Watch 2019 JRAD Videos

OATS OATS Complications

Status
Not open for further replies.

mgroesch

new member
Joined
Feb 1, 2016
Messages
5
Age
27
Location
Pittsburgh
Gender
Male
Country
United States United States
Hi, I am a 23 year old male who had a microfracture and screw inserted in 2008. Two months later in 2008, I had the screw removed. I continued to play lacrosse and Bowling for the rest of my high school years. In October of 2015, I started to get more and more pain in my left knee and scheduled with the orthopedic surgeon. I found out that I have a 3.0cm by 3.0 cm defect on my medial side taking up over 2/3 of my knee. The surgeon then proceeded to schedule an OATS procedure which was November 10th. They have still not found a donor graft who is big enough to replace my defect. I have 2 second opinions scheduled with a knee replacement specialist on February 3rd and February 9th. I was wondering if my knee is beyond repair. I still want to remain active at least in Bowling since lacrosse is out of the picture. Is there any advice about PKR and OATS. I also have a medial unloader brace which makes work tolerable but without it I am in terrible pain.
 
Last edited by a moderator:

fuzzybunny

member
Joined
Oct 18, 2014
Messages
173
Age
44
Location
New York
Gender
Female
Country
United States United States
Did your doctor discuss ACI, which uses your own cells, as an option?
 
OP
OP
M

mgroesch

new member
Joined
Feb 1, 2016
Messages
5
Age
27
Location
Pittsburgh
Gender
Male
Country
United States United States
No he didn't and he seemed dead set on OATS. It is coming up on 4 months waiting for a donor and I am beginning to doubt that the surgery is right for me.
 

Pumpkln

MODERATOR
Moderator
Joined
Oct 27, 2011
Messages
21,927
Location
United States, West
Gender
Female
Country
United States United States
mgroesch,
Suggest you seek a second opinion from a surgeon who also does ACI, to see if you are a candidate. It would allow you to proceed sooner.
 

ORpatella

junior member
Joined
Feb 21, 2015
Messages
52
Age
34
Location
M
Gender
Female
Country
Germany Germany
I'm sure you have other options before a replacement is performed. If you only have one defect, as others said, you might be a candidate for MACI. Hope you'll get some more information during your upcoming appointments
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
37,687
Age
78
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
I don't know much about either OATS or ACI. I gather that thy both have potential, but I'm not sure that enough have been done to be able to assess their long-term effectiveness. I'm going to ask @Josephine if she has any further information.
 

referee54

omega
Joined
Dec 21, 2007
Messages
17,881
Age
65
Location
Northern Part of the Buckeye State
Gender
Male
Country
United States United States
mgroesch,
Suggest you seek a second opinion from a surgeon who also does ACI, to see if you are a candidate. It would allow you to proceed sooner.
I agree---I would look to get a second opinion so that you can ascertain as to whether or not you are headed in the right direction and that your OS's advice is on the money.
 

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
Joined
Jun 8, 2007
Messages
84,940
Age
78
Location
The North
Gender
Female
Country
United Kingdom United Kingdom
Just for those who don't already know:
OATS stands for “osteochondral autograft transfer system”. It is one of two types of cartilage transfer procedures. The other is called “Mosaicplasty”. Cartilage transfer procedures involve moving healthy cartilage from an area of the knee that is non weight bearing to a damaged cartilage area of the knee.

Autologous chondrocyte implantation (ACI) is not recommended for treating knee problems caused by damaged articular cartilage, unless it is used in studies that are designed to produce good-quality information about the results of the procedure. These results should include measuring any improvement in patients’ quality of life, and the benefits and risks of ACI over a long period of time.

Matrix-induced Autologous Chondrocyte Implantation (MACI). Available comparative studies suggest that MACI may be superior to marrow stimulation techniques, but long-term outcome data and comparisons against conservative management are lacking. No data are currently available demonstrating its capacity to prevent or delay the onset of osteoarthritis. The role of MACI in cartilage repair surgery remains a subject of intense investigation and has yet to be fully defined.

I have a 3.0cm by 3.0 cm defect on my medial side. The surgeon scheduled an OATS procedure which was supposed to be November 10th. They have still not found a donor graft who is big enough to replace my defect. I was wondering if my knee is beyond repair.
I would say that with a defect that big, it almost certainly is.
I still want to remain active at least in Bowling since lacrosse is out of the picture.
Has someone told you that a knee replacement will make these activities out of bounds? Because if this be so, you should read some of the stories in here Stories of amazing knee recoveries.
 
