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OATS OATS for a second time

fro60ol

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good afternoon all,

June 2017 is when I had my first knee surgery. at that time I had a large loose body taken out along with a fix to my meniscus. was doing well for about two month post-surgery then started having issues again, locking, catching , clicking, giving out, etc. so I followed up with my Dr and went for a follow up MRI. had that don in OCT finally was able to see home in NOV and he said I will need OATS surgery. he does not handle many OATS surgeries so he referred me to 2 other Drs. unfortunately neither took my insurance but I was able to find a Dr that did. I saw him yesterday and he is recommending a MEGA OATS procedure. both he fem and the tib are bone on bone. I had that done in March of 2018 and recover was very painful and slow. Was able to move and workout again in august of 2018. Shortly after my vacation in Hawaii in sept. I started having the same issues again. After an MRI showed that the donor bone was not intergrading with my bone as it should my Dr and I decided the next course of action would be to drill into the bone from the top( so it went into the plug but not damage any of the cartilage. I had that done in December of 2018.

I am now waiting on another donor as that also has not worked. My knee is always in pain!! I just want to feel better again and workout. I understand it wont be at the level I am used to but I am in so much pain I cant workout at all most days. When I do have a good day I sometime don’t go to the gym as I don’t want to ruin it by using the knee.

Any tips/help/suggestions any of you have will be greatly appreciated. If you need more info from me feel free to ask!
 

Pumpkln

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@fro60ol
Welcome to BoneSmart, glad you joined us! :welome:

Please post your surgery dates, a moderator will add it to your signature for you. Having the exact dates will help us properly advise you. Thanks!

Has any one mentioned a knee replacement after 3 failed surgeries?
We have members in their 20's that have had TKR's.

New BoneSmart members like you are in various stages of their journey to knee surgery. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?


If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?


Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing knee recoveries
 
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fro60ol

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Thank you for the welcome!

All
June 2017
March 2018
December 2018
Sometime 2020

They been saying I am too young for a TKR.... however my dr did say if this next surgery fails that will be the course of action
 

Jamie

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I'm going to assume your surgeons have not wanted to do a total knee replacement for you because of your younger age. Is this correct? Unfortunately many times when arthritis is as advanced as yours seems to be the OATS procedures are less than successful. Since you've already had 2 failed procedures, you may want to consider talking to an experienced joint replacement surgeon about having a knee replacement. The recovery should be no worse (and likely easier) than what you've experienced. Then you can get on with your life.

I suggest that you talk with a surgeon at HSS in New York City at least for a consultation. I can recommend some names to you if you like. You have had a lot done to your knee so far and you want someone who is experienced with knee replacements and could deal with any specific issues resulting from the failed OATS procedures.
 
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fro60ol

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You are correct about my age I am 34 now. I have had one failed OATS. I have another coming up in a few weeks/months. Waiting on the donor again. I am currently seeing a dr form the Rothman group. Based in philly.
 

Celle

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@fro60ol - OATS procedures are usually only successful when osteoarthritis is in a very early stage. Yours is too advanced for that - your knee already had areas of bone on bone, indicating advanced OA, back in 2018 - and you've already had one failure. The chances of a second OATS being successful are pretty slim.

I agree with Jamie, that a knee replacement is now a more appropriate treatment for your knee.

While some people may say that you are "too young" for a knee replacement, that is now considered a rather old-fashioned attitude.
Modern knee replacements can last at least 20 years, and many are expected to last for 30+ years.

In case you think that your ability to be active after a knee replacement will be limited, have a look at some of the stories in this area:
Stories of amazing knee recoveries
 

Jamie

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Sorry.....I misunderstood and though you had already had the second procedure.

The Rothman Institute certainly is an excellent facility and one we routinely recommend for our members. I'm assuming that the surgeon must feel strongly that you have the potential for some success with this slightly different approach. At least you are aware of what the surgery and recovery entails and I'm sure you've factored that into your decision.

The choice for you is to decide if you want to go through another procedure that has a fairly high chance of failure or not. If you haven't had a conversation with your surgeon about the pros and cons of just going on to a TKR, you might consider doing so. Or even consulting with a different surgeon to talk about it.

