Second-Generation Autologous Minced Cartilage Repair experiences

[gaoshanfelix]

Another month passed, very little changes. I had to work quite a lot, temperatures were still very hot - so very little training and sports. I had started running - but after 3 days @ 1.8km I gave up again as my knee very slowly but consistently became worse each day.
Just some days ago I tried again - and my gait while running was better - but not normal. So I stopped after 500m. Last Friday had a small surgery (not knee related) and supposed to not do sports for 2 weeks. Well I lied to the doctor about my schedule as he would surely have refused to do the surgery otherwise, as today I will fly to Nepal - so cut those 14 days to 6 days.

I plan to do 420km of fastpacking - more than 70% of the distance above 4800m altitude. Summiting if lucky to 6500m peaks - and 35.000m altitude up and down. As this consists of loads of sidetreks in addition to a hike in from Makalu region to Everest / 3 passes trek - I can actually shorten it to around 290km if things go wrong. Weather right now is still Monsun and lots of snowfalls - but it looks to clear up by Thursday which will be my first hiking day (2800m uphill, 600m downhil and 35km or so after a morning flight). Maybe I will already miss my first day goal but let's see. I just don't know if I need to keep it slow due to the small surgey the first 3-5 days.

I will go semi light with around 10kg backpack - including my laptop for work, but excluding water. I was thinking of cutting down to 7kg and taking a 38l backpack only - but just cannot get over to live on a single underpant and pair of socks to exchange, a single tshirt to exchange and otherwise just one set of clothes. So I will take 5 pairs of socks, 5 underpants and 5 thermal shirts so I can wash them from time to time (calculate 2 days before exchange - so 1-2* washing). 16" Laptop simply adds 1.3kg and I go with 2 chargers in case of problems/backup (another 260 grams, plus 130g of USB-C cables). I will take 1kg of collagen protein with me - because I know it's hard to get much protein at all at altitude in Nepal. Without that I am sure I cannot build muscles. 3 years ago I did some hikes in 1.5 days days that average trekkers need 7 days for. I acclimatise really fast and then can keep a decent speed even above 5000m altitude. Hope this time it works out the same.

As I will run the downhills - I hope after those 24-25 days I will be able to finally run in the flats too. I think it may just be a muscle thing.
Then I will go relax for 10 days in Thailand doing only little sport - and later kick of my winter road bike season in Taiwan - hoping to not burn out and finally reach 4.5w/kg. This June to mid October was just awful - Except June where I could keep the volume up somehow - and the 3.5 weeks in August - it was just bumming around kitesurfing which isn't a real sport for neither power nor fittnes.

But yeah - last week Thursday a quick and super hard mtb ride (35 minutes uphill at 172 BPM) I actually finally got a good time on my downhill in - without any protectors - so my knee seems to be more stable now allowing me to ride fast and confident again. Was about 15% faster than in August but still 15% off my best times 3-4 years ago (though with protectors). So some things must be working and I was more secure on the downhill than any time last 6 months pre surgery.

I never have pain - just sometimes a little bit uncomfortable feeling, or every day 3-4 times my knee clicking on first movements. I really hope the Nepal hiking trip will kick start my fully back to normal again. It finishes just 1 week short of 1 year post surgery.

[gaoshanfelix]

Well sadly not so good news - My knee kept on improving until reaching near perfect state in my first week in Nepal. I had no pain or even bad feeling whatsoever my first 5 days hiking at a really high pace - doing 2 days of over 35km 2000m uphill/downhil carrying a 10-12kg backpack. Then I think on my 6. day I had a stone in my right (good leg) shoe - took it off without sitting down - and then wiggled a bit to put it back on and heard a slight snap and immediately a tiny bit of pain.
Since then I have had some clicking in my knee again from time to time.Some little pain too from time to time and it just never really improved again - more the opposite.
Yes I recently ran 5km in 40 minutes or so - it was not painful but uncomfortable - no swelling next day. But I'm just stuck with a 1-2/10 pain and sometimes - especially walking or running downhill (which was perfect before) a not comfortable feeling.
The loads of hiking have helped me to gain back muscle power also at extended leg - I am now over 80% on static power at all extensions vs the good leg. Explosivity is still missing - meaning jumping off I get less than 50% distance/height vs my right leg.

