Has anyone had an OATS procedure? (for knee bone/cartilage)

I had this done in 2006. The recovery was longer than I expected. 8 weeks on crutches, 6 months before I started light running, about a year before I started training. I'm 54 - recovery might be faster for a younger person.

I feel like it was 95% successful. There is still an area of my knee that is bone-on-bone and I've altered my stride slightly to avoid it, and as a result of the imbalance I'm prone to compensation injuries. But I couldn't run at all before the procedure so no complaints.

Good luck.

I'm so glad you're able to run. That's good to hear!

I also had MFC defect. With MFC defects there are 3 options:

1) microfracture

2) OATs or cadevar transplant

3) ACI - Genzyme grows cells in lab and transplant.

None of the options are great, the all involve very long recoveries and no one comes out 100%. If you can get to 80% by 1 year you will be lucky.

I had microfracture and it gradually improved but it took 2 years and got me to about 80%. I can now run again and before the surgery running was impossible. However my knee can only take about 30 mpw, but that is ok, better than nothing.

Good luck with it but my point is lower your expectations and expect long recovery and no where close to 100% recovery.

I fractured the distal end of my femur at NYC Marathon in 2009 and had to DNF at 18 miles. MRI showed a 1 cm defect and OATS was suggested. So I flew across the country and they had me all laid out, ready to chop and plug the bone but when they got in there with arthroscopy the defect was only minor, equivalent to an abrasion compared to breakage of cartilage and bone.

I was lucky, Dr. and PA said that they were "flabbergasted" becuase the MRI looked definitive.

That said, I have a friend who had the OATS procedure 10-12 years ago. The recovery was long, and he's had to cut back but he's still running well, doing 5Ks to half marathons at 20-30 mpw and some cross training.

I had it done almost exactly a year ago to the day. As others have said,it's a loooong recovery. I've only been doing any "real" running for the past month, am up to about 30 minutes or so. The knee doesn't really bother me too much running. Sometimes during the day I get pain if I step the wrong way. The worst part was the 1st 6 weeks being non weight bearing. You'll have to get pretty creative just doing normal everyday things! But for me so far it's been pretty good. There was no way I could run before the procedure. And for me it was no gradual wear of the cartilidge. One minute I was feeling pretty smug just finishing up a 14 miler, the next minute BANG, I could hardly walk. Doc said somehow a 1.5 cm chunk of cartilidge tore off, exposing bone. Just be very patient with it and good luck. P.S.-I'm no spring chicken (57) with alot of miles under my belt. If you're a younger person I'd think that your results should be even better.

Thanks for all the replies everyone!

I had the procedure done on 6/25 and am just about to hit 2 weeks of recovery. The good news is that so far, there is no pain in my knee. I didn't have neuroblock during the surgery, and I haven't taken any painkillers at all.

The bad news is that my range of motion still seems rather limited. I'm still at 70 degrees. If I try to go further, it just won't really go. Most of the swelling is gone. My OS says I'm recovering fine, but from what I read online, most people after OATS seems to have > 90 degrees after two weeks. Anyone have experience with this?

Truffle,

I had nearly the same injury do to a hard fall on some tree roots while running. I had the microfracture done and range of motion sucked for a long time. I had to wear a machine thing at night to constantly move my knee up and down. The PT hurt but I did it. I spent many hours in the pool, then the bike, then the eliptical, all with lifting and PT. It took a year to be able to do some light jogging and nearly two for consistent training. The god news is that my knee is probably 98% right now at 60 miles a week. I've run a marathon on it and it is fine. It will never be normal but it is run-able.

It's too bad it took so long to heal, but wow, a marathon is great news! I'd be so happy to get up to that kind of mileage.

I had the cartilage implant from my own cells (ACI). I had a bad accident and couldn't run at all. My recovery was a bit harder than I expected. 10 weeks on crutches, PT for 4 months, and started running 6 and 1/2 months after surgery. First year I had a fair amount of soreness and swelling. The first 6 months back I slowly built up to runs of 4 miles. By the end of the year I could do 7.

