Carticel Surgery - one man's diary

I stumbled upon this blog (Jim's bionic knee) a few months ago and felt as if I was reading from my own post-surgery diary (if I had kept one). He uses phrases that I have uttered word-for-word during my rehab. If anyone is thinking about having the ACI surgery here is a great overview of everything about this surgery, from the patent's perspective. In hindsight I wish I had followed through with keeping a journal of my rehab. It's hard to believe it's been 9 months since my surgery. I will say again that I have no regrets about my decision to go through with this surgery. My life had gotten to a point where simple daily activities were made harder because of the chronic pain I had. While I am not 100% back to "normal" yet I feel much better than I had before the surgery and know that I will continue to feel better. I did not have a goal of going back to soccer, rugby or triathlons but am looking forward to the next 50 years of my life and instead of saying "I had a total knee replacement at 35-40" I can say...I had this über cool surgery where they grew my own cells to make new cartilage and fixed my knee." (yes I do plan on using the word "über" when I'm 80.)

After surgery - scar treatment

I personally subscribe to the idea that scars give you something to talk about and are a sign of your past. I take pride in my scars (mainly because they tell a story). Some great do's & dont's from a fitnessmagazine.com article are listed here: DON'T expose new scars to the sun. Ultraviolet rays can slow the healing process and, since they stimulate melanocytes (the cells that produce pigment), can cause dark discoloration. When you're outdoors, always slather on a broad-spectrum sunscreen with an SPF of 15 or higher. to try: Neutrogena Healthy Defense Oil-Free Sunblock SPF 30 and L'Oréal Ombrelle Sunscreen Lotion SPF 30. DO gently massage the mark once the surface is completely healed. "Massage helps break down the dense bands of collagen that attach to underlying tissue—a common reaction to cesarean sections, appendectomies or hand wounds," notes Robert Bernard, M.D., a plastic surgeon based in White Plains, New York, and president-elect of the American Society for Aesthetic Plastic Surgery. Once skin has grown over the site, gently massage the area with lotion in a circular manner for 15 to 30 seconds a few times a day. Another preemptive strike: Apply Mederma*, a nonprescription ointment that contains onion extract, which has been shown to inhibit the formation of collagen.

DON'T treat with vitamin E. Despite what your grandmother may have told you, vitamin E has been shown in a University of Miami study to impair wound healing. (In addition, one-third of the patients tested also developed an allergic reaction.)

DO ask your physician to remove external stitches before they leave "track" marks. To prevent those little bumps that form on either side of the incision and become permanent reminders, Dr. Bernard routinely removes stitches after a week. (full article online at fitnessmagazine.com)

*For my first ACL surgery in 1997, I used Vitamin E capsules. I would pierce a whole into the tiny capsule and use the pure Vitamin E oil on my scar. The above information suggests NOT to do this, but I had no negative reaction to this treatment. I don't recall putting anything on my scar from my 2nd ACL surgery besides lotion, and that scar has healed just fine. It is a relatively thick scar (maybe a 1/4 inch wide) but it is not discolored at all. For my most recent ACI surgery, since my scar is 6+ inches in length I decided to be more proactive in my scar reduction efforts. I have been using Mederma (not as often as is suggested) since my doctor gave me the OK. I have been happy with it, but agree with several online reviews that it is a bit pricey for a small amount. I will also agree that a small amount goes a long way. I have two tubes, one at home and one at work. I do try to apply it with some regularity and I am now almost 9 months post op and I still have a decent amount in both tubes. I think the most important feature of Mederma is that you are applying a nourishing substance and massaging the scar multiple times a day, which helps breakdown the scar tissue underneath the scar, which is crucial.

My Knee Story

Who am I? Why am I writing a blog about knees? Good questions!

Me: I am a 28 year old female, and I have had four knee surgeries. Two Anterior Cruciate Ligament (ACL) Reconstructions (one left, one right), one arthroscopic (right knee), one Autologous Chondrocyte Implantation (ACI) /Carticel (right knee)...in 12 years.

I now consider myself an ex-athlete, I grew up playing soccer competitively for 15 years, played women's rugby for two years in college (yes that is a real sport), and ran triathlons for two and a half years. Now I bike, swim, hike, do yoga and pilates and look towards the future. My knees need to last me a long while, it's time I start being nice to them.

Why?: After my diagnosis' I was looking for some sort of resource or group where I could talk to others who had these surgeries, and find out just what was about to happen. For my first ACL surgery in 1996 the Internet (and dial-up connection) was not a good outlet. Now after my ACI surgery the wealth of information available online was helpful, but overwhelming, and I found very little personal connection.

This blog will be a resource for helpful, concise information and a way for others who have undergone these knee surgeries (or are about to) or have other such knee injuries to connect to each other, share tips, advice, or lend a friendly ear. Please feel free to comment with questions, or advice, links, or references.