OATS - MACI Knee options for 25 year old

[Jared419]

Hello everyone!

I had an Osteochondral Allograft (OATS) procedure on my right knee last January (2022) when I was 24. The surgery replaced a 16mm defect in my lateral femoral condyle. It was a hard recovery, but I was fully released by June. I continued to have some knee pain, and it has worsened some. An MRI in October 2022 showed some edema in the bone marrow around my surgery site. My doctor has tried an unloading brace and rest, but It didn't help. They performed an arthroscopic surgery in November to re-inspect the site. He said the graft looked good from inside the knee. I still had pain, so they did another MRI in December. It showed that the swelling had worsened some.

My doctor isn't sure what to do. He is sending me to his colleague in a couple of weeks. I also have a second opinion appointment with another practice scheduled in a couple of weeks. Some things they are suggesting are a revision OATS surgery with a larger graft and possibly with an osteotomy. The osteotomy seems pretty scary to me. He did not think PRK or TKR would be the answer due to my age and activity level (farmer, part-time firefighter).

I would appreciate any experiences you can share about similar situations. I don't want to undergo another OATS surgery, but I'm not sure a knee replacement at 25 is the greatest option, either.

Thanks in advance!

 

[Jockette]

@Jared419 Hi and Welcome!

I moved your thread over to the Recovery Forum since you’ve had the OATS procedure.

I‘m sorry things have not improved more. Getting more opinions is very important so that you find a doctor and a procedure that you’re comfortable with. There are surgeons who do work with younger patients getting TKRs, so maybe keep that in mind. With the right doctor, it just might be a good option for you.

Please give us the dates of the OATS and the arthroscopic procedures so we can update your signature. Thanks!

 

[Peter Mac]

Is MACI an option for you?

 

[Jaycey]

@Jared419 Welcome to BoneSmart!

My suggestion would be to find a more modern thinking surgeon. There is no age discrimination in joint replacement. The old school thinking that implants will only last 10 years is out the door.

Look for a surgeon who specialises in younger patients.

 

[Jared419]

Is MACI an option for you?

I'm not sure. I am not familiar with "MACI." My surgeon did mention the possibility of injections into the graft with a 'bony mixture substance'. I may ask about this at my next appointment.

@Jared419 Welcome to BoneSmart!

My suggestion would be to find a more modern thinking surgeon. There is no age discrimination in joint replacement. The old school thinking that implants will only last 10 years is out the door.

Look for a surgeon who specialises in younger patients.

Great, thank you! I've read this online a few times, but so far they don't even consider it. I see a different doctor on Wednesday. Maybe he will think differently?