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Author Topic: Multiple Lession (Trochlea / Femoral Condylae  (Read 8698 times)

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Offline Basil01

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #15 on: January 23, 2005, 07:19:15 AM »
and to add at the end....

Many thanks to my OS and to my PT- despite the hard time they had given me-  because i owe them a lot

Offline Jules

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #16 on: January 23, 2005, 12:51:46 PM »
Hi Basil01,
A big Congratulations to you!
Well done and enjoy your new knee now!
I went to see my OS 10 weeks post op and found I had been told the wrong lesion sites by the junior doctor, whilst in the hospital. I have two grafts behind the patella and one on the medial femoral. I have corse crepitus and have to go back in 2 months for another review.
Its great to hear your news as I am feeling a little negative about my knee at the moment.
Again congratulations.
Jules.
Apr 01 - bi-lat debride
Dec 01 - bi-lat mircrofracture & LR
Nov 02 - bi-lat debride & LR
Oct 04 - bi-lat A'scopy & harvest
Nov 04 - R ACI
June 05 - R A'scopy/shave
May 06 - R TKR
Aug 06 - L  PFJR
Jan 07 - L open LR
Oct 08 - L open LR
Feb 09 - L A'scopy/shave
July 09 - L TKR......
20 ops in 13 years

Offline Basil01

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #17 on: January 24, 2005, 11:13:47 AM »
Thank you Jules.

Just one wish for you  and everybody else who is in the rehabilitation process ....At the end  to feel the same emotions as i was on Saturday...

Basil

Offline mariajuvan

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #18 on: April 07, 2005, 08:41:14 PM »
HI Basil


I'm happy for you and your success.

Was your trochlear defect full thickness and how limited were you before the surgery?

Did your surgeon recommend surgery? Or after the arthroscopy did he say lets see how you do and then you complained of not being able to do anything and he recommend it?

Thanks

Maria


 

Offline Basil01

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #19 on: April 08, 2005, 06:59:18 AM »
Hi Maria,

Yes the trochlea was indeed full thickness and I was limited to no more than 300 mtrs walking. In the past I was able to jog more than 20 km.
It was not the first arthroscopy.
In fact in the past i had undegone 2 more for debridement so there was evidence of the damage.
I have only to decide who will perform the surgery as i had consulted various experts in ACI in Greece, Europe and USA who all of them suggested ACI.
Needless to say that several other doctors have commented as follows ....My apologizes or the Free translation from Greek
"What do you want to under such a surgery.....which is doubtful and with no results!!!!"
I can assure you that i have start running again.... going up and down stairs and on summer (if the quadrisepts are ok) skiing...no slamom but surely double... As far as tennis is concerned I prefer to stay of the safe side and start late this year...
The only drawbacks are
1. Patience to become one of your virtues.
2. Gain of weight

Otherwise it is worthwhile

Hope i was of some assistance






 

Offline Nick_Knack

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #20 on: April 08, 2005, 01:34:30 PM »
Basil,

Have you had success in regaining your quadriceps strength?  Also, is your range of motion same as other leg and was it ever not the same (as result of surgery actually I mean extension not flexion)?



What caused your trochlea defect?  I thought trochlea defects were usually caused by mal-aligned knee caps.  Did you need to have an osteotomy of any kind?

Thanks,

Nick
Age: 35
1989 rt ACL (+25 degrees ext loss)
1994 rt ACL resection (+ 10 deg)
2001 rt ACL revision (+ 10 deg)
2003 rt med meniscus repair (+10 deg)
2004 rt LOA and post capsulotmy (zero degrees)
2005 rt LOA and tib bone plug removal (even w/ other leg)
2006 rt Fulkerson TTT & ACI Carticel

Offline Basil01

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #21 on: April 08, 2005, 03:55:03 PM »
Dear Nick_Nack

As far as quadriceps strength....Is getting stronger and stronger day by day but it need quite some work....I think that it is a matter of huch you are committed to...
The range of motion ....About 145 deg The Right knee is about the same
As far as the damage is concerned yes indeed have valgous malalingnment but accoring to the oppinion of various doctors is insagnificant.
Most probably cause of damage is an old blow from the kneecap when while slept on a stair i hit the knee on the edge of the stair.
This including my obsession with skiing (water and Snow) as well as tennis are the major factors for the trochlea defect.

Do not forget I am 44 years old...

Hope  i was of some assistance to you

Vassilis
   

Offline mariajuvan

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #22 on: April 08, 2005, 08:01:15 PM »
Hi Basil,

Thanks for your response.  yes it was helpful.

In a previous post you said you have a patellar lesion.  Do you know where it is and how big it is.   Does yours bother you?  Mine is 1cm2 superior and lateral but not full thinckness. 

You also mentioned that you had a couple of previous debridements.  How was your knee after them?  Were you ever able to get back to unlimited walking and any sports between debridements?

Thanks again,

Maria(NYC) 

Offline Basil01

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #23 on: April 09, 2005, 11:04:01 AM »
Hi Maria

The patellar lession is abt 1 CM2 but unfortuantely i can not recall its location.
As far as the previous debridements is concerned i can assure you that after the knee was feeling OK even during skiing (water skiing - passing buoys- at 33 miles)  for at least 4 years... However it was a deteriorating condition...I mean that there was a significant difference in the recovery period.. But may be it was due to "aging" (The last debrediment was carried out in when I was 41)

Basil

« Last Edit: April 09, 2005, 11:06:11 AM by Basil01 »

Offline mariajuvan

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #24 on: April 11, 2005, 04:57:20 PM »
Hi Basil,

So, it sounds like it took  4 years of "regular activity" for you to get to full thickness lesions where you needed ACI.

