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

Thanks Javi for the tips. Post op day 120 I’m trying to walk more now without the walker/crutches. Lots of soreness/stiffness. The bike is a good idea. I hope to be able to go up/down stairs soon also. Your IG page is great motivation!

Hi all! I am 33 years old and considering the OATS surgery. I need some words of wisdom from those of you who have gone through it!

I had a lateral release surgery on my knee cap 15 years ago and have had 2 loose bodies in my knee since then. Over the past month the loose bodies have become more problematic, locking my knee, etc and I have been experiencing more pain in my knee. So I had an X ray and MRI which also revealed some cartilage damage (so far cartilage damage is mostly asymptomatic). I am following up with the Dr. to determine extent of cartilage damage, but he mentioned the OATS surgery would be required at some point. So now I need to decide:

1) take out the loose bodies now and do the OATS surgery later (timing unknown of when cartilage damage would become symptomatic or deteriorate extensively);

2) do both procedures now to remove the loose bodies and the OATS.

Keep in mind that most of my symptoms are likely due to the loose bodies and the cartilage damage is mostly asymptomatic for now....

From reading this forum it seems the OATS surgery is quite invasive and requires a long recovery time... But on the flip side, is 1 surgery better than 2? Especially if I end up needing the OATS surgery in just a few years... we are in a pandemic and stuck at home anyways... so much to think about!!!

I'd love to hear about your thoughts based on your recovery, and also for those of you who had 2 surgeries, did you wish you had just gotten it all done at once?

Hello. How has your pain been? My left sided OATS surgery on 10/220 has been healing slowly. Pain when walking and especially at night.

I got my surgery done only 17 days ago. I am 17 years old rn. I was the most energetic person in my friend group, and I'd frequently encourage my friends to jog with me Or play football together. Somewhere around 3 years ago I had pain developing which I didn't really bother to get checked because it didn't bother me too much. Then one day after cycling 5 miles back and forth to my friends house to play football, the next morning, my knee was swollen up like a balloon, and I couldn't bend it. My defect was 0.45 ml in volume approx. It's been more than two weeks now, and I've been doing my physio exercises. There is a little pain here and there, but the doctor said that's fine.

I felt obligated to write about my experience here, because I am some one who really worries too much about anything. I was overthinking so much, that i was worried if I'd even be able to walk ever again. But when I found this thread, i felt very relieved. I will make sure to write an update on my recovery maybe 2-3 months later :D

I'm 34 and had a similar injury operated on as an 18 year old. I had:

1. Arthroscopic surgery to harvest healthy cartilage cells, which were then grown in the lab

2. Open knee surgery (autologous chondrocyte transplant) to repair damage to articular cartilage in left knee

Rehab from this is slow. The cartilage takes a long time to mature and the graft is not fully stable. I had 12 months of rehab (cycling, pool running), then played 5 minutes of basketball and cracked the graft while twisting/turning.

3. Arthroscopic surgery (microfracture) to repair crack in graft by stimulating growth of scar tissue.

Got back to a fully active life (occasional running, squash, tennis). 'Sticking' sensation in knee, which it turned out was due to the cartilage graft growing over the edge of the hole it was intended to repair.

4. Arthroscopic surgery to trim graft where it had overgrown (approx 8 years after the original surgery).

Aged 30, slowly returned to club running. Have since built mileage to a consistent 60mpw (and looking to build further). Had to focus a lot on supplemental exercises to restore a more balanced stride, as body had a history of compensating to avoid weaker knee and needed to be taught to move normally again. At least for me, recovery was a very long term process. If you are motivated, you may be able to improve a lot more than you think.

I am almost 5 months post-op OATS (autograft) done on November 6, 2020. Recently, I have been able to attempt small stairs, but it has been very slow going. I also have been able to sit in the floor and get myself up without help. I was finally able to use the regular stall in the bathroom and not the stall with the hand rail. I was even able to walk around a shopping/tourist area in Pigeon Forge, TN for a few hours with minimal pain.

Two weeks ago, I attempted body-weight squats (not a full squat) and wall slides in PT. I was hesitant to try, but the PT staff said it was time. I should have gone with my gut instead. That night, I experienced pain and swelling in my knee. Here I am, 2 weeks later, with very little improvement. I feel as though I have been set back months on my recovery. Every day, I am having pain and swelling with reduced ROM and I feel as though my knee could give out at any time. I am icing my knee several hours throughout the day and also taking Advil/Tylenol around the clock. I am no longer able to use stairs in any capacity. I wake up every morning in pain. I have new pain in the posterior area of my knee. I have also had lots of grinding and crunching around my patella (this was happening before the PT injury). I followed up with my surgeon last week. They agreed that I should not have attempted the squats in PT. They performed a Durolane injection on my knee to help with the grinding around my patella (verdict is still out on that). I wish they had done some kind of imaging to make sure there was no significant injury.

