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Author Topic: Journal- One week until my first BMAC (Stem Cell) Injection. Ways to prepare?  (Read 3280 times)

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Offline mulberrysdream

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I'm a 25 year old male, 11 most post Medial Meniscus Transplant and OATs, and still experiencing chronic pain and more recently some new crackling and different pains within the joint and along my patella tendon. This last surgery was my 6th surgery on my right knee.

I'm scheduled for a BMAC injection next week and have read about various ways to prepare in order to get the most benefits from the injection.

Has anyone else undergone BMAC after a similar procedure? What can I expect as far as pain/discomfort during and after? I've been given some valium and hydrocodone to take before the procedure as there is no anesthesia for this. Obviously I have learned to tolerate pain...but the whole bone marrow extraction and injection into my already painful and bone spur filled near is not very appealing....although hopefully it will be worth it!

I will keep this updated along the way to share my progress if people are interested :)

Thanks for any and all help!
Right Knee-
MT Menisectomy, Chondroplasty, 10/16
MT Repair, Chondroplasty, Clean out+ BMAC/PRP7/16
Meniscus Transplant & OATs 8/15
Notchplasty,Osteophyte Removal,Prep for MT/OATs 7/15
loose body removal, menisectomy- 4/15
Menisctomy, loose body removal1/14
Lateral Release08
Meniscus Repar 07

Offline dal_knee

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Were all these surgeries done by the same surgeon??  Who is your surgeon?

What are you trying to treat with BMAC?  You may be able to retard somewhat the OA, but after so many knee surgeries this may not help very much at all.

There is not much you can do to prep for BMAC.   I assume they told you to avoid anti-inflammatories for 1 month prior.  And for 3 months afterward.

Depending on physician experience and needle gauge, the extraction could be painful.   And then depending on how much inflammation is already present within knee joint, that, again might be painful.  Everyone is different. 
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 mulberrysdream

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Three surgeons, who've each done two surgeries. First two were done at HSS, and went great. Second two were done here in Vail Colorado (where I have called home for 3 years), out of Vail Summit Orthopedics by Dr Joseph. He is a really friendly guy, but absolutely butchered my knee and lied to me about hoq much of my medial meniscus was left. Stupidly, I let him try to fix me again...and was told after surgery I did not have a micro fracture...when in fact I had. I also had to beg for a PT script.

My most recent two were done by Dr Laprade out of the Steadman Clinic here in vail. Words can't describe how amazing Laprade is. I won't be letting anyone else aside from him open my knee up ever again. I am extremely lucky to live less than two miles from the Steadman Clinic...where I should've gone when I first got hurt out here a few years ago.

My goal with BMAC is to try and buy a little more time with the meniscus/oats...hopefully slow down my OA (grade 3-4). I am having BMAC done by Dr Evans out of the Steadman clinic, he is their Regenetative Medicine guy. I meet with Laprade next Wednesday before my Friday injections to discuss it with him in person and also to try to better understand why I have been having more pain in the last 6 weeks than I have in months....and to find out if a giant bone spur above my medial joint line is causing some of these new issues (the sour has grown in the last few months)

I may also try PRP in a few weeks, after we see how I respond to BMAC, to treat some tendinitis I have developed in my patella tendon.

What is your reason behind thinking due to my number of surgeries, the BMAC may not do anything?

I have certainly heard mixed ideas on what they think it could do for me, at this point I'm grabbing onto anything that can potentially help improve my situation. I was told by Dr Evans that he has never seen a knee as far gone as mine in someone remotely close to me in age.
Right Knee-
MT Menisectomy, Chondroplasty, 10/16
MT Repair, Chondroplasty, Clean out+ BMAC/PRP7/16
Meniscus Transplant & OATs 8/15
Notchplasty,Osteophyte Removal,Prep for MT/OATs 7/15
loose body removal, menisectomy- 4/15
Menisctomy, loose body removal1/14
Lateral Release08
Meniscus Repar 07

Offline dal_knee

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The reason I say that is because it make more sense to try a stem cell injection BEFORE going the surgical route, since many of the types of surgeries you've had are known to cause OA that would not have otherwise developed.   

Since LaPrade did your last two, would you mind writing what kind of medium to longer term outlook he has envisioned for your case?
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 mulberrysdream

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If only I had seen Laprade when I first got hurt out here instead of going to Vail Summit Orthopedics...I would be in a much better position and likely wouldn't have developed the severe OA that I did in such a short period of time. Hindsight is always 20/20.

Laprade's hope is that the OATs and MT will help SLOW the progression of my OA and allow me to live a mostly normal life (including getting back to snowboarding...hopefully this year?). Unfortunately there is no way to stop the OA, and my current concern is that it is progressing more rapidly than anticipated, or that I possibly have another cartilage issue under my kneecap.

I go see Laprade again tomorrow (11 months post MT and OATs) to try to figure out why I have been in so much more pain the past 2 months (maybe tendonitis...maybe scar tissue...or something more significant?). I also hope to finally learn from him directly (not from his PA or AT) what he thinks BMAC will do for me. I've talked this over with his PA and AT ,as well as my PT, in addition to multiple consultations with Dr. Evan's office...but I haven't yet had a long, in person, conversation about this with Dr. Laprade. I look forward to seeing him tomorrow and hopefully will figure out what exactly I've got going on at the moment, and how we can fix it.