I can now run about 30 miles a week but not nearly as fast as before because a combination of missing 2 years and being older. But I can run 10 miles at a clip and feel VERY lucky since my original prognosis was I'd never run again. Good luck, be patient and don't give in to dispare.

I had a similar process, but cadaver tissue was used. I was told that it can take months to obtain insurance approval, and to find a match. I was lucky to be included in a study utilizing a treated cadaver tissue that makes it compatible for everyone, thus not requiring a match. The longevity of the product is yet to be determined.

I am on my 4th week of non-weight bearing and will start a slow progression to full weight bearing in about 10-12 weeks from the date of surgery. I have been able to ride my bike on a fluid trainer (lowest gear) for the last three days and it has actually helped loosen things up. It took that long to get the range of motion to ride a standard bike.

The toughest aspect with this procedure has been the extended period on crutches and non-weight bearing. The treated leg obviously atrophies and will require some time to get back to full strength---hoping the bike will take care of it.

No PT prescribed, just exercises I can do at home.

I was told the soonest I can expect to run is 6 months.

In 2007, I had 3 TruFit (synthetic) cartilage plugs implanted into my right femur due to cartilage damage in my right knee. Recovery was 100%; I trail run regularly in the Boulder mountains. In 2011, a trip/fall incident on a trail resulted in cartilage damage under my left kneecap. Surgery 10/31/2012: involved 2 (cadaver) cartilage plugs inserted in femur. My surgeon, who does a lot of professional athletes, now prefers cadaver plugs; he prefers not having to drill any holes in non weight bearing part of femur to extract your own plugs.

Recovery: I was on my exercycle the day after surgery, working on my own rehab an average of 2 hours daily. Also take high doses of specific nutritional supplements and LOTS of high quality protein (absolutely essential to rebuild tissue and heal). Off crutches after less than 1 week, continued to use 1 crutch for about another week, then off that. Walking normally within 3 weeks, at which point, I could also hike on local trails, and was doing weight machines for legs; low weight - high reps (20). By 4 weeks I could walk 6 miles on flat ground and go on 4 mile hikes with +1,000 foot elevation gain (wrap knee in ace and use trekking poles for stability). I'm approaching week 8, and have been doing leg machines with higher weights, 4 sets at 15 reps, and I can do easy running on flat surfaces for 1/4 mile without any knee discomfort; range of motion (which I work on daily) = completely straight to leg bent with heel within 1 inch of my butt. Plan to ease into longer running distances gradually, and should be back out running the trails of the Boulder mountains by late January (3 months). I'm a shocked by all the stories of others who have had this procedure, talking about such long recoveries, and not running for 6 months or more. Working on my knee rehab 2 hours daily has been essential for my faster than normal recovery. I would advise anyone doing knee surgery to be proactive about your own recovery; don't just rely on PT twice weekly; you need to be doing strength & range of motion exercises DAILY (exercycle is an essential piece of recovery equipment!). I'm a 61 year old male with BMI = 19.5.

Do you mind giving some more specifics? How big were the defects? To clarify you had multiple plugs inserted into femur? How big were they? Location? is this all under the patella?

I just don't understand your recovery. I've heard partial weight bearing after a week, but to be completely off crutches at two... easy running at 2 months...

who was your doctor? Is this how he explained the recovery prior to surgery?

What supplements were you taking?

Thanks, awesome recovery.

I’m considering the OATs procedure (Osteochondral Allograft Transplantion Surgery) and I’m seeking any insight from someone with a similar injury.

Background:

Tore my right ACL at 18 years old in 2001. Repair with patellar tendon graph and 2 pins and a screw. No major issues with the knee. Fast forward to 2016 and I am in the best shape of my life. I decided to do deep, heavy squats that likely exacerbated post ACL repair trauma and created a small lesion in the articular cartilage.

I’m now 34. I have a lateral femoral condyle lesion less than 1CM (at last MRI in 2016). The lesion is in a posterior position on the weight bearing femoral condyle. There is some surrounding edema. Has anyone had a similar injury?

