Everybody's situation is different of course but are you eligible for a high tibial osteotomy or even one on the femur to open that gap between the two bones? I had one last year with a donor cartilage/bone graft on the midial chondial of my femur and I'm back running again. I imagine you and your doc have already explored this though.

I would definitely seek advice from a very specialized reputable sports med practice. In my case, I went to Andrew's Sports Medicine in Birmingham, AL.

Good luck,

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thechromedome
http://www.favoritefinishlines.blogspot.com
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Chromedome has given you good info. Lots of studies on UKA (unicondylar knee replacement) and HTO (high tibial osteotomy.) Although they are commonly used in similar situations, frequently different depending on the individual, a reasonable average longevity would be 12-15 years. That said, it's easy to find research showing greater or lesser survival. As far as your post op abilities, again very wide differences per individual user. That would be a good discussion for you and your surgeon. If you choose to proceed with either of these treatments, please look up the success/failure rates of meniscus transplants as well. Choose a doc who's done lot's of your selected procedure. Lots.

John

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John H. Post, III, MD
Orthopedic Surgeon
Charlottesville, VA

Thanks gents.

I see the doc and PT on Friday. I should have a better idea as to what my options are then.

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Blogging

I'll preface this that I am not a doctor but I have been in your exact situation. I've had 2 ACL's replaced in my left knee along with a complete medial menisectomy. I have about 60% of the cartilage on the lateral side left.

I thought I wouldn't be able to run again after the removal of the medial cartilage. It took me about 2 years to get back into form and I can now run pretty consistently 10-15 MPW. The key for me was twofold - First, I used the swim, bike, and PT to get my squad strength up so my knee felt as stable as possible. Once I had that, I started very limited running and slowly built into the mileage. I wore an unloader brace on my left knee for the first year and that really helped. If I keep the quad strength up I can continue a limited run schedule and race (I did a HIM last summer wearing the brace for the run portion). If I don't keep the quad strength I lose stability in the knee and it gets very painful. There is nothing else to really injure in the knee anymore so it's just a pain tolerance issue.

I looked at other options that you mentioned but the success rate seemed low and given all the surgeries I just didn't want to go under the knife again. I'll be looking at a replacement in 10 years or so according to my ortho surgeon (I'm 37 yo) so in the meantime I take what the knee gives me.

No real advice, just want to say hang in there. I'm 2 weeks post op for a patella dislocation and some cartilage damage so I feel your pain. Best of luck.

Hey. What did your knee surgery involve? Lateral release? mfx?

I had my mpfl reconstructed and some cartilage chunks removed. Evidently, the doc thought that I had enough spontaneous fibrocartilage growth that microfracture wouldn't do much additional good.

Microfracture surgery is pretty much career ending for most who have it. I was told that the cartilage that rebuilds from the stem cells in the released blood just isn't as good as what is there from default. When I had my knee scoped a few years ago, my doc was concerned I might need microfracture and I was very grateful when I didn't need it. I think it's a blessing in disguise.

I hope it all works out for you over time. Good luck!

Thanks, that's what I'm hoping. I suppose time will tell.

Well, no...but it's better than denuded bone getting all whackatooodled every time you take a step :D

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mmm-mmm-Momo Charms
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How big are your lesions? Kissing? Amount of meniscus remaining? Location? I ask b/c once your lesions get to a certain size/grade, it's a contraindication for transplant.

Mine are grade IV, and diffuse (covering the almost the entirety of teh lateral joint space), and I have no meniscus...so "kissing" lesions. After my mfx failed, they were smaller...but still too big to qualify for anything like additional cartilage work and transplant.

I had a DFO (my damage is lateral...for medial, you'd most likely have an HTO), which allows you to keep your own bits and put off a PKR. It has worked quite well, frankly. Which is just as well, I guess...b/c lateral PKRs really aren't that common, and I'd prefer not to dink around with one. :D

Ask your doc to try an unloader brace. If it works for you (and yoru issues are unicompartmental), you might be a good candidate for an osteotomy.

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mmm-mmm-Momo Charms
Handmade beverage charms, jewelry, and miscellanea
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