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Author Topic: looking at a MEGA oats surgery  (Read 1702 times)

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Offline fro60ol

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looking at a MEGA oats surgery
« on: December 06, 2017, 06:52:50 PM »
good morning all,
been reading a bunch on here since June when i had my first knee surgery. at that time i had a large loose body taken out along with a fix to my meniscus.  was doing well for about two month post surgery then started having issues again, locking, catching , clicking, giving out, etc. so i followed up with my Dr and went for a follow up MRI. had that don in OCT finally was able to see home in NOV and he said i will need OATS surgery. he does not handle many OATS surgeries so he referred me to 2 other Drs. unfortunately neither took my insurance but i was able to find a Dr that did. i saw him yesterday and he is recommending a MEGA OATS procedure. botht he fem and the tib aare bone on bone.


has anyone ever had this done and can offer some tips.  any infomation will be helpful

Offline Vickster

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Re: looking at a MEGA oats surgery
« Reply #1 on: December 06, 2017, 07:00:21 PM »
Ask about success rates for kissing defects in weight bearing areas (assuming WB).  How big are the defects? Is there any other damage? How much meniscus do you have? Medial or lateral?
Do you need an osteotomy to realign the joint and stop the plugs just rubbing away again? Seems unusual to have such rapid deterioration on the two surfaces
If it's just one compartment, have you considered other cartilage repair options and different ones even such as a PKR
I'd be getting multiple opinions and understanding all the variables, esp daily rehab time (reckon you'll be looking at 12 months plus before feeling half way better)

There's good stuff in the learning portfolio like http://www.kneeguru.co.uk/KNEEnotes/articles/expert-views/2017/cartilage-repair-options

Good luck :)
« Last Edit: December 06, 2017, 07:06:20 PM by Vickster »
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #2 on: December 06, 2017, 07:22:29 PM »
thank you for your response... i am too young for a TKR (32)... he said the successes rate sis good even for what i have.   i believe its a Lateral.

before i had the surgery in June the Dr saw these issues and was going to do micro fracture but the ares was way too big  3cmX 3cm

i am going for x-rays to determine if i have an alignment issue.

Offline Vickster

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Re: looking at a MEGA oats surgery
« Reply #3 on: December 06, 2017, 07:37:15 PM »
I said PKR but yes probably still too young if planning on an active lifestyle

The stem cell augmented microfracture might be an option

Lateral is I believe more of an issue. Has a meniscus replacement also been mooted as with the shock absorption gone the success might be compromised.

Get CT as well as X-ray if required

What country are you in?
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #4 on: December 06, 2017, 08:13:26 PM »
you did say PKR not total  my mistake!!! we have not discussed meniscus replacement      i am at work now  tomorrow i will bring in all the notes in have from the Dr


i am in the US   

Offline badleftknee1

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Re: looking at a MEGA oats surgery
« Reply #5 on: December 14, 2017, 02:51:06 AM »
Hey Fro, I also posted a similar story on the blog awhile back. I am also 32, active in sports all my life and more of a weekend warrior now a Days. Anyway, I have a massive area of cartilage loss over my tibia and a a good deal of wearing away on my medial femoral condyle (“kissing lesions”). I only found out after having a relatively acute Soccer injury with pain that didn’t go away- meaning I was living with pretty severe cartilage loss prior to this but it was not symptomatic. I saw a few different surgeons, and tried to best understand options and recoveries. It’s really a lot of information and takes time to understnd, and different opinions to get comfortable with, I’m not completely there yet.

A few things I learned- filling in cartilage is hard to do, you are not looking at a straight forward outcome- id say 75% or so are successful, and the larger defect the worse outcome. With large lesions the only way to fill it all in is with OATS allograft, for me a truly successful outcome in a patient who is as active as you want to be, particularly long term, say 2+ years later after you have finally recovered from a very long rehab process, is very hard to find. Another thing to consider is that you need to correct what lead to the defect in the first place- e.g. missing meniscus may require a meniscal transplant which automatically limits your activity level as cutting aports not advised, a Valgus deformity of the knee may need high tibial osteotomy, etc. finally, remember all of these procedures are ultimately just bridges to knee replacement. Although technically too young for partial knees (Oxford in particular) have shown that 15-20 years of durability can happen- and if they fail a lot of times it’s due to replaceable inserts etc; so they are really pretty good option once you get to the “right age” which is all a Big debate.

For me, I decided against a Big alllograft and meniscal transplant up front- I went with a microfracture on one of my many lesions, the one that was thought to be causing the most pain. I’m not doing a “definitive” correction but if I can stay active and pain-limited I will take it over my limited activity levels after meniscal transplant. The other concern I had was that if the impants fail the you may be in a worse place than you started and may need a more urgent PKR just to do your daily activities.

That’s just my 2 cents. Everyone is different and procedures seem to be getting better. Check out a blog by lateralmeniscusissues, 5-6 months post op form lateral meniscus transplant and OATS- long recovery but so far so good (compared to so many other horror stories on here!) .

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #6 on: December 15, 2017, 06:32:30 PM »
thank you very much for your input!

i know this is just a bridge to a TKR i accept it and i am ok with it.  given all the factors for me ( size of the defect, My weight, muscle mass) micro fracture on my femur is just not a good option  my first DR said it was be less than 30% chance of success rate.   


i had and x-ray to show how my alignment was with my hip/knee/and ankle... had a friend look at the film who is a surgeon (not knee) and she said it looked "ok"  i see my dr again jan 2


are there any questions that you guys have had that i should ask the DR?

Offline badleftknee1

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Re: looking at a MEGA oats surgery
« Reply #7 on: December 27, 2017, 03:59:54 AM »
Hey Fro,

I guess if I were you I would ask...

1) what does he think the success rate will be...how many of these large OATS procedures have you done? How are those folks doing?

2) Do you expect a revision surgery?

3) Do you/we need to consider an additional correctional surgery with the OATS (meniscal transplant, HTO, etc)....if not, what's to say the replacement cartilage won't just wear out

4) What is are my activity limitations post surgery? (than consider how this compares to what your limitations are now)

5) What is my recovery like (weeks NWB?) (Surgeons notoriously bad at not knowing how brutal and protracted recoveries can be...big OATS procedures from what Ive read 12-24 months to get back to baseline)

6) Are knee replacements less successful after large OATS procedures? (there is literature on this out there)

Thats all I got for now!

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #8 on: December 27, 2017, 04:22:32 PM »
thank you very much...

i see him this Tuesday and will bring these questions with me along with a few others.


i am excited and nervous at the same time about this. i really am ready to feel better.

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #9 on: January 05, 2018, 03:44:49 PM »
quick update, say the Dr. the other day still waiting on the tissue bank to find matching donor for me. annoyed about it because it pushes my surgery back.

right now it a waiting game

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #10 on: January 31, 2018, 01:12:12 PM »
another update, still waiting on a donor. spoke to the Dr. and he says i am first in line, so we will see when it happens. i hope its soon the last few weeks have been getting worse.

Offline fro60ol

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Re: looking at a MEGA oats surgery
« Reply #11 on: February 26, 2018, 02:11:09 PM »
quick update, i am still waiting on a donor. i have fallen and my knee has given out 5/6 times in the last week or two. the Dr did give me some pain medicine that has defiantly help me sleep at night.... hoping for a donor soon i am read to get this done!















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