OATS - MACI Sowing my OATS

[ColoradoSnowman]

An update......Baby steps continue. Drove 7 hours each way through a snowstorm (6 feet in the mountains!!!!) to have the Steadman Clinic do an exploratory assessment of the knee as well as a debridement and PRP.

First of all the Steadman clinic is great. My surgeon is Dr. Vidal, can't recommend working with him/them highly enough.

What was found when he went inside were 2 lesions both on the trochlea. The larger one was ~14mm the smaller ~10mm. The MRI indicated another lesion on the patella but was not found visually. Otherwise the said the knee was in great shape. He did mention that the larger lesion had a blister or cyst (I was foggy talking to him post op, so may have the terminology wrong).

The plan is to wait 3 months for full recovery and then determine whether this did enough. He said due to the good condition of the knee and my desired activity level, if we did have to go forward it would be with OATS and TTO, not PKR.

That being said 2 weeks post op, so far so good. I really won't know whether this debridement did the trick until I am allowed to take the knee out for a run/climb/MTB/HIIT. All of that is off limits until 6-8 weeks post op

 

[Jockette]

@ColoradoSnowman

Best wishes as you recover from this procedure. Please give us the date and we’ll make a signature for you.

Even though you didn’t have a knee replacement, some of our Recover Guidelines will still be helpful. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.​

3. Do what you want to do BUT

​

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

​

​

4. PT or exercise can be useful BUT take note of these

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity Progression for TKRs​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[JusticeRider]

Hi @ColoradoSnowman that sounds like a great first step! It’s no fun to have an extra surgery, but sometimes they need to get in there and get eyes in the inside of your knee before they really know what you’re dealing with. And if you’re lucky, what they did then will be enough to give you full relief. How great would that be?? Please do keep us updated!

 

[ColoradoSnowman]

Hi,

I want to bump this thread and maybe get it renamed as I am going in for OATS, donor material dependent on March 25th.

I know from personal experience that there isn't a lot of information on OATS so I wanted to document my journey for others that might be researching.

The previous exploratory surgery found my knee suitable for OATS, but while he was in he also did a debridement, as it was described to me there was a blister under some cartilage that was cleaned up as well as other clean up and a PRP. The Doc told me it was 60% chance that this would address the problem and for a while I thought it had made a big enough improvement not to warrant doing the OATS.

But over time I just kept on going through cycles of injury through strengthening to injury again maybe four to five times. It clearly wasn't going to get better.

Both my knee docs who saw my knee said that they really really really didn't want to do a PKR on it and flat out refused to consider a TKR because the rest of the knee is in really good condition, just the two isolated lesions on the trochlea in the notch. They couldn't do an OATS on me where I live so I am going to the Steadman clinic, Dr. Vidal. He came highly recommended as the guy to go to for this kind of surgery on this part of the knee. Bad part is that it is 6 hour drive from my house, good part is that he is highly confident that this will be successful >90%, success meaning I can go back to half marathons.

He says 6 weeks in a fixed brace, 12 weeks to walking normally, 6 months for return to sports, although I'd imagine low impact activities like biking might come online a bit earlier. Other good news because of where the injury is I should be weight bearing immediately and strangely and contrary to everything I've read about the procedure, he said that it shouldn't be that painful and that I should only expect to be on opioids for a few days.

I guess the only other relevant info is that I'm a 53 yo who is fitness oriented both in the gym and outside so I want a knee that can perform at a non-competitive athletic level.

So that's it. Hopefully I get it done on the 25th.

 

[Layla]

I want to bump this thread and maybe get it renamed

Hi there,
We will be happy to change your thread title for you. Please let us know how you'd like it titled and we will complete the edit.
Thanks so much for documenting your journey here. We appreciate it. I wish you all the best!

 

[Louloume]

I had an OATS and TTO yesterday. Failed MACI Dec 2022.
Like you said not much out there.
What I know so far.
It hurts! The TTO hurts most I think. I had a patellar OATS.
Asked for an overnight stay - worth it 100%, wish I could stay longer.
Wish I had someone to rub my ankle area as the muscles are very sore.
I have a post-op implanted nerve block. Very much yes.
Woke up from surgery in alot of pain. Just for reference I had a pre MACI scope, debridement, bone spur removal scope on a Friday, was on the ice coaching 8U's on a Wednesday (took it easy). As soon as the nerve block was started pain improved dramatically.

 

[ColoradoSnowman]

I want to bump this thread and maybe get it renamed

Hi there,
We will be happy to change your thread title for you. Please let us know how you'd like it titled and we will complete the edit.
Thanks so much for documenting your journey here. We appreciate it. I wish you all the best!