I’ve been living an altered lifestyle since the injury in January of 2016. The comfort level with pushing myself isn’t there. Multiple flights of stairs create some pain. I recently began wearing a DonJoy OA Reaction Web Knee brace. It unloads the lateral side by applying pressure on the medial side and has helped. I’ve returned to jogging around a 7 minute mile pace but only short distances. Today, I did the elliptical for 25 minutes and although the knee discomfort is present now, it will probably be ok tomorrow. Dependency on the unloading brace is increasing.

The injury isn’t that bad now except for the altered lifestyle. I don’t have the confidence to run long distances and even the stairs out of the subway sometimes gives me issues. However, I can’t run far or long, and I can’t play sports as before. Perhaps it’s a confidence factor. My concern is that the injury isn’t presently bad enough to warrant such an invasive surgery. I also worry the outcome would be worse than I currently experience. The posterior position of the lesion makes the surgery more difficult.

I’m very curious about the recovery. How bad is the pain of the recovery? What’s the realistic time frame for non weight bearing? How long is the physical therapy process? Are there any other treatments I should consider? (The last surgeon I saw said OATs was the only option.) What’s the realistic timeframe to being able to run? Has anyone heard of a worse than before the surgery outcome? Any insight on a similar injury or recovery would be greatly appreciated!

I had the OATS done in Dec 2015 on my left knee. Mine was due to injuries sustain during HS. I have not been able to push off that leg to walk up stairs since. I have to take one step at a time, and I have just started treadmill walking again.. but I have a lot of pain that I am trying to push through just walking. If I had to do it over again I would wait. PT was not helpful. That was only because they were not helpful as a group. I really wish I would had looked into additional options before I had mine done. I have less motion and ability than I did before surgery. Surgery made things worse.

I’m currently in the same situation. I’m 26 years old. I recently re aggravated my knee injury almost two months ago. Although the usual swelling subsided, I could feel that it wasn’t still right. Ended up seeing my doctor and after a X Ray, he scheduled me for an MRI. Got the MRI done this past weekend and yesterday the PA informed me of the condition of my knee. Injury initially occurred back in 2011. I took a five year hiatus from football and began playing again in 2016. Fast forward to now, I’m informed that my body has healed as much as it could on its own and now I have to have surgery. I’ve begun my research on both the OATS and ACI surgeries. The OATS seems to be most cost effective but the ACI has been prominent in individuals in my youth status. Any advice y’all can give me???

Yes, I had the OATS procedure done April 24th 2018. I had a 2mm loose body and my knee was locking up on me all the time. Fell down the stairs and gave two people a near heart attack when I fell over in the Trader Joe’s parking lot putting groceries in my WRX.

The first 10 weeks of being not weight bearing were hell. I am at 6 months post operation and my knee is not locking up. I am able to walk better, carry things with out my knee locking up, walk up & down stairs, and hit baseballs. I still do not feel comfortable running and still have slight pain where my plug is located on the medial part of my knee.

I think it will take some more time for the graph to heal. I feel this surgery was way harder to recover from than my ACL reconstruction in my right knee. I am 35 years old and was a US Army Ranger for 8 years. So, who knows. I am just going to play my cards right, continue my physical therapy, and see where things are at after a year post op. Then get another MRI.

I hope this helped. A bi lateral Don Joy knee brace has been helpful.

I just had my OATS surgery under patella and trochlea along with a Tibial tubercle Osteotomy. I’m at week 10 and pushing some weights at PT and boy this knee smarts....anyone else had this recently? I’m just wondering how hard to push as the whole pain vs soreness post pT are hard for me to differentiate

I'm in the same boat as you. I'm 9 months post op and still use a cane to walk. Just hope this improves and is not permanent. I'm 45...too young to be using a cane forever.

I had a bakers cyst behind my knee. It went away on it's own after 8 years. Had a torn meniscus that caused my knee to swell up after every run. Took an ibuprofen every day for over 6 years. Finally quit swelling up and no pain. Had an accident at work and couldn't run for 3.5 years. Massage therapist finally found a pinched nerve in my neck. Also had some disc damage. Felt completely recovered after 7 years.

All you need is some patience.