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Author Topic: OATs and Knee Brace  (Read 5205 times)

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jackpowell

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OATs and Knee Brace
« on: June 04, 2004, 01:52:35 AM »
Is the standard protocol for OATs to have the knee in a brace locked at zero degree except when doing CPM for several weeks.  I know that is true for ACI but what about OATs?

If so, how many weeks do you wear the brace for?

Offline JessToni

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Re: OATs and Knee Brace
« Reply #1 on: June 04, 2004, 03:58:25 AM »
I just had the oats procedure as well as some other work done.  I have a bledsoe brace locked at zero except for being in the CPM machine.  I will have to wear the brace for eight weeks.  let me know if you have any more questions :)  I am almost three weeks out from surgery.

Jess

Offline JG

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Re: OATs and Knee Brace
« Reply #2 on: June 04, 2004, 04:29:08 AM »
Jack,

I wore mine for about 6 weeks.  Have you decided on what procedure you are having?

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

jackpowell

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Re: OATs and Knee Brace
« Reply #3 on: June 04, 2004, 04:41:01 AM »
Hi Jess and Janice,

      Thank you both for your responses.  I just had exploratory arthroscopy and it was determined that since my MFC defect was only 1 cm2, ACI is out and I will be having an autograft OATs.  I am waiting insurance approval and then wait for surgery.  I am looking at mid to late summer I guess.

Jess, how large was your defect and how are you doing?

Janice, how are you coming along?  Thank you again for talking to me on the phone a while back, I learned a lot about the various options.

Jack

Offline JessToni

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Re: OATs and Knee Brace
« Reply #4 on: June 04, 2004, 04:57:56 AM »
my entired medial compartment has damage, but there was one area that was significantly worse off from a past OCD lesion, so that is the area that was fixed with autograft OATs.  the area was about 1.2 cm.
I had a high tibial osteotomy done at the same time to shift my weight off of the medial compartment.  My dr. likes to do the two procedures together.

I am doing okay so far.  still quite a bit of pain and not sleeping well, but the doctor is happy with the progress so far.  i have been using the CPM machine for 4 hours a day and I am still not able to do a straight leg raise for the life of me.  

Please let me know if you have any other questions :)

Offline JG

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Re: OATs and Knee Brace
« Reply #5 on: June 04, 2004, 09:36:07 AM »
Hi Jack,

Things are good.  I am about 14 months out.  I just had a surgery about 6 weeks ago to see how the grafts were healing as well as to check on some "noise" and medial joint pain.  

I actually had an MRI right before the surgery that showed subchondral cysts...which meant that the grafts either weren't healing or were still in the process of healing.  

As it turns out the grafts looked really good, which was a relief.   They will probably need another 12 months to fully heal.  My OS said he was really surprised because of  the number of grafts he transfered in.  Keep in mind my small defect was 2 cm2 and the large one was much much larger (it did take 15 grafts that were 10 - 15 mm each).  The limits of the procedure was certainly stretched.  Overall, I ended up having really bad scar tissue/adhesions.  He did a lateral and medial release and lysis of the adhesions.

I do have some nagging IT band and peroneal nerve (swelling from the last surgery putting pressure on it) problems, but my medial joint is the most problematic.   It's been bothering me for about 5 months.  The surgery didn't show anything and I am beginning to think maybe the MFC grafts are not doing as well as the trochlear grafts.  

I've stayed fairly active.  I am on 3 weeks no activity right now to see if I can get the swelling out.  Prior to surgery I was cycling about 100 - 125 miles per week, swimming and even jogging (only 15 minutes a couple times per week).

I still need to have my lateral tibial plateau fixed and my only option is microfracture.  Interestingly enough, I had so much scar tissue formation that is covered my lateral tibial plateau defect.   My OS left it and thinks it will last a year of two.  It is just laying on top of the defect so it could easily detach with on swift step.

It's nice that you are having an autograft for your OATS.  I couldn't have the autografts because I needed way more than my knee could provide.  Also, there is really no wait for you other than your doctors schedule and insurance company.  I would total encourage you to not even put a foot down on the surgery leg for at least 6 weeks.  I stayed totally NWB for 8 and then partial for 4 weeks.  The best advice I received was from my PT and OS...don't put a toe down on the floor and give the grafts time to heal.  It's easy to disturb the grafts.  I checked in with my PT at 5 days post-op.  We agreed that I would check in about once every 2 weeks and actually started 1x/week at week 8 and 2x/week when I was fulling weight bearing.  Both my PT and OS said they would rather me no do anything than push it too hard.  It was really good advice.

If you have any question, you can give me a call.  If you don't have my number, just email me.

Best of luck...Janice  
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline kathleenj

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Re: OATs and Knee Brace
« Reply #6 on: June 04, 2004, 04:56:43 PM »
Hi Jack,

I had an OATS done in Dec. of 2003 for a 10 mm defect on the MFC.  I was not in a brace nor a CPM machine.  I was NWB for 4 weeks and then partial for about another 2-3.   Unfortunately my graft has shifted and I will be having the OATS redone next week.  I truly believe that the reason it shifted is because I started weight bearing too soon and began working again too soon as well.  Just as Janice has mentioned, I too, cannot stress the importance of being NWB for as long as possible to let the grafts heal.  Do not even toe touch.  It is so important, as I am a perfect example of why.
Good luck with your surgery and if you have any questions feel free to ask.
Kathy
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline JG

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Re: OATs and Knee Brace
« Reply #7 on: June 04, 2004, 10:46:57 PM »
Kathleen,

Funny thing...I am beginning to wonder if my medial joint pain is due to 1 slip I had about 2 weeks post-op.  I hit water with my crutch tip and it slide out from under me.  I used my left (operated leg) to catch myself.  Other than that, I never even put a toe down.

