A year after having my knee sawed apart

Alternative title: A year after ACI / AMZ knee reconstruction surgery

I have always been active, playing most sports in high school and then football in college. After all of that, I started to run, and it got to be pretty important to me. However slowly, but surely, running started to hurt with every step. Not screaming pain, but more like a pain telling you ‘if you keep doing this your not going to be able to walk when you at older,’ type of pain. I still wanted to run, so I said to myself let’s try and fix this! I have had 200 + physical therapy appointments and 5 knee surgeries. This post is to celebrate, reflect one year after my biggest, and most recent surgery!

AMZ ACI Knee Surgery

All this and I still can’t even come close to running. In fact, it is significantly worst than it was before. It’s still not possible to kneel my reconstructed knee, and running is intense pain. Long bus rides are torture, huge temple stairs are intimidating, I find myself at the back of the pack of a hike even with significant Ibuprofen consumption. Worst of all getting into position for that perfect photo, I sometimes get’s stuck like an 80-year-oldd man.

This past month it has been a year since I had some major work done, and I wanted to take you through what it’s been like & how it effects my travels.

First of all what is an AMZ / ACI?

Sounds complicated… well it is.

First set of letters – ACI: stands for Artificial Cartilage Implant. Yes, I have cartilage that was taken from my knee in a previous surgery, synthesized in a lab in Boston, and then stuck back into knee.

The Second set of letters – AMZ: stands for extremely painful and aggressive surgery, well actually it stands for this long word: Anteromedialization! Okay, what the hell is that? Well, my knee caps don’t fit properly in my knee joint. The knee cap glides back and forth in a track, but mine weren’t exactly lined up, so the doctors had to basically realign them. Once they are realigned then they can put back on the new cartilage from the ACI part above, and I will be back in business.

Okay, next part is a bit graphically described, if that kind of stuff bothers you I have included a picture of a rainbow.

rainbow nica sjds

I still haven’t fully explained what all goes into the AMZ: In order to change the location of my knee cap the doctors cut my tibia bone (the larger of the two lower leg bone about 2/3 of the way through and 4″ long from the front, and another 2/3 from the side same length. So there is a chunk of bone still with a strap of tendon hooked on the other end to my knee cap. The bone piece is the ground and shaped to change the profile of my knee cap track. After it’s perfect it is screwed the main part of what’s left