I too am "older"  I'm 38 and I'm sure my lesions will continue to deteriorate also.

I guess I will try to get my legs as strong as possible, continue with my sports and be followed closely by an orthopedist.

I don't recall, did you have ACI or MACI?

In the US they are not doing using the biologic scaffolds they have in Europe;MACI yet.  I guess I shoud wait until then, I think everything can be done arthroscopically then.


Best Regards,

Maria

Summer is coming... have fun, you sure earned it!

Offline Basil01

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #25 on: April 12, 2005, 03:37:09 PM »
Maria,
It took me more than 4 years... it seems that it has started weill before and it was my strong quadricepts that save me..

No  i had only arthroscopies for debrediment and some prillie drilling nothing more.

As far Europe is concerned I think that in Germany are more advanced than in USA... Even today they are performing ACI arthroscopically in 25% of the cases

For more information Check the Freiburg University Clinic

Hope I have been of some assistance

Basil

Offline Nick_Knack

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #26 on: April 13, 2005, 12:17:43 AM »
Hi,

In February, Genzyme bought the Verigen company (German) which makes the MACI scaffold system.  Hopefully, we can catch up a bit.  I agree that the Europeans are ahead of the U.S. in this technology. 

What is the real advantage of MACI?  Is it that there is no periosteum flap needed?



Basil,

Have you built your quadricips up? If not, how far along are you?

Nick
Age: 35
1989 rt ACL (+25 degrees ext loss)
1994 rt ACL resection (+ 10 deg)
2001 rt ACL revision (+ 10 deg)
2003 rt med meniscus repair (+10 deg)
2004 rt LOA and post capsulotmy (zero degrees)
2005 rt LOA and tib bone plug removal (even w/ other leg)
2006 rt Fulkerson TTT & ACI Carticel

Offline blackbeltgirl

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #27 on: April 13, 2005, 01:41:06 PM »
Genzyme is currently in preclinical testing for Carticel II.  There's very little info on their website, but I get the impression that the next generation will be arthroscopic for many patients.  Maybe there's a connection....
ACI was supposed to be 2/21/06.  On 6/29/06 Insurance co said have another scope, and if it still looks good, they'll ok the ACI.
Microfracture Dec 7, 2004
   3cm x 6cm lesion, LFC; 3cm x 1cm lesion, trochlear groove; lateral tibial plateau lesion
2nd degree black belt, tae kwon do (had to stop)

Offline mariajuvan

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #28 on: April 13, 2005, 04:49:52 PM »
Hi

Your right, when they use these "scaffolds"  they do not need your periosteum to hold the cells in place.  So it saves you a scar.  I believe they can also do it arthroscopically, which saves your knee a whole open procedure.

In Europe they are using "biologic scaffolds". (something that holds the cartilage cells in position)some are made of collagen others are made of carbohydrates and they are like small thin sponges almost.  They pour the cartilage cells on the scaffold and put it directly where the cells need to grow new cartiage and it sticks to the area all by itself.

I believe we are waiting for FDA approval here for use.

I believe you are right; this is Cartical II and I heard that certain centers of excellence for cartilage repair  in the US may using them in 2006,  if everything goes alright.


Maria
« Last Edit: April 13, 2005, 05:58:53 PM by mariajuvan »

Offline jtk

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Re: Multiple Lession (Trochlea / Femoral Condylae
« Reply #29 on: June 07, 2005, 07:16:08 AM »
Hello all,
I underwent multiple lession repair (Trochlea and Medial Femoral Condyle) on November 30, 2004. At the same time, they also did the procedure to realign my knee cap (Fulkerson procedure). Surgery was four hours long, but I was fortunate to live in Atlanta and have a fantastic surgean located hear who is a leader in this field. It has been six months and I have followed the rehab exercises very closely for the first 5 months, now I am on my own. Overall, I would have to say I am doing well and my doctor agreed at my 5 month check-up.

I have to say each week it seems to get slightly better, with occasional setbacks when I over do it. What hurt last month does not this month, but not fully normal yet. Overall, my knee is better then it was before the operation and I am hopeful at this point it will continue to heel until I reach complete recovery. I am 40 and when my knee gave a year ago spring, I did not hesitate to choose this operation. I wanted a chance to get back to normal with my own cells at work as quickly as possible. I had my operation within the first year of trouble occuring. My advice is pick a very good experianced doctor, and find a rehab person that is also well trained, as you will need them for many months afterwards. 

Now a quick question. I golfed 18 for the first time after 5-1/4 months, then stayed up most of night catching up on work emails with my leg on the coffee table. It hurt pretty bad for about a week afterwards. I took the next weekend off, then played again the following week and after this second round, it did not bother me as much afterwards as I iced when I got home and also later that night. However, ever since I golfed, I noticed that if I hold my knee while bending it fully and extending it, I feel a slight click. While doing my rehab exercises, (I continue to do these each day possible), when I am laying on my back in bed, bringing the knee up tight, and sliding it down, I now feel a slight click when I have my hand on the knee during extension. I do not feel a click when bending it up from the sitting position straight and back down, only when fully bending it.

Has anyone had this also and what did your doctor say? I am concerned it is a bad sign that I may have perhaps hurt it somehow. Pain is not bad, can walk normal, shoot some hoops with my kids (round the world type game), so overall I think it is strengthening. First time I felt a click however, so I am nervous.

Let me know if anyone has similair issue, or if anyone has any questions about my experiance
« Last Edit: June 07, 2005, 07:36:12 AM by jtk »















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