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Old    Eric Roberts (ers906)      Join Date: Feb 2010       12-16-2012, 6:53 PM Reply   
Has anyone had a partial knee replacement (also known as a makoplasty)? I am 37 years old and typically ride 2-3 times weekly year round. My orthopedist saw a 2 cm diameter full thickness cartilage erosion on my medial femoral condyle, as well as the corresponding meniscal damage. So far there has been only partial tears and strains to the anterior cruciate and the medial collateral. As my surgeon stated, I have the knee of a 60 year old with arthritic development, etc. I have been in a brace for months that tries to relieve the pressure on the inside of the knee. I have to wear the brace at work, riding, out for a drink at a bar, etc. And it is not seeming to help like the dr wanted it to. So surgery is likely my next option. Has anyone had one of these surgeries? recovery time? strength after recover? etc....
I appreciate your help
Eric
Old    UncleJessie (unclejessie)      Join Date: Jan 2004       12-16-2012, 9:49 PM Reply   
Eric,
I am dealing with a similar issue but not yet to your extreme case ask about an oesteotomy. They cut your leg bone so you carry the weight on the opp side of your knee. Sounds crazy but my doc says it is a real solution vs partial knee replacement. I am havn micro fracture next and if that doesnt help i may go for the oesteotomy.

Good luck. Btw, i am 43 and kinda stressing on the whole issue to. Wake has been part of my life for 15 years.
Old    Mike North Carolina (MIKEnNC)      Join Date: Nov 2012       12-17-2012, 6:04 AM Reply   
damn bro, is that strictly from wakeboarding or mix of other sports injuries, thats pretty scary
Old    Nick A (Therapy10)      Join Date: Oct 2011       12-17-2012, 10:06 AM Reply   
I'd talk to your surgeon and other respected orthos and ask about alternatives such as microfracture surgery, osteotomy, ACI - Autologous Chondrocyte Implantation, etc. These other procedures can buy you a few years. Once you do a knee replacement that's final. Avoiding knee replacement (total or partial) until you're older is highly recommended because each time they have to replace them (10-15 years on avg) the outcomes and function are reduced (granted research on this topic usually is with regards to well elderly). I've had two patients (I'm a PT) with unilateral knee replacements that returned to playing tennis and golf (their goals) without issue but they were mid 50s.
Old    UncleJessie (unclejessie)      Join Date: Jan 2004       12-17-2012, 10:49 AM Reply   
Nick,

How is the recovery for the osteotomy? My Doc says they would screw in plates to make the bone cut more solid. Can you recovery full mobility w/o excessive pain of having the plates and screws in there?

Uj
Old    Nick A (Therapy10)      Join Date: Oct 2011       12-17-2012, 12:52 PM Reply   
UJ,
To be honest I haven't seen anyone s/p femoral osteotomy. Typically osteotomies are performed with for lateral compartment osteoarthritis (outside of knee hurts, which is less common than medial compartment arthritis) with knee valgus deformity (excessive knocked knees alignment). A quick literature reviews shows that return to function and improvements in pain were noted but understand this patient population had higher median ages so the results may not be completely applicable to your case hence talking things over with your surgeon. The best thing anyone can do is be aware of all the surgeries possible and ask the appropriate questions (even better to ask several surgeons).
Old    Nick A (Therapy10)      Join Date: Oct 2011       12-17-2012, 1:03 PM Reply   
Here is a paper I found on osteotomies that covers the subject well and has some data on outcomes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2899359/
Old    Renn Crichlow (GeistWakeDoc)      Join Date: Aug 2010       12-17-2012, 1:48 PM Reply   
The likely recovery from the osteotomy will be about 6 months. It will take about 3 months for the bone to heal, and then about 3 months to regain strength/balance/coordination.

The potential solutions to your problem are varied, but all of them require a long recovery 6m or more.

I do not know whether after a partial knee replacement, or UNI-condylar replacement whether your could ride a wakeboard... I would likely advise to take up surfing after a "UNI"... although there are people who play doubles tennis pretty hard after a UNI... but... the forces in riding with fixed feet in boots are way higher and less predictable than tennis...

With this problem you need to seek out someone with a wealth of experience in "complex" knee reconstructions. People who could easily offer you an osteotomy, cartilage replacement, unicondylar knee or microfracture. Only someone who can do all the options can really advise you on the best course to try and keep riding...

typically these people list "cartilage restoration" under their list of professional interests...
Old    Daniel Bragg (twowake)      Join Date: Jun 2010       12-18-2012, 1:21 PM Reply   
I have 40% of the cartilage gone on my right knee. I had a scope, bi lateral release and micro fracture surgery done last year. My doc says i can have this done numerous times as long as it continues to work. My knee feels great now. I actually rode better this year than i have in a while. Im looking at knee replacements in 7 to 10 years.

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