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Author Topic: Post Osteochondral Allograft- anyone experience clicking sensation?  (Read 1130 times)

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Offline ArmstrongK

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 Hi everyone-

I had an osteotomy plus a patella osteochondral allograft in September 2017.
Things are going ok but Iíve noticed a clicking/snapping sensation under the patella recently and Iím not sure what that is. Has anyone else experienced this?
Should I be worried?
Also- for all you people out there who have had a patella osteochondral allograft-
When did you start trying stairs? When did you start trying the elliptical?
Was knee extension (ie: short arc quads) with ankle weights painful?

Thanks guys!

Offline Brandon123

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Re: Post Osteochondral Allograft- anyone experience clicking sensation?
« Reply #1 on: February 18, 2018, 01:28:17 PM »
Hi Armstrong,

I haven't had a patella osteochondral allograft, but I think it would probably be a good idea to check this clicking/snapping sensation with your OS, just to be on the safe side.

What kind of patella cartilage damage did you have?
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline ArmstrongK

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Re: Post Osteochondral Allograft- anyone experience clicking sensation?
« Reply #2 on: February 18, 2018, 09:13:59 PM »
I had grade 4 cartilage damage- just the patella.  Yeah, I'm going to ask them about the clicking/snapping sensation, I have a follow-up appointment in about a week. 

Offline Baddchad

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Re: Post Osteochondral Allograft- anyone experience clicking sensation?
« Reply #3 on: February 20, 2018, 01:36:00 AM »
Hello Armstrong,

For some reason this site is not allowing me to respond to your PM so I have to post on this thread.  I think you have the background on my surgery (almost 2 years) but here's what I can tell you. 

The beginning of my therapy progressed and I kept making strides through about October - November 2016.  Then, my gains slowed down.  Sorry I cannot remember when I started doing stairs but I do remember that my goal was to bike normally and be functional with a lot of things by our 4th of July trip.  That all worked out, which was only 3 months post op. 

The peak of my knee health wasn't until August of 2017.  At that time I had run in straight line / sprints, in grass.  I was up to 100 lbs for single leg presses.  I was able to bike, complete 50-80 stories on a stair mill, elliptical was no issue, biking at a fairly high intensity...etc..

The problem is the knee is still really stiff a lot and I never felt like I've gone DOWN steps right since the surgery, be it mental or physical, I just don't. 

Anyhow, back in August I was pushing it harder to get more out of it and I tried to run on a treadmill at about 8MPH.  I did that on August 1st for about 2 minutes.. No issue

Three weeks later I did a pretty heavy leg routine and I tried to run for 3 minutes and the day after it got really sore.  During that leg workout I did some machine squats, presses, lunges, bike...etc.. Like I said a big day.

The knee got very sore for a few weeks and I went into a panic.  I went to see the Dr. in September 2017 and he said I probably pushed it "outside the envelope of function." 

My Dr. is James Bradley, UPMC St. Margarets, Pittsburgh.  He is the team physician for the Pittsburgh Steelers.  The doc now tells me that he would not even perform the cartiform implant if I needed this surgery now.  He said what they do now is take a healthy patella from a cadaver and then cut the center of my patella out and insert in the exact piece from the donor. He said the surgery is tricky but the results are good.  The thought is that having bone grown into bone is better than trying to grow cartilage to bone.  The donor would already have good cartilage so it would just be like healing a broken arm in theory.

I now have a one year old and am 2 months away from moving to a new home.  Due to my knee issues when we decided to move we got a large ranch house that is ONE story.  I literally have no steps in the entire house.  We did a renovation and I make it "knee friendly".  I even have a walk in shower.  So, I think I will probably summon up the courage to go at this one more time with my much better rehab environment.  I have all the paperwork to get a new MRI and get on the donor list.  He did say that once I commit, I must get the surgery within like 6 days of the phone call because it's live tissue.

