October 4, 2015

Blog Purpose

Hello, my name is Megan.  I'm a 34 year old female who used to be an avid runner.  I am 6 weeks into recovery from autologous chondrocyte implantation (ACI) surgery for a cartilage defect on my medial femoral condyle.

I started this blog to spread awareness for people considering this surgery and to document what to expect during recovery.  I've spent hours googling blogs and information on ACI recovery.  I was disappointed at how few blogs there were that discussed the recovery after ACI.  The few blogs I did come across were quite helpful for reassuring me that what I was going through was normal and to give me perspective that this recovery is a MARATHON, NOT A SPRINT!

Let's face it, surgeons like to cut and are not necessarily the best at chronicling what comes after surgery. It's especially difficult for surgeons to convey the emotional rollercoaster that happens during a long and difficult recovery.  As you read this I hope it will provide a roadmap as to what ACI recovery is like and if this surgery is for you.  I'd like my readers to keep in mind that everyone heals differently and at different rates, especially when it comes to knee surgeries.  So with that, let's start at the beginning....

31 comments:

  1. Thank you for doing this blog. I am about to do the ACI surgery pt 1 on Wed.. You are the first person in the US I have seen to have this and so recently. I am in NJ and have had 3 previous knee scopes and ACI Surgery will be my 4th on this knee. I am getting nervous what my surgeon will find.

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    1. You are quite welcome. I hope you find it helpful. I was nervous too about what my surgeon would find when he looked in my knee as well. But if your surgeon already discussed ACI with you I'm sure he thinks it's a good option. They can treat lesions in all sorts of places with this surgery so I'm sure you'll be fine. Good luck with your first surgery! I'd love to know what happens and if you'll be doing part II.

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  2. I am going to have this surgery today. I did not do all the research I should have. I am obese and 51 years old. I am very out of shape and just had an ACL repair in that knee in the spring. I do not understand why insurance approved this for me after reading about it. I should never have let fear stop me from doing good research. My surgeon is an excellent surgeon but he just really loves to do this procedure. I realize that. I am hoping against hope that if I work really hard I will be able to walk my dogs again and enjoy hikes that are a few miles long. That's really all I want. Plus being able to bend and clean and kneel some day

    Here I go!!! Marathon time

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    1. Good luck with the surgery! If your surgeon loves the procedure that must be a good sign. He must have good success with it. I'm sure being able to go on hikes and walk your dogs is not too much to ask. I'll be sending you positive thoughts!

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  3. Thanks for this blog. I recently had the procedure done on 12/31/15. Im 6 weeks out and I only have 75 degrees flexion. Its been difficult get the extension and when extending from a flexion it still hurts and the pain is the same (maybe worse) prior to surgery. Im religious in my PT and cant wait to walk again. Im depressed from not being able to do things for myself. Hopefully next week my Dr will tell me I can start to put weight on my knee and also drive my car. I really hope this procedure helps my knee. Although my Dr has told me that I will need a patellofemoral arthroplasty in 1-2 years (so why didnt we just do that in the first place). Im only 31 years old and it just sucks to have this happening so early in ones life. Thanks for the blog, ill reference this more often so I can get a better idea in what to expect on this road to recovery.
    Signing out
    Dan

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  4. Dan, good luck on your recovery. I had the same thoughts about having to go through this at a young age and I had trouble with feeling helpless and depressed in the early stages. But it does get better.

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  5. I had ACI done in Oct 2015, I has just completed the Tulsa marathon, and 3 weeks after started to feel pain in my knee. At first I thought it was runners knee, but while at national guard had it pop climbing under a desk. I continued to run on it until I had a consult with 2 doctors. I had to male a deal with my ortho not to try and run for a year from surgery. The first 8 weeks was brutal. CPM 3x day for 2 hours each time. PT started on Friday two days after surgery. Was in PT for 16 weeks. Non flexion brace worn for 12 weeks. Loader brace worn for up to 6 months. PT was hard (of couse) at first but got easier. The good thing about my therapist is they had an Alter-G treadmill (anti-gravity) so I could start running at a reduced weight. Currently I can walk with without and braces all day long, and have good flexion. I woukd say the only thing that is still concerning me is I still have some swelling, and when I kneel down it is still tender. Aside from that my procedure has gone suprising well.
    I would say to anyone wanting this done, be honest with your surgeon about the expectations of the surgery (e.g. I want to do a couple more ironman races, and marathons, so he was more strict with my rehab).
    Hope this helps.

    Mike

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    1. Mike, thanks for the comment. Your situation sounds exactly like mine. Mine started hurting after a half marathon but I continued to run on it for awhile because I also thought it was runners knee. And I had a sports medicine doc tell me it was runners knee. Of course it never went away and the MRI showed the cartilage lesion. Well your surgery is only 2 months after mine and it sounds like you're doing great. I don't have any swelling anymore but I still have some pain in the graft site. My PT also has an alter G that I hope to use when I transition to running. But at this point, I don't feel I'm ready to try running yet.

