OATS - MACI Recovery ????

[HighCountry]

I had an OATS procedure on my right knee 4/2019. All ligaments looked good, Doc cleaned up the meniscus. The only issue Doc advised was the 1st plug didn't take, the 2nd plug took and it was a 10mm fill. Doc said my bones were abnormally hard?

I was good, non weight bearing 1st six weeks, and started stationary bicycling after 6 months, but after a month of overdoing it getting slightly swollen results, I backed off and continued the healing process.

I'm closing in on my one year anniversary, and still cannot run or jog due to pain. The six month x-ray looked good and flush, but I'm still experiencing pain.

Any others dealing with slow recovery issues? Doc told me to be patient, but worried this plug didn't take? I knew I wouldn't be back to 100%, and thought I'd be happy at 90%, but I'd at least like to have the ability to run. The only issue I have now is the knee is still slightly swollen, and I'm afraid I could be susceptible to arthritis?

Not sure If I'll be in line for micro fracture or PKR now?

Any thoughts or experiences are appreciated!

 

[Jamie]

Most surgeons will tell you that you shouldn't participate in active sports like running or jogging for at least a year after an OATS procedure. Since you we a bit hard on your knee at about the 6-month period, you could expect that your full recovery would take longer than the year. This is a case for patience. Recovery from this procedure is long and you cannot do anything to "hurry it up."

What is your surgeon's plan for the area where the plug didn't take? That certainly could be contributing to your pain. I would not suggest that you allow your knee to stay hot and/or swollen. I can't point to any scientific studies that say for sure that it would lead to osteoarthritis, but logic tells me that it just might.

I think it's too early to start thinking you must have a micro fracture or knee replacement. But I do suggest that you take care of your knee and don't push it so hard that you have pain or swelling.

 

[Rockgirl4]

I'm not a medical professional and will just pass on some interesting experiences plus an honest conversation from when I met my TKR surgeon in 2018. Keep in mind I don't know from your original post if this was your FIRST knee surgery.....I only know your age. Please feel free to take/leave anything below......

For background, before TKR, I'd had 7 surgeries on the right knee: 2 w/ Biocartilage plugs and 2 Microfractures----none worked----ALL occurred when I was >35 yrs old (38, 41, and 43). I definitely do NOT want to be a downer and suggest YOUR'S hasn't worked, but I thought it fair to throw this out in case you don't see the results we all want dearly. Thankfully I DID have a successful Microfracture on the OTHER knee in May '18 before I met my TKR surgeon. It's been 2 yrs, so time will tell how long it lasts.

My main point----My TKR surgeon was a breath of fresh air from many orthopedists and sports surgeons doing all sorts of fancy procedures. I'd been "sports surgeon-ed" to death and went to THIS guy asking for the truth about all my options and whether I was jumping the gun on TKR. I basically needed a fresh set of eyes/experience. He's no ordinary Orthopedics Surgeon. He's a Hip/Knee Revision/Reconstruction Specialist who has seen it all--the weird, the young, the old, you name it. His job is to FIX things, regardless of what got you there, and he came VERY highly recommended.

Just from the medical history, he knew in <5 minutes my right knee needed replaced. However, I wanted to ask about timing on replacing the left knee, as it wasn't as bad. Here's the interesting part----He said stop chasing the "cartilage repair hopes/dreams" and move on to a TKR when you can't take the pain anymore. He nicely, but bluntly, said I was sold a bill of goods. He discussed how the odds of any articular cartilage repair procedure working is VERY slim in someone over 32-33 yrs old, and only with small lesions. After age 35, the odds of success are ~10%. The research from larger studies backs that up.

NONE of my procedures had a decent chance of success due to age. He said the common problem is most sports surgeons are going to attempt ANYTHING to stop you from having TKR at age 46-47, even if there's little chance of success. The case studies are usually a VERY small sampling of "perfect" candidates with similar ages--thus skewing the success rates. Age DOES play a role though---and the difference in 35 to 45 is HUGE in cartilage repair. This is why more and more people are getting knee replacements in their 40's and 50's, as many surgeons are finally admitting the cartilage repair techniques are just not very successful in the over 40-ish crowd.

Lastly----if you ever get to this point----don't buy into the "you're just too young" and "they only last 10-15 yrs." These are old myths that have been disproven. I truly hope you see improvement soon though and that this OATS procedure works for you.

 

[HighCountry]

Thank you both!!! This is my 1st surgery. Injury came from the local gym treadmill locking up on me a few times, and I finished the job training for a 5k run at the local track.

When the Doc gave me the green light non impact exercise, he told me to do it as the knee tolerates. Hindsight, I overdid it. When I stopped I feel I extended my recovery a month or two.

Closing in on my year anniversary of the surgery and I will continue to be patient. The only exercise I do now is paddle board. No cardio is killing me! I've got to diet now, and hope loosing a few pounds will also help lower the stress/impact on my knee!

Thanks all for your take! Appreciate it as this is new territory for me!!!

 

[Celle]

The only exercise I do now is paddle board. No cardio is killing me!

There are lots of cardio exercises you can do using your upper body only. Have a look on the internet for some suggestions.