Sorry, let me talk about you.  I would just say be patient and DO NOT panic at every little snap, pop, or ache.  I have learned that only a little needs to go wrong with a knee for the symptoms to feel like MAJOR problems and that is not the case.  I had really bad days, really good days...etc. As a rule of thumb, not keeping the knee moving is bad because it gets too stiff.  Over doing it, can cause inflammation and that is the thing you will fight the most.  Once you get through the basics of therapy, I doubt you will do anything that will "undo" your progress.  I was too afraid something would happen but it's just a wear issue I think.  I literally did some sort of rehab at least 6 days a week for a full 6 months.  Then, I cut it back to like 4-5 times a week and sometimes would go to the gym and just pedal the bike with little resistance just to keep it moving.  I did a ton of running in place and against resistance bands.  I would recommend that.  Like I said, the last thing to come is walking down steps correctly.  I still don't.  It's just mentally hard for me to weight bear going down after so long of it hurting. Sorry for the novel but I'm 22 months post op and have lots of strength in many motions.  However, I have no strength or comfort with the leg extension motion, none.  Other things such as lawn mowing and snow blowing are difficult because I have a ton of power pushing forward but cannot pull the mower backwards.  Anything that really loads the cap is just uncomfortable and will eventually inflame the joint.  I will say that I am shocked that I can do a stair mill (not stairclimber) as long as I can. It is the only piece of cardio equipment that I've found I can get my heart rate up before my knee starts to get sore.  I am in really good shape so it's not that I cannot do a lot, just need to really get moving to get my heart rate up.  Hopefully things are going well for you and something I've written about helps you.  I felt very alone during this process so reach out for comfort.  I think this site is hard to use so email at [email protected] 

one thing I should also note is that I still have my screws in my knee and he says they are fine in there and I have full range of motion.  I can bend my operated knee as far in any direction as I could pre surgery.  I feel my leg is about 100% fine but just the cap is not quite right and limits my abilities to function at high levels.  Also, I can squat down to get underneath things and wax a car, things like that.  Take it easy...

Offline Baddchad

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Re: Post Osteochondral Allograft- anyone experience clicking sensation?
« Reply #4 on: February 20, 2018, 01:43:09 AM »
Armstrong,

one more thing. I keep thinking of one more things... How old are you?  I got my surgery at 41 so I was a late candidate.  I'm guessing you are younger and this will go easier for you.  I would say looking at all of this that the functional exercises are much better than the stationary leg presses and lunges...etc.. Also, don't panic when you have tightness or swelling in the joint.  That will last for a long time.  As long as you don't have pain with the exercise or the "pops" I would not panic.  I had a ton of that stuff and every time they said "does it hurt when it pops"  It never did.  Ok, good luck, just email me if you want to trade notes..later..

Offline Brandon123

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Re: Post Osteochondral Allograft- anyone experience clicking sensation?
« Reply #5 on: February 20, 2018, 04:27:08 PM »
I had grade 4 cartilage damage- just the patella.  Yeah, I'm going to ask them about the clicking/snapping sensation, I have a follow-up appointment in about a week.

Ok, I understand. Let us know what the doc says!
RK sharp pain while running, diagnosis chondromalacia patellae 6/09
RK arthroscopic chondroplasty 9/09
RK rehab, recovery, 90% normal, started running again -> back to square one 5/15
RK diagnosis patellofemoral arthritis + LK diagnosis chondromalacia patellae 8/15 -> conservative treatment

Offline ArmstrongK

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Re: Post Osteochondral Allograft- anyone experience clicking sensation?
« Reply #6 on: February 26, 2018, 01:44:52 AM »
Thank you Baddchad and Brandon for responding.  Baddchad- I sent you an email.
This recovery has been super rough and sometimes very depressing and frustrating.
Iím still sometimes having pain with simple walking and knee extension exercises (like short arc quads).  Though riding the bike doesnít seem to bother me.
Getting a PRP injection tomorrow- I hope that helps.
Keep you posted!















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