Though I want to be cute, but in the end probably just something descriptive like OATS Trochlea

 

[ColoradoSnowman]

I had an OATS and TTO yesterday. Failed MACI Dec 2022.
Like you said not much out there.
What I know so far.
It hurts! The TTO hurts most I think. I had a patellar OATS.
Asked for an overnight stay - worth it 100%, wish I could stay longer.
Wish I had someone to rub my ankle area as the muscles are very sore.
I have a post-op implanted nerve block. Very much yes.
Woke up from surgery in alot of pain. Just for reference I had a pre MACI scope, debridement, bone spur removal scope on a Friday, was on the ice coaching 8U's on a Wednesday (took it easy). As soon as the nerve block was started pain improved dramatically.

I fortunately get to avoid the TTO piece so I'm sure it will be a breeze .

Hopefully the pain eases for you shortly. Did the OP give you a timeline to weight bearing?

 

[Louloume]

I had an OATS and TTO yesterday. Failed MACI Dec 2022.
Like you said not much out there.
What I know so far.
It hurts! The TTO hurts most I think. I had a patellar OATS.
Asked for an overnight stay - worth it 100%, wish I could stay longer.
Wish I had someone to rub my ankle area as the muscles are very sore.
I have a post-op implanted nerve block. Very much yes.
Woke up from surgery in alot of pain. Just for reference I had a pre MACI scope, debridement, bone spur removal scope on a Friday, was on the ice coaching 8U's on a Wednesday (took it easy). As soon as the nerve block was started pain improved dramatically.

I fortunately get to avoid the TTO piece so I'm sure it will be a breeze .

Hopefully the pain eases for you shortly. Did the OP give you a timeline to weight bearing?

I know I am non-weight bearing and non-bending for at least 2 weeks, but because of the TTO. They said it could damage where they placed the front of my tib. They moved it over 1.5 cm.

Today is better than yesterday.

Highly recommend the Ambit continuous nerve block.

When I woke up from surgery the pain was severe before they placed the nerve block. I have a post over in post op where I will try to chronicle how it is going.

 

[ColoradoSnowman]

I got word my graft donation is available and my surgery is confirmed for March 25th.

 

[ColoradoSnowman]

I'm getting excited. So sick of this knee pain and disfunction. This time next week I'll be on the other side!

 

[mendogal]

I imagine you're well prepared at home - a nest to relax in with surfaces for everything you need at hand, precooked food stocked in freezer, etc.

 

[Layla]

Good news on the confirmation for the 25th. Sounds like you're ready to roll!
Wishing you all the best and lots of comfort as you wait.
@ColoradoSnowman

 

[ColoradoSnowman]

I imagine you're well prepared at home - a nest to relax in with surfaces for everything you need at hand, precooked food stocked in freezer, etc.

Good ideas, thanks

 

[Layla]

Best Wishes tomorrow!
Join us on the healing side once you're resting comfortably at home.
We'd love to support you on your healing journey.
Hope to see you soon!
@ColoradoSnowman

 

[InkedMarie]

Today the day! How did it go?

Marie

 

[ColoradoSnowman]

Just got out of the surgery. It went great, I can’t recommend enough about the Steadman clinic.

Surgery was about 2 hours. They took marrow from my hip to bathe the graft in before implanting. I had two smallish lesions in my trochlea and the decision was made to do one big graft ~30mm instead of 2 small ones.

Woke up in a brace, no issues with anesthesia. Surgeon said the knee looks really good, no clean up at all. PT guy had me walk around on crutches, weight bearing in a locked brace seem to be pretty easy.

I had some pain immediately post surgery but a press on the nerve block (I have it for 4 days) and a quick fentanyl knocked it right out. Now during first evening the nerve block and oxi are doing the trick.


I think that’s it for the moment.

 

[mendogal]

Excellent!

Yes the implanted nerve blocks are amazing at helping manage those first few days.

 

[Layla]

Wonderful news! Glad to read surgery went well.
I hope you get some restorative rest overnight.
Keep us posted!
@ColoradoSnowman

 

[ColoradoSnowman]

Looked over the surgery notes and photos. Ended up getting a single 27.5mm plug in the trochlea. Some pain this morning but very controllable. Now for the fun part, the 6.5 hour drive home. They say I can take off my brace (set at 0 degrees) in the car as long as I’m not putting any pressure on it but I have no idea how I would be able to get the thing back on again. So locked and loaded for a day of travel over snowy mountain passes.