Ba-Dg-Er

So it's been forever since I posted ... who knows if anyone remembers me, probably better if they don't. Either way introductions and re-introductions are most certainly unimportant. I ride/race road bikes so we have that in common and now I have injured my knee which brings me to my question ...

Anyone here have any experience with cartilage replacement? I have injured my knee for like the fifth time and according to my MRI the patella cartilage is more or less destoryed. My orthopaedic surgeon has refered me to another doctor that specializes in cartilage replacement and I am trying to get as much information as possible before diving into this, especially any cycling specific information I can get. Specifically any information about recovery time and ability to ride/race pain free afterwards.

40-Dan

Wish I could help. I had a significant percentage of the cartilage in my right knee removed several years ago. I was pretty gimpy and could not hyperextend it for at least a year afterward, but, now, I don't even notice it.

Good luck.
Dan

-VELOCITY-

I've had 2 knee operations. The first was to repare the femur which I cracked. I was on no wieght bearing for 8 weeks. Then the second was for my menicus. Which I walked out of the hospital limping but needed 6 weeks of therapy. I ride now because it actually helps the knee feel better. As a matter of fact after my last surgery the surgeon recommended that I ride at least 4 times a week to strengthen it. Boy was he right. When at first I didn't ride I felt pain all the time. Now since I've been riding for almost 2 years I don't have to wear my knee braces and they feel good.

Ba-Dg-Er

I've already had surgery on this knee twice, this is the first time anything like this has been recommended. The prior two times it was an arthroscopic procedure which I left on crutches for physical therapy but had no problems returning to the bike shortly thereafter. This injury has pretty much killed my racing season for this year, and I want to make sure it doesn't do the same for the beginning of next.

corn oil

I had two knee surgeries, one to clean up some torn miniscus tissue, which I was up and running after a couple of days and second an ACL reconstruction. ACL takes a long time to completely heal over somewhere between 6-12 months. You can do it sooner but it takes alot of physio therapy, and have the healing capabilities of a 18yr old.
Whatever you do, try and keep going to therapy as long as you can, it may be long but worth it in the end. Don't forget only time can heal wounds - good luck!

just my .02

BTW - I'm back riding stronger than before and no knee pain at all.

octaneTom

Ba -

I've had 4 surgeries on my right knee: three arthroscopies and an ACL reconstruction way back in 93 (basketball injury). 2 weeks ago today I had it scoped to clean up some loose debris that's kept me out of action and off the bike for over a month now (some debris got stuck in the joint). My surgeon took some cartilage cells out while he was in there, and has recommended the same procedure (Carticel replacement) as you've been recommended to replace 3 areas in my knee where the cartilage is basically gone and I'm down to hot bone-on-bone action. They send the cells out to a lab, grow them for 5 weeks then implant them in the empty areas with patches/covering made from your shin (!) Good times.

I started some research online and the recovery looks pretty awful—but most places seem to indicate riding again in 6 months...but it looks like running/tennis are out for 12-18 months post-op(!).

Here's a rehab/experience journal from someone that's had the surgery that I found and started reading last night:
https://users.erols.com/equinox/aci_patient.html

Like I said, looks fairly intense, but he also says he doesn't regret doing it. If I do it, it will probably be this winter and I'd rehab while it's cold here in Michigan, hoping to back riding by late spring/early summer.

Good luck, IM me if you want to chat more about it.

Tom

Cypress

I had two operations on the same knee last year. One to fix the meniscus, the other to remove 1.25 cm of my fibular head. I'm back on the bike and stomping ass harder than I ever did in the past. Do your therapy and you'll be just dandy.

Gus Riley

I remember you Ba-Dg-Er! Thanks for bringing this question up. I've injured my left knee somewhere along the way and am thinking of seriously bringing the subject up with my doctor later this month.

Ba-Dg-Er

Hey Gus ... good to see you again, sorry to hear about the knee injury though. I will let you know what I find out on Wednesday.

soze

As someone who has popped their ACL and went on to chondromalacia because I was an idiot: DO YOUR PT. All of it.

Talk with your therapist, they can often work in cycling on some of it. Cycling, particularly spinning, does wonderful things to help build and strengthen the muscles supporting the knee so that you don't have strange movement that allows cartilage injury to happen.

Oh, and if something hurts to do while you're recuperating, stop and rest a moment. Your PT exercises are still valid so long as you do them all in the same day, not necessarily in the same sitting.

smellygary

Octane tom gave you good info. Cartilage is removed from your knee, sent to a lab, grown, then sent back to be put back into your knee and tacked down. But its expensive and theres mixed results. The problem with cartilage is that its not very vascular (not a lot of blood flow though it) so it takes a long time to repair and grow. Thats just the nature of cartilage.

The problems that a lot of people have in rehabing their knee is they don't do what their PTs tell them to do. The knee, hip, shoulder, whatever starts feeling great so they quit doing the PT. Or it hurts too much so they dont try hard enough. Do what they tell you, in the way they say.

The other problem with surgeries like this on the knee is that some people expect miracles, and they usually dont happen. Cartilage replacement is often to delay the eventual total knee replacement, is it really is bone on bone. Activities like running, soccar, tennis, basketball will probably go out the window. Theres just too much impact on the cartilage, and too much risk to the new cartilage. Its an important consideration to realize that certain activites will need to be moderated.

Things like cost, rehab time, availability of a good PT near you, diet and meds, when to do the surgery, are all important things to consider.

lovemyswift

A woman who works in my physical therapy office had that surgery in March. They replaced her shin bone with a cadaver. She was in a brace for something like 4 weeks. Even though she had the therapists working on her on a daily basis she was having difficulty with her range of motion. The way she explained it was the surgery is very new and the protocol hasn't been set yet.

I finished PT two weeks ago and she was still walking with a limp.

See if your ortho has a printed protocol that tells what to expect during recovery. Mine gave me his protocol for ACL surgery which was divided into phases. It was very helpful in helping me understand at what point I was in the healing process which helped to keep my expectations in check.

Kathi

haimtoeg

Knee problems suck - I have had over six months of 2-3 times a week PT to fix lingering knee problems. Before starting that I bought a cane because I was sure I would be limping for the rest of my life. The orthopedic surgeon and the phsiotherapist saved my life and my health, even though they have forbidden me from ever again running or playing tennis I can ride my bike and spin. This surgeon was opinion #15 over as many years and the only one who did not tell me that there is nothing he can do and I should take some pain killers and shut up. My conclusion is that you got to find the best surgeon and physiotherapist and go with their program - if what they say makes no sense to you then keep shopping.

Ba-Dg-Er

Thanks everyone for your advice and information ... I go under the knife on Monday to repair a whole number of issues and grab some cartilage for the replacement process.

Dewbert

I've had both knees fixed (acl tear) and cycle instead of run because it's easier on the knees.

alraicercsu

had surgery on a knee back in high school after I tore it up running cross country. I race my bike now instead and its much easier on my knees I just have to strech the one knee so it doesn't act up.