Monday, September 17, 2012

Carticel 1-year (+2 months)

I'm now 14 months post-ACI (Carticel implantation) in my left knee, and about 6 weeks removed from my 1-year check-in with my doctor. I've got mixed emotions and a mixed review to offer.

(btw: a recap of my prior posts on my knee surgery/Carticel experience can be found by clicking here.)

Compared to either pre-surgery, or this time last year (two months post-surgery), I'm in great shape. I rarely think about the condition of my knee during my daily activities. In contrast, climbing stairs was painful pre-surgery, and only occurred two months post-surgery if I scooted up stairs on my butt, and even then I would try this only a couple of times per week.

Also positive is the subtle progress in knee health that I've made since my last update 5 months ago. I'd describe improvements as slow and steady, as I don't notice changes week to week, but I do feel more capable every month. (Along with more "life" in my knee every month.) I've also had friends notice that I seem to be walking more smoothly even though I generally only grade myself as "not walking normally yet."

You may be sensing a "But.....," and you're right. Here's a few critical observations:

-While my knee function has mostly returned, there is still an element of wear and tear (or stamina) that is humbling. Example: football tailgating season has begun, and I can definitely say that tailgating for 1-2 hours, walking into a stadium, sitting for 3 hours, and post-game tailgating for an hour or so is tremendously exhausting on my knee. Once home from the tailgate, all I can do was curl up on the couch, and also take it easy the next day. Note: I don't experience pain during the football experience - there's just cumulative wear or knee exhaustion. The positive spin on this is that with no pain, I'm just pushing stamina boundaries, and my hope is that this issue will diminish in time. (Downside: it is less obvious to me when I have pushed too far.)

-In general, my surgically repaired knee doesn't have the same springiness that my "good" knee has.

-Prolonged periods in dress shoes really, really take a toll. In response, I've traded style for comfort in my dress shoes (no more hard soles for me), which has made for an improvement.

-I also sporadically experience very intense but momentary pain when I torque my knee. These outbursts are diminishing in frequency, I think, but I probably have one once every two weeks.

I'm also a bit peeved that my recovery isn't complete one year on. All of the Carticel literature suggests recovery in 12 months, and I was hoping that I could rejoin my adult baseball team this summer. However, when I went to my doc for my 1-year check-in, he cautioned me that Carticel recovery is really a 1-2 year activity. I swear that in all of my previous interactions with my doc he stressed the need for a full year for the new tissue to adhere and recover, with no mention of the possible need for a second year. The doc also kept in place some restrictions on my activities - I still can't stand up on my bike pedals, and I'm nowhere close to running any time soon.

The doc also suggested that I place more emphasis on diverse exercise. Prior to my check-in, I was regularly cycling 15-25 miles 3 or 4 days in a row. (Performance wasn't perfect - my best days were always the first of several in a row, and anything beyond 2 hours was labored.) I have since cut back cycling to every other day, and am rotating in other no-impact exercises - swimming and walking. The negative here is that cycling in the Blue Ridge Mountains in the fall is a fantastic experience, and there's been a few days where I'm sad to not be able to cycle due to my new exercise schedule.

(That said, I've still pedaled 1,500 miles this year.)

So, if you were to ask me if Carticel implantation has been a good move based on my current knee health, I'd say that my knee health is better than pre-surgery, but has not yet reached my goals or expectations one year post-surgery. I'm very hopeful though that my knee health will continue to improve. If so (and there is reason to believe in further improvement), I should be able to give a good review for Carticel.


Slammah Montana said...

I stumbled across your blog while researching support for Carticel patients. I'm almost 4 weeks out from my surgery and very much thinking "what did I do to myself??" Thank you for sharing your experience; I hope your knee continues to improve and I hope we both come out of this glad that we went through with the surgery. It's very hard to stay positive all day, every day (especially while I am still in the immobilizer brace phase). Stay strong!

JJ Chap said...

I've been following your progress. Do you have a recent update? I am one year from my carticel procedure.

tim said...

would love an update! How are you? Also, did you have any other procedure other than the carticel implant at the same time? Reason I ask is my surgeon is suggesting that in addition to carticel, he will perform a meniscus transplant AND correct alignement in my bow leg (aka break the bone and reset). ugh...
let us know!
best, tim 2

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