As Celle has mentioned in her post above, it sounds as though you may have a rather advanced case of arthritis in your knee. When this is the case, the potential for success with any OATS procedure is reduced. But if you do choose to go ahead with this different OATS approach and it fails as well, you probably should plan on discussing a knee replacement.

Please keep us up to date on what you decide to do and how your recovery goes.
 
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fro60ol

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Thank you... I spoke to my dr the other day. I am in the process of losing weight as we both feel it will be better for post surgery and just to make me healthier. The weight is coming down albeit slowly as most days I am in so much pain I can’t work out of any kind, however it looks like covid won’t get in the way of my procedure. Waiting on such a large donor plug takes time
 

Jamie

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Good for you for being able to lose weight prior to your procedure. It definitely will help. You're making progress.
 
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fro60ol

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It’s been hard as I can barely move most days... but I am working with a nutritionist so that’s helping. I would like it to be happening fast to I can get the procedure done as soon as I can.
 
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fro60ol

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just an update:

pain has been as high as ever the last few weeks. spoke to my Dr. to review my MRI and X-rays I had taken 2 weeks ago. there is nothing new on the MRI but that damaged areas are worse. I am down 15 pounds and 25 from my heaviest. my Dr. wants to have the surgery done by end of summer. he didn't say this but I feel that is to avoid the second spike of Covid that many are predicting for the fall.


trying to push myself for the weight loss but the pain has been so bad sitting hurts never mind walking.
 

Jamie

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I'm so sorry you're still in a holding pattern. Did you have a discussion with your doctors about the possibility of a TKR versus this more extensive OATS procedure?

What is your BMI? Or if you don't know that, let me know your height and weight and I can figure it. I cannot tell from your posts how much overweight you really are.
 
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fro60ol

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I have spoke to him about it he said it wont be covered because of my age. if this fails he can make the case that there is nothing left to do but a TKR.

my BMI is 40/41 in there its high but my body fat % isn't overly terrible. 25/30% I understand its not great.
 

Pumpkln

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I have spoke to him about it he said it wont be covered because of my age
Have you spoken to your insurance company about coverage for a TKR?
They may have a blanket policy, but given your history of failed OATS and a failed bone plug, they should at least give your case a through review of continuing to do the same thing again and again vs other options, such as a TKR.
 
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fro60ol

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I have not spoken to the insurance about it. I will have to call them. even though the 4 Drs I spoke too ( My current, the one that did the first surgery, and 3 friends both orthos) they all said the same thing it wont be covered..... I will give them a call anyway
 

Jamie

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Pumpkln is right. If this is the justification for you continuing to have procedures that aren't working, you need to talk this over with your insurance company yourself. Granted, I don't know what kind of insurance you have, but I can tell you that many people your age get knee replacements when they need them without going through these additional invasive procedures. The usual requirements from insurance (if there are any) are physical therapy and a series or two of injections. So, if the problem is your insurance, your surgeon should be able to prepare a letter based on this past failure and help you justify a replacement....provided you and the surgeon agree that's the best option for you. You shouldn't need a second failed surgery. I cannot imagine that another risky procedure is a better option than just getting the knee fixed and moving on. I hope you do get an opportunity to talk with your insurance company and find out exactly what they require to consider a knee replacement. Make them outline the requirements for you and show you where in your policy that information is contained so you have it to take to your surgeon. You might need his help to write a justification letter, but that's something surgeons do all the time with great success.
 

Jamie

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Are these surgeons you're talking to in your local area or are you seeing someone in New York City at a larger hospital? If they're local, it might be a good idea to get an opinion from someone connected with the larger facilities in the city. I'd be happy to make some recommendations for you if you're willing to make that short drive.
 
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fro60ol

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i am seeing a Dr with the Rothman group. I cant do the city as post op would be too much of a pain
 

Jamie

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Okay. If you decide you would like help finding a surgeon for another opinions, just let me know and I'd be happy to assist. All you need to do is give me a general idea of the area where you could travel to and let me know who you've been seeing up to this point.
 
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fro60ol

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I am currently seeing Dr Even Conte at the Rothman group.
 

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