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  6. Megan,
    I would try the Alter-G with a loader brace. After the initial brace that I had to sleep in an use for the first 4-6 weeks, they gave me a loader brace which I wore everywhere for about 6 months. The Alter-G helped with confidence in my knee and also helped build muscle back. I am able to walk up and down stairs (down still is a little weird), and I can ride the bike with my biking friends without any issues. We did a 72, and a 55 mile ride with some hills. I recently got back from vacation in Boston where we averaged 10 miles a day walking. I just started mountain biking which I was really nervous about, but that went well also. My right leg is still a little smaller than my left as you indicated in your blog about leg size. I think that will come back in time.
    I am sticking to the doctors plan that he has laid out for me. I have been icing it at night more often to assist with some of the swelling. One question I would like to ask you and the others is does you knee cap pop a lot when your leg is either bent or has been straight for some time? Mine sometimes pops pretty good, and catches me off guard.. :-) I have another appointment in August, and am hoping he is happy with the progress.

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    1. Yes! My knee pops all the time. It doesn't do it as much anymore but for months It felt like scar tissue breaking up. I was worried about this at first but it didn't cause any pain and has slowly subsided. Every once in a while it will catch me off guard but it kinda feels good like something is releasing. I've heard from others that this is very common after this surgery and it's caused by the surgical glue breaking up inside the knee. My patellar tendon was cut in half and glued back together to access my lesion.

      As for the alter g. I'm looking forward to trying this soon. I'm up to 15 min mile pace walking on the treadmill with no pain so I'd li,e to try really light jogging in the alter g to see how it feels and really test it out.

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  7. Thanks for posting. I had this surgery 9 days ago at Temple and wanted to see what other persons were going thru.

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    1. I wish you the best on your recovery. I hope you're doing well. The first 6 weeks are the hardest but it gets better!

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    2. Oh, yes. They really are. I'm in SO much pain and ice, meds, this CPM machine and rest aren't working. And movement of this leg, I the immobilizer equals hours of subsequent increased pain. I am trying to keep the faith. And your blog is so informative!!!

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  8. Hi everyone! I'm trying to soak up as much information as I can...I'm post op 3 weeks from knee surgery and cartilage harvest. I'm most interested in recovery...and expectations after...I'd like to do another ironman and marathons, etc and I'm only 34. I haven't run in 10 weeks �� Thank you for sharing!

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  9. Hi everyone! I'm trying to soak up as much information as I can. I'm post op 3 weeks of part one/ meniscus tear/ cleanup of knee. Surgeon is recommending ACI and looking for more info/expectations etc. I'm only 34 and incredibly active and keep getting the...'you should never run again' look when I bring up another marathon/ironman. I stumbled upon this and I'm thankful I found it to follow everyone's journey.

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    1. Hi Sarah. You sound a lot like me. I was 34 when I had my surgery and was very active. I'm still active but in a different way now since I can't run even though it's been 14 months since my surgery. I bike, swim, do yoga, and lift weights to stay in shape. Last weekend I decided to test my knee and went on a 6 mile hike with various types of terrain. It went pretty well but running is still nearly impossible. I have mixed feels about the surgery thus far. I really don't feel much different. I feel like over the last year I have been rehabbing the invasiveness of the surgery while my injury was never really repaired. But even 14 months is still soon and I am still healing. I am waiting to hear back from my surgeon on the results of my latest MRI. Hopefully I'll get some answers as to how I'm progressing.

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  10. I'm coming up on week 4. The pain has lessened, greatly and I'm happy. It's still very sore under the kneecap. I'm tired of this knee immobilizer, that's for sure. I'm taking less Percocet, which is also good. Sleeping longer than 3 hours is hard, still. I've had only 2 physical therapy sessions. I'll keep you posted!

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    1. It sounds like you're doing pretty well. Yes I started sleeping much better when I got to ditch my brace after 8 weeks. Sleeping with that thing was a pain in the ass. Hang in there. It only gets better.

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  11. Sarah,
    Like Megan said it get better after week four for sleeping. You menntioned that you have only had two PT sessions. Are you doing anything on your own (Quead sets, heel drags, bending the knee. Are you in a CPM machine?)
    I am a little over a year (Oct 14th), and I am going in tomorrow for another scope to clean out the knee and possibly take some overgrowth out. Dr. thinks that this will help, so I am hoping this is all it is as I still have tightness around the knee. I can jog, but only for about 20 yard (no pain, just weird tightness). I was thinking of signing up today for IM Chattanooga, but thought it better to wait.. :-)

    Sarah - Trust the process and challenge yourself in PT.
    Megan - Hope your MRI results are good and you can start running again.

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  12. There are many orthopaedic surgeons specialized in different fields such as joint replacement, hip replacement, bone replacement, and knee replacement. But makes a difference between a surgeon and the best knee surgeon in Mumbai is the equal ratio proportion of quality and years of experience with.

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  13. I had this surgery on my left knee in 2013 after having an acl replacement. I did the surgery at 235lbs and have fluctuated up to 300lbs over the years. I'm currently 260lbs and trying to continue this weight loss journey, especially for my knee. To this day I can't sprint, or do high impact activities, at least to my full extent. My surgeon obviously suggest to lose weight. My goal is 185lbs. Hopefully by then my knee will feel way better.