OP
OP
M

mgroesch

new member
Joined
Feb 1, 2016
Messages
5
Age
27
Location
Pittsburgh
Gender
Male
Country
United States United States
I visited a knee replacement specialist today and he said that a partial is out of the picture. He said I was much too young for a partial and my original OS was on the right track with the OATS. However, he said that my defect was the largest he has seen in 20 years as a practicing surgeon. The news made me very uneasy since my injury was the "largest" he has ever seen. I am still worried about going through with this and if I will ever have a graft big enough. He also said I had significant bone loss. Also an update, I was thinking back and I remembered the surgeon saying that there is fluid behind pieces of my defect that could break off at any time. It seems to me like the PKR would be the best solution but I don't have 10+ years of schooling and experience...... Sigh
 

Josephine

NURSE DIRECTOR EMERITUS
Nurse Director
Joined
Jun 8, 2007
Messages
84,940
Age
78
Location
The North
Gender
Female
Country
United Kingdom United Kingdom
Sorry, I disagree. I don't think a partial would do as this kind of condition has a tendency to spread.
You'd be much better off with a total.

And if you search around, you will find a surgeon who is prepared to consider your clinical condition and not be put off by your date of birth. They do exist, you just have to find them.
Try using this Using "Find a Clinic" to find surgeons
 
OP
OP
M

mgroesch

new member
Joined
Feb 1, 2016
Messages
5
Age
27
Location
Pittsburgh
Gender
Male
Country
United States United States
Hello all,

Last year I had a scope done of my left knee in March of 2017. Following the scope, I had a stem cell injection about 2 weeks later. Moving forward, I had an OATS procedure (autograft) in July of 2017. Presently, I am seeing a pain management doctor that prescribed me gabapentin 800mg 3 times a dat and percocet 5mg as needed for pain. Neither one of the medications have helped and I have tried several (nucynta, tramadol). I spoke with my OS and he said that I shouldn't be one all those medications. I use a medial unloader brace but it only helps slightly. I am seeing my OS this Wednesday and I am concerned about what he is going to say as I know OATS is a one shot procedure. I was doing research on the internet and say partial knee resurfacing. I was curious if this would be the next step. I am a 25 year old male and I have an active lifestyle playing with my kids and I would like to resume doing those activities. I was wondering if anyone had a similar situation or could give me some details about the possible next steps. Thanks in advanced.
awww.kneeguru.co.uk_KNEEtalk_Themes_premiummgc_images_icons_modify_inline.gif
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
37,687
Age
78
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
Hello again, @mgroesch
I see you've already asked for advice on this thread,
https://bonesmart.org/forum/threads/oats-vs-pkr.34668/#post-875969

Did you come back and read the advice you received there?

I'm asking because Josephine, who is a very experienced orthopaedic nurse, gave you advice there. In fact, I'm going to combine the two threads, since they are so closely related. Hang on while I do that.
 

Celle

MODERATOR
Moderator
Joined
Nov 19, 2011
Messages
37,687
Age
78
Location
New Zealand
Gender
Female
Country
New Zealand New Zealand
OK. I've merged the two threads together. I think it would be a good idea if you go back and read the thread from the beginning now.

Your poor knee has already had so many procedures performed on it. I think it's time to get it fixed once and for all, and fixed properly.
It's clear that you have a considerable amount of damage to your knee cartilage. You've had several procedures that haven't worked. It's time to go for a total knee replacement.

Why am I saying a total, not a partial? Because partial knee replacements have a history of not being very durable. While I had one that lasted for eleven years, I seem to be the exception. Many partials (PKR) fail within a year or two and have to be revised to a total (TKR). Why have one more operation on your poor knee that will need yet another operation a few years down the track? Do it once, do it right!

You've probably been told that you are "too young" to have a knee replacement. That's old-fashioned thinking. Nowadays, a TKR can last for 30 years or more, so there's no need to worry about needing a revision for a long time.

In one respect, you are too young - too young to be submitting yourself and your knee to surgery after surgery, too young to be in such pain, and too young to have your life restricted by this knee.

Look for a surgeon who will look at the state of your knee before he/she looks at your age.

I'm going to ask @Josephine to advise you again.
 
Status
Not open for further replies.

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
50,524
Messages
1,367,542
BoneSmarties
31,723
Latest member
Harryrightknee
Recent bookmarks
0

Top Bottom