Good luck next week...Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

jackpowell

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Re: OATs and Knee Brace
« Reply #8 on: June 05, 2004, 08:13:07 PM »
Hi Kathleen,

I am sorry to hear about what happened.  That is terrible.  I am going to be very cautious after the surgery.  I have studied tons of OATs rehab protocols and pieced them all together to develop a very detailed, diciplined and conservative rehab schedule.  Since you are going through it again, I can forward a copy of it for you.  Jess may also be interested since she is early in the rehab process.  Let me know if you want it and I can e-mail it to you.

Jack

jackpowell

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Re: OATs and Knee Brace
« Reply #9 on: June 05, 2004, 08:15:51 PM »
Hi Janice,

The first thing I want to say is that you are simply amazing.  Your perserverence and attitude keeps us knee sufferers all going.

I can't believe you were actually jogging!!  Plus all the cycling and swimming.  You are an inspiration to the rest of us.  

Please keep posting.

Jack

Offline kathleenj

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Re: OATs and Knee Brace
« Reply #10 on: June 07, 2004, 09:51:02 PM »
Janice,

That medial joint line pain is really disheartening isnt it?
That is how I began to know that something just wasnt right with my graft.  I was certain that it just didnt feel right and sure enough my gut instinct was right.  
I am not saying that is the case with your pain, I just know how scarey it can be to think that after all this time things arent healing right.  Since your OS mentioned the grafts looked good, I would try not to worry too much.  You had a lot of work done in there and like he said, it is still healing.

Just out of curiousity,  was that little fall you took after your 1st surgery or after the one about 6 weeks ago?
You mentioned not toe touching so I would have to assume it was after the 1st and if thats the case,  I am sure your OS would have noticed something wrong by now.  

Hang in there, and keep me posted as to how things are coming along.

Thanks for the well wishes this week.  I am beginning to get a bit anxious as my surgery is scheduled on thursday.    
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline kathleenj

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Re: OATs and Knee Brace
« Reply #11 on: June 07, 2004, 09:58:51 PM »
Jack,

Thanks for the offer to share your rehab research with me.  I think for now I will hold off on looking at it.  Unfortunately my surgery is this thursday and my stomach is already in knots and I am afraid that if I start to read about rehab it may send me over the edge.  
People are telling me that it good that I have done this before so I know what to expect....honestly, I would rather not know what to expect.  I was much more relaxed the first time around.  (if that makes any sense)
I will post after the surgery and then maybe if you dont mind I would love to have a look at what you have come up with.  
Thanks again.
Kathy
right knee oats 12/03 scope autograft
right knee revision oats 6/04 open autograft
loa, plica excision, chondroplasty 12/04
synvisc 5/05
patellofemoral OA
patella baja

Offline JG

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Re: OATs and Knee Brace
« Reply #12 on: June 08, 2004, 02:02:46 AM »
Kathleen,

My fall was after the big mosaicplasty procedure in April 2003.   Believe it or not, I really didn't see my OS very often after my surgery.  I saw him about 3 days post-op, because of a possible infection.  Then I saw him at week 4, week 8, 6 months and 1 year.  We both figured I had at least 12 month healing before any results could be seen.  My medial joint pain didn't start until after my 6 month appointment.  My PTs and I thought it would go away, but it really didn't.   I see my OS for a 7 week post-op this week.  At this point, I would imagine we will just keep an eye on it, because he didn't note anything after my last surgery.  Maybe another MRI is warrented.

I haven't really done much for about 2 weeks now in terms of rehab or exercise.  I usually can't go 2 days without doing something.   My back surgeon put me on prednisone for 7 days to see if it would help alleviate my back but also to reduce the swelling in my knee.   I seem to have a few problems from the last surgery....common peroneal neuritis,  IT syndrome, back, and medial joint pain.  I plan on going back to PT starting Friday afternoon, so that should get me back into the swing of things.

Good luck on Thursday.  At least you know what you are getting into this time and hopefully you will just breeze through it.  Honestly, my surgery last year was only a big deal because I was on crutches for 12 weeks or so.  

Remember to ice, ice, ice and take extra time on crutches if you need to.  

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

Offline JG

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Re: OATs and Knee Brace
« Reply #13 on: June 08, 2004, 02:08:03 AM »
Jack,

Thanks for you kind words.  I think my attitude stems from not thinking I have a knee problem.  It's kind of the only thing that gets me through...I just pretend it's fine all the time.  

Keep me posted on your surgery.  Funny thing is, my insurance company final just paid the two surgeons who assisted on my surgery....14 months after my surgery!  You've got to love the insurance companies!

Janice
Sept-99 - L knee LR
Aug-02 - L knee LR/menisectomy
Apr-03 - L Knee Mosaicplasty Using Allograft (18 grafts)/LR/debridement/menisectomy; Right Knee menisectomy.
Apr-04 - L Scope - LR/Lysis Adhesions

jackpowell

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Re: OATs and Knee Brace
« Reply #14 on: June 08, 2004, 11:46:20 PM »
Best of luck Kathleen!!