    Btw I hope you all know that this ACI treatment is only temporary, having a life span of up to 9-12 years.

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    1. Hi Fernando. Thanks for the comment. Congrats on the weight loss! I know how important it is to keep extra weight off knee joints.

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  14. ACL - Anterior Cruciate Ligament, Reconstruction Surgery is Done For Injured Ligaments of the Knee.Most ACL injuries happen during sports and fitness activities that can put stress on the knee:
    Suddenly slowing down and changing direction (cutting)
    Pivoting with your foot firmly planted.
    Landing from a jump incorrectly.
    Stopping suddenly.
    Receiving a direct blow to the knee or collision, such as a football tackle.
    ACL tear Surgery should be done because of following reasons:
    If you have also torn a meniscus or if you have torn more than one ligament then surgery to reconstruct your ACL is likely to be your best option.
    People who choose not to have an ACL reconstruction are at high risk for secondary injuries such as a meniscus tear or an injury to the cartilage or cushioning on the ends of our bones. Both of these injuries dramatically increase your risk for developing arthritis in the knee.

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  15. Very nice post. I am looking for best knee replacement doctors for my knee surgery.

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    1. Good luck on your knee replacement Akansha. Knee replacements are pretty common now so I bet it will go smoothly and you'll get great results.

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  16. Hi Megan ,
    Your blog has really been helpful , and makes me feel like I'm not alone in this . My history is identical to yours as far has not having any past surgeries or injuries . I ran 30-35 miles a week with a few races each year. This camenout of no where ! I'm 3 weeks post op on Maci which is just the bran new version of ACI. This so far has been so so hard to go from being a super active person to being basically bed bound , especially with the cpm requirements! It's hard to see the light at the end of the tunnel . Most people could do this for a week or two, brace, crutches , limitations ... but looking into the months ahead with more of the same is very depressing ! I'm nervous all the time that I'm doing the right thing as I have gotten mixed info from people involved . I'm so afraid I'm doing something that will ruin the surgery ! I had my surgery done in Boston, but live in Maine , where I'm watching the best months of the year from my window ��. Glad to know the difficulties with flex are normal as o don't have much at this point . I also can't seem to get my quad muscle back which is frustrating. Hoping to be able to swim next week( with a pull bouy) and feel like I'm exercising a bit , my surgeon is super conservative when it comes to infection so no pool yet. Katie

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    1. Hang in there Katie. I had the same concerns and worries about doing something wrong and ruining the surgery. After six weeks it get so much better. I started swimming at 4 weeks and used a pull bouy for weeks. I used it until I felt comfortable enough to slowly kick. Getting in the pool will be a huge mental boost for you since you are used to being so active. It gets better! It was months before I had normal flexion with no stiffness. This comes in time. Now I can bend my knee with no difficulty and it feels like I never had surgery when considering the mobility and range. Don't worry, you'll get it back it just takes time.

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  17. Megan, I am 3 weeks out of the MACI surgery which is basically the newest form of ACI. I had my surgery done in Boston. I have an identical past to yours as far as running history , miles and being injury free until now . This injury came out of no where . Your blog has really helped me in knowing I am not alone on this journey- one could deal with these crutches , brace and cpm for maybe a few weeks but this recovery is so long it's hard to see the light at the end of the tunnel and not get super depressed . Being so active and then watching the world go by from your bed is pretty rough, trying to stay positive ... just so worried that I'm doing everything right . I have very little knee bend at the moment but after reading your blog I won't get so upset , seems normal at this point. Quad also isn't on board yet , working to get it back . Hopefully can swim at week 4, would be wonderful to get some cardio in, will use pull bouy . Imagining a life without running is hard but I'm being realistic . I have a feeling my surgeon will be against it .

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  18. Hi Megan,
    I am wondering how you are doing now 3 years after your ACI procedure. I am researching ACI, as I may be a candidate for it. I had a bilateral arthroscopy and lateral release 6 months ago with very little improvement. I have spent 4 months doing PT, and am now doing 6 more weeks of PT in preparation for PRP injections. I am 41 years old and was a fitness instructor and more active than most women my age, until I began to have knee pain and was diagnosed with bilateral patellar arthritis. I have accepted the fact that I will never be able to dance or run again, but my knee pain is constant, except when I am completely non-weight bearing. I am hoping that I can find some people that have had positive results with ACI, MACI, or microfracture. My goal is to be pain free in most environments, with walking, cycling, and normal day to day activities like caring for my 2 year old daughter. So how would you rate your pain scale with activity now that you are 3 years out? Are you glad that you had the procedure? Thanks so much for any information that you can give me!
    --Susanne

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    1. Hi Susanne. 3 years after ACI I have minimal pain. I can do most things that I want to do physically. I don't run much though but cycling, walking, and hiking are no problem. I wasn't in much pain before my surgery but I just wanted to be able to run again. So that's why I had the surgery. I'm about the same, maybe a little better than prior to the surgery.

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