and shorten the life of the cartilage? What are you going to do when you need a knee replacement at 40? Dude, find a new way of exercising.
30 y/o male

09/2009 - MFC chondroplasty (grade 2-3 tear)
03/2010 - MFC microfracture (OS went in to clean out scar tissue adhesions and I woke up with a MFX)
07/2011 - MFC Denovo NT

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #26 on: January 12, 2017, 01:09:17 AM »
Why would you even want to start running and shorten the life of the cartilage? What are you going to do when you need a knee replacement at 40? Dude, find a new way of exercising.

Thank you for the advice! Who knows if will ever be able to run again anyway  :)
04/2016 Denovo NT on LFC/trochlea

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #27 on: May 03, 2018, 09:20:20 PM »
Two years after surgery

Thought I would provide an update on my long term progress -- I remember not seeing that many long terms updates on Denovo NT specifically when I considering the surgery. Two years since the surgery is a particularly important date to me, since my doctors told me that's how long it may take to reach full recovery.

The ultimate result of my Denovo NT has been a definite success, but with some qualifications.

The most important outcome for me is that I was able to return to playing basketball recreationally. I run, I jump, I pivot, I move laterally, and 99% of the time do not feel anything special in my knee. My top running speed has suffered just a little bit, and my vertical leap have suffered some as well. I do try to keep my playing time short (a few hours a week, at most an hour at a time).

I have purposefully avoided other sports that stress the knee, such as running. I still do strength training (but mostly upper body) and occasional casual hikes and bike rides.

I have not re-built the strength in my post-op leg to match the other leg. Part of the reason is that a couple of the prescribed strength-building exercises can still be painful, which I attribute to the lingering after-effects of the surgery rather than the initial cartilage problem (the pain is in a different spot of the knee).

Overall, I am very satisfied with the outcome of the surgery.

My future plans is to go back to my doctor and try to understand what is preventing me from getting the knee to 100%. I definitely would not risk another surgery though, since I am very happy with the progress I have made and do not want to jeopardize it.
04/2016 Denovo NT on LFC/trochlea

Offline andreaga

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #28 on: May 15, 2018, 10:46:02 PM »
hi, I'm wondering how everything is going for you as you're now 2 years after DeNovo Graft surgery. I'm 5 weeks post op and really would love to hear something positive. Thank you.

Offline 01

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Re: Denovo NT for lateral femoral condyle cartilage defect
« Reply #29 on: May 24, 2018, 07:15:29 PM »
Hi andreaga,

my current progress hasn't changed since my earlier message. At 5 weeks post-op you are still at the beginning of your recovery, so the positive message is that there's still a lot of improvement you should see.
04/2016 Denovo NT on LFC/trochlea