It's quite frustrating to be almost a year out of this surgery and still be in such significant pain and limited in my activities. I am hoping it is just tendonitis from overuse(getting excited and ahead of myself the past few months after gaining 95% of all my strength back), and my guess is that some of my clicking and pain is the result of some scar tissue build-up and a large bone spur below my medial joint line pushing in on my MCL and joint in general.

I'll post an update tomorrow after I talk with Dr. Laprade and learn what the next steps are in this long journey...
Right Knee-
MT Menisectomy, Chondroplasty, 10/16
MT Repair, Chondroplasty, Clean out+ BMAC/PRP7/16
Meniscus Transplant & OATs 8/15
Notchplasty,Osteophyte Removal,Prep for MT/OATs 7/15
loose body removal, menisectomy- 4/15
Menisctomy, loose body removal1/14
Lateral Release08
Meniscus Repar 07


Offline mulberrysdream

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Not getting BMAC tomorrow.

I just found out that i've torn my meniscus transplant in the posterior region :(

I'm waiting for a call back to schedule surgery for Laprade to look around and clean things out, and assess the situation and possibly do a repair.

Needless to say i'm not feeling too happy right now.
Right Knee-
MT Menisectomy, Chondroplasty, 10/16
MT Repair, Chondroplasty, Clean out+ BMAC/PRP7/16
Meniscus Transplant & OATs 8/15
Notchplasty,Osteophyte Removal,Prep for MT/OATs 7/15
loose body removal, menisectomy- 4/15
Menisctomy, loose body removal1/14
Lateral Release08
Meniscus Repar 07

Offline dal_knee

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Is yours a cadaver implant or CMI?  If it's from a cadaver do you know how old was the donor ?
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 mulberrysdream

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Cadaver. All I know is they were "young". I'm 25 and I know they were not older than me.

My hope is that the tear is small enough, and not at the root, so that it could possibly be resolved with BMAC....but won't know until they open me up :(
Right Knee-
MT Menisectomy, Chondroplasty, 10/16
MT Repair, Chondroplasty, Clean out+ BMAC/PRP7/16
Meniscus Transplant & OATs 8/15
Notchplasty,Osteophyte Removal,Prep for MT/OATs 7/15
loose body removal, menisectomy- 4/15
Menisctomy, loose body removal1/14
Lateral Release08
Meniscus Repar 07

Offline dsamp15

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I was unaware that we can even do surgery to swap out the entire meniscus, that's pretty rad. Best of luck with your upcoming appts and procedures. All of us on here can relate to the frustration of knee problems and set backs.

Offline psny

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How did you re-tear your meniscus after the transplant? Also, why is the OA progressing if there is a normally functioning meniscus there to prevent uneven loading? Is it just traumatic OA from all of the surgeries?

Offline mulberrysdream

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I didn't re-tear it myself. I'm in the lucky small percentage of people who got what looked like a perfect graft...but apparently wasn't. Dr. Laprade said he had NEVER seen a tear like mine. That's not what you want to hear from one of the leading knee surgeons in the world...But he put 17 stitches in it to make damn sure it stays together. He also noted that the rest of it looked perfect and the bone plugs had all settled perfectly.

OA was really bad last year when I had the transplant, as the result of about 18 months of being bone on bone from a previous surgery and my prior surgeon telling me I was totally fine. It is not traumatic OA, but the result of bone on bone and cartilage defects.

I am now undergoing a series of BMAC injections (starting with 4) in hopes of improving the cartilage throughout my knee, and general healing properties as well...but really to slow the progression of OA as much as possible.

At this rate I'll be lucky if I can put off a knee replacement until 45.

I had my first BMAC during surgery on 7/28, combined with PRP. I had my second BMAC treatment yesterday, and it went a lot more smoothly and comfortably than I expected. I'm a bit sore and swollen today (no surprise as I swell VERY EASILY) and my back is sore from where the bone marrow was harvested...this happened a few weeks ago as well and is no big deal. Pain medicine and muscle relaxers make it very tolerable.

Yesterday the Dr. I am seeing for BMAC (not the one given during surgery) out of Thrive MD sent out a sample of fluid he drained from my knee before the injection to be tested for "A2M"...which is a new biological treatment that can potentially treat OA at the molecular level. Not everyone is eligible for it..but I hope I am.

I'm 25 and grasping onto anything I can....I don't want a replacement and I want to get back to having a normal life. Ideally snowboarding would be nice...but I just want to walk without pain. It's been years.
Right Knee-
MT Menisectomy, Chondroplasty, 10/16
MT Repair, Chondroplasty, Clean out+ BMAC/PRP7/16
Meniscus Transplant & OATs 8/15
Notchplasty,Osteophyte Removal,Prep for MT/OATs 7/15
loose body removal, menisectomy- 4/15
Menisctomy, loose body removal1/14
Lateral Release08
Meniscus Repar 07















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