I did not manage my plan in Nepal - then on the other hand I went higher than envisioned before - twice 6000m and passed Nepals most technical pass - Amphu Lapsta solo on trailrunners without equipment except micro spikes. Pretty big achievement and could have easily summited a 6500m but just didn't have the permit - so after ascending in 3:20 hours from 4700m to 6000m and just crushing it - I turned around. and ran back down to 4700m in 1:35 hours. Just killing it at that altitude. Somehow I didn't really fully recover after catching a cold after Amphu Lapsta and had to slow down. I ended with hiking 320km - 25000m uphill and 22.000m downhill in 19 days hiking plus 4 rest days. Still 2-3 times the speed of average tourists.

But I really don't know what the heck happened while wiggling my show on. There was simply no hard power at all - maybe my knee shifted inwards a bit at the same time. I just know it destroyed my hope of getting back 100%. The first days hiking I was so perfect - I was sure I can start running after Nepal at any distance - was thinking about training for a sub 10 hour Ironman in mid 2023.
Now I am like - will I ever be able to run again without being uncomfortable. I am afraid that my knee just isn't fit for running anymore except running uphill. Yes cycling no worries and my power seems to come back quite quickly. I still miss nearly 10% vs June but improved loads during the last 2 weeks. Guess in another 2 weeks I'm back to June numbers.

I tried 2 weeks of BPC 157 now - seemed to only made it worse but then somehow it helped my HRV numbers within days which were completely down since Nepal - but actually had been problematic since my mrna crap injection in April when I got myocardities. Actually I somehow thing the BPC cured my myocarditis finally fully - but did the opposite of helping to my knee. Then however some others reported worsening first 2 weeks of taking it too - and then drastic improvements so I will stick to it for another 2 weeks.

[gaoshanfelix]

Well it was quite un eventful since my last post. Hiking in general no problem, running/jogging in the flat still impossible. Last Saturday then suddenly a pinch in my knee when stepping down while hiking (no fall, hit, whatsoever - even stable knee axis for sure while stepping down) and some swelling so I got a new MRI. MRI seems fine with still slight bone bruise around the cartilage implant areas, still a tiny baker cyst, and in general slight cartilage unevenness also retropatellar (first time in an MRI that is mentioned).

Guess I'll soon go to see my doctor for a 2 year (3 months) early checkup and let him evaluate the MRI. Didn't get a MOCART score on the MRI - seems the doctor assessing the images has no clue what that is or saw it out of the scope what you pay for.

I know I have to be really careful about sports like hiking if I have other health problems, like this time I had a Salmonella infection, the last time the pinge came after quite some exhaustion too. both time my HRV values were crap - but my muscles itself felt good.


I kinda feel running/jogging will never be possible again - at this point in time no major improvement seems likely.

[JackWilliamGraham]

Can anyone tell me where in the world I can go to get a minced cartilage repair for a defect in my cartilage? (The defect caused by a traumatic event.) They are doing the Arthrex minced cartilage repair in Germany? England? Would I have to be a Citizen of those countries to get treatment? Are there other countries where there are clinical trials here in late 2023? Anyone know anything?

[vickster]

The poster of this topic states that he had the minced cartilage repair done by Stefan Marlovits in Vienna, Austria so perhaps reach out to his clinic in the first instance.
If you’re a candidate and the treatment is offered privately, presumably they would consider if you’re able to commit to the surgery, post operative protocol, rehabilitation and are able to fund your treatment as an overseas patient. People come to the U.K. for private treatment certainly but I’m not aware of surgeons here who offer the treatment.
Again, reach out directly to Arthrex for names of surgeons using their method and then do lots of research.
What country are you in? Have you researched all the options available to you there?
Good luck

[The_KNEEguru]

Just as an aside, what's the difference between 'minced cartilage repair' and Dr Kevin Stone's original 'paste grafting'?

See also:
https://www.schulthess-klinik.ch/en/new ... turtechnik
https://www.cartilagejournal.org/articl ... 6/fulltext

[gaoshanfelix]

Can anyone tell me where in the world I can go to get a minced cartilage repair for a defect in my cartilage? (The defect caused by a traumatic event.) They are doing the Arthrex minced cartilage repair in Germany? England? Would I have to be a Citizen of those countries to get treatment? Are there other countries where there are clinical trials here in late 2023? Anyone know anything?

There quite a few doctors doing minced cartilage in Germany. And no you won't need to be a citizen nor have an insurance - but if you don't have your health insurance in that country you will pay full out of pocket. Your nationality dosen't matter in Germany or Austria at all.

There should be some docs (but less) in England too.

BTW - saw my doc and also to him the MRI looks great - so can only be that the new cartilage simply has a worse structure than the original - of course the edema that caused the pain is visible. I don't think I can ever go jogging again - and will have to limit sports that cause too much impact. Trying PRP which is now done per default a couple of times following the surgery - but yeah hard to say it does more than placebo or not.