I accepted a new job before the set back. I left my job of 12 years. It will involve lots of walking around the hospital and being on my feet all day. Right now, I am so frustrated and discouraged. The recovery has been much more difficult than I could have imagined. If I could go back and do it over, I would not have had the surgery.

It has been 207 days or 30 weeks from my surgery (September 18 2021).

This was my damage:

Medial cartilage: region of full thickness chondral loss along the weightbearing surfaces of the medial femoral condyle. This measures approximately 1.7 X 1.3 cm

Patellofemoral cartilage: Focal chondral FISSURE along the femoral trochlear groove

I saw my doctor yesterday and got X-Rays, and is healing ok, still not fully living tissue, but is getting integrated well.

I am doing PT in the same clinic of my doctor to avoid communication issues, and gained back muscle and strength, doing lunges, some squats and deadlifts, you can follow my journey on IG:

https://www.instagram.com/javi_fit_journey/

45 years old, doing weight liftings at home upper body carefully lower body just PT, riding the stationary bicycle every day. 220 pounds

Greetings!

Javi

i just had this procedure done march 16, 2021. i was told the same thing, light running after 3 months and no heavy workouts until 6-8 months post-op

I’ve been following your journey on IG. Your progress is amazing. My surgery was lateral femoral condyle. Progress is very slow. I still use a cane occasionally and unable to go downstairs. Going up is painful but I see the progress. Quads take a bit of work to fire and that is why my walking is altered. Keep up the good work

Wow stairs and able to go to the floor and back up. I’m 6.5 months post op and unable to go to the floor and up. Stairs I’m just now doing a little better with less pain.

I’m sorry about your set back I know how frustrating that is. I also feel like this recovery is unlike anything I could have ever imagined.

hey that was me!

I'm a over 3 months past my surgery so I'll write about my experience till now

2 weeks post op - I could only bend near 60 degrees at this time. Non weight bearing completely and brace was on all the time. Ice pack every 2-3 hours.

4 weeks post op - I was bending near to 90 degrees. The doctor told me that now I can touch my toes down on the ground when walking with crutches. Brace was still to be kept on

6 weeks post op - Knee bending was near 110 degrees. The doctor told me to put my foot down fully when walking with crutches. I was told to slowly wean off the crutches. He also said that I will get full ROM in the next 4-6 weeks.

8 weeks post op - Knee bending was 135 degrees. I first weaned from two crutches to one, and then no crutches at all. I got covid at this time but my symptoms were mild and I could get by with a paracetamol a day. I also had a terrible pain in my foot for a while probably because it had not touched the floor in a while but that went away after a while. I had clicking in my knee at the start, but it went away.

10 weeks post op - ROM was 150 degrees. My gait was still a bit wobbly.

12 weeks post op - full ROM but gait was still a bit awkward and the doctor scolded me quite a bit for being overprotective of my knee and that I should have been walking normally now. I was allowed to sleep with the brace off and sleep on my operated side as well.

14 weeks post op - Gait is back to normal now. However my quads have reduced in size considerably. I am 99% pain free except 1 or 2 times during my physio exercises. I still have stiffness when I approach the 160-180 degree range

I'm slowly getting to back to doing most of the normal daily stuff and it feels great.

I'll write a final reply to this at maybe 8-9 months post op. Cheers everyone!

I opted for the HALL procedure.

Hi. I’m wondering if you ever got to hiking the JMT. Can you tell me more about your recovery? Thanks. Weighing microfracture vs OATS.

I am currently 17 weeks post-op from the OATS procedure. I had a 22mm fragment in my lateral femoral condyle and the doc said my cartilage looked like a scrunched up door mat. I was 23 y/o at the time of surgery and had been hurting and giving out after exercise for 6 years. When I got my MRI, the doctor wanted to simply screw the fragment back into place, remove the screws 6 weeks later, and see how it would heal. I decided to get a second opinion which is where I was presented with the OATS option. I opted for that and waited for a tissue donor. As everyone says, the first several weeks are hell. I could barely sleep in a recliner and getting up to go to the bathroom was excruciating. It took me about 7 days to be able to stand next to the shower long enough to sponge bathe, but I couldn’t hop off get the lip to actually get in the tub. PT started immediately after, basically just trying to regain quad control and ROM. After 5.5 weeks I was able to start weening off of crutches. Daily activities such as brushing your teeth, cooking, and dishes got considerably easier after that. The most difficult part for me (still) is going up and down the stairs. While I have been cleared to start light jogging at 16 weeks, loading my surgery leg and bending it to go down the stairs still hurts too much. I have been religiously following my PT protocol, icing, and taking care of my body to allow for a quick recovery. This surgery is a beast! I was told I would make a full recovery and would have no restriction. My hope is to run a trail marathon as a recovery goal, but it could be a long road! Stay tuned.

I had this surgery on August 16th. I go back for my 6 week follow up on Sept. 26 and I can only get to 75° flexation. I am able to raise my leg up on my own with no issues. Will I still be able to go to PT or will I get held back because of my range of motion?

How’s your recovery going?

Yeah I had the procedure! I found this thread very early during my recovery (about 1 week after surgery) and it was very helpful. Had surgery March 2023. I’m 9 months out now. I’ve had a varied journey. I can tell my knee is better than before the surgery in terms of mechanics, but it’s still too soon to say in terms of impact tolerance. My initial stage recovery was very speedy. My muscles recovered fast and I got back ROM pretty quickly. Strength training has been (mostly) great too. But, getting back to running has been a hassle I only just started running a month ago, and my knee does not tolerate it well. I do 2 mins running 4 mins walking, and then recently upped it for 3 mins running 3 mins walking. Each was done 5 times. I try to do this 3x a week. But sometimes my knee still hurts days after running.

Hey all! Anyone have updated personal experience with an osteochondral allograft of the knee (not ACL, meniscus, etc)? Would love any tips, advice, wish I had knowns, personal experience stories (good or bad), and progression timelines. Studies I've found say 79-92% return to sports but it feels like the people of Reddit and Google disagree: what say you guys?

I'm staring down the barrel of having this done within a month (for an 11x6 mm lateral femoral condylar cartilage defect). Had clean up scope April 2022 and did great til it suddenly didn't on the treadmill at orange theory two weeks ago. So, OCA time. Too big for MACI.

As an ex gymnast, crossfitter, frequenter of the half Ironmans, and 5-6x per week worker-outer, this sudden inability to do much more than stiff-legged walk is pretty hard emotionally. Add to that the 6 weeks non weight bearing required post op, 12 months til return to athletics, and ugh. Don't get me wrong, I still have perspective (it's not cancer, etc thankfully), but still ugh.

My specific questions are:
- Are the nice folks of Reddit being dramatic when they say it was 10 days before the excruciating pain went away after surgery? I mean, it's 2024! Surely we have better pain control now?
- I'm a small animal vet so not only active but may need to suddenly jump up to avoid an angry dog. Did you really take 16 WEEKS off of work (as my surgeon is recommending)? What in the world. I'd love 16 weeks off to go hike Patagonia but there's only so many things I can do sitting on my arse at home. Is aiming for a 12 week return insane if I just see the things that fit on tables?
- How did your recovery go? Give me all the details.
- Tell me literally anything else you wish you'd known or think I should know
Thank you!!

Its been almost 7 years post surgery for me and I'm so glad I did it.

1. I dont remember pain being that excruciating but was definitely worse than meniscus surgery. I had surgery on a Wednesday and took the next week off as well and just laid around. I was prescribed oxy and took like I was told to never really get into pain.

2. I was able to go back to work as I moved into a desk role during recovery. I was non weight bearing for 16 weeks. Obviously everyone is different and some DRS are way more cautious than others but i know you want the procedure to work so I wouldnt risk putting weight on it until cleared.

3. For recovery I did PT twice a week for like 6 months. I was able to start walk jogging at 9 months per Dr orders. I do forget when I was walking comfortably but it wasnt long after I was cleared to walk. The PTS were excellent at working on my leg/knee mobility. My DR did limit me to 2 runs a week when I was fully back but I've now wiggled that up to 4 with 2 being easy 30 min jogs, LR, and speed day.

4. Was a college athlete and this happened in my 30s so I knew when I came back I wouldnt be as fast as I was but wanted to be able to walk pain free and run again. Now I've qualified for Triathlon World Champs and doing a dozen 70.3s and a full. On the full knee was great till mile 9 and then I had to walk it in. I was just hitting the 8 hour mark so DR thinks just the time stress on the knee caused the pain as I've done 2 full seasons of 70.3 post Ironman without issue.

Good luck and any other questions?