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Author Topic: Hemicap  (Read 380 times)

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Offline Brankon

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Hemicap
« on: December 22, 2019, 10:20:07 PM »
Hi, Iím 29, bad right knee have had history of knee dislocation which gave rise to tibia tubercle operation, arthroscope, steroid and hyaluronic injections. Most recent mri shows grade 4 arthritis behind the knee... went to a cartilage regeneration specialist and he did not inspire confidence, basically said the damage is too big/extensive for him to have confidence that a chondrotissue or aci would work. Itís gone too far. His crappy advice was to wait it out which Is s**t when your in pain. He advises that option to have a partial knee replacement is best option but again would prefer to delay this. Another option Iím seeing is Hemicap implant. Without being a surgeon , this seems like good option as they remove limited bone and not as intrusive or big an operation as a PKR... seeking feedback from anyone that may have had a hemicap implant because the fact there is such little reviews online makes me nervous, is it an option for me? Could be an alternative to just waiting until Iím 50 to get knee replacement or an alternative to a PKR?... again any feedback would be massively appreciated

Offline Vickster

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Re: Hemicap
« Reply #1 on: December 22, 2019, 10:38:40 PM »
There might be some posts if you use the search function. I can't remember anything specifically from the last few years though

The other option is get second and third opinions from patellofemoral specialists, preferably those who have done a number of hemicap surgeries with oversight of long term results in their patients.
The results for cartilage repair are not great for the kneecap due to the shearing forces when bending, so any surgeon is right to be cautious
Have you had the depth of your trochlea assessed etc?

What country are you in? There's a specialist list for PF specialists in the primers in the learning hub which might offer you some options to try. I'm not sure if /how widely the hemicap is available outside the US
« Last Edit: December 22, 2019, 10:50:48 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 Brandon123

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Re: Hemicap
« Reply #2 on: December 26, 2019, 10:47:20 AM »
Brankon, I think you're in Ireland right?

Here is the list of patellofemoral experts: https://www.kneeguru.co.uk/KNEEnotes/primers/whos-who-knee-surgery/whos-who-patellofemoral-surgery

An alternative to partial knee replacement (if we're discussing patella/trochlea only) is fresh osteochondral patellar allograft resurfacing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020115/

Unfortunately, fresh allograft resurfacing is expensive and not available (I think) in many places except U.S.
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 Dave33

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Re: Hemicap
« Reply #3 on: January 04, 2020, 03:08:12 PM »
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6042054/

I didn't have this option presented to me when I had my pfjr done, but I can certainly see the appeal. Pretty much tops in terms of not burning bridges from a bone-sparing perspective, while still addressing damage with arthroplasty.

One thing in skimming the attached; I noticed that one study showed 25% failure due to breakdown of surrounding cartilage, and that's a concern that I would expect as a layperson. Focal damage tends to spread over time, so it might be a short term bridge operation at best, and I'm not sure what risks would be present in converting this implant to a larger partial. But for someone very young, it could be ideal insofar as one could theoretically go from a focal implant to a full partial, and then a full, as opposed to partial to full.

Anyway, best of luck. It's a big decision being so young considering implants, so make sure you talked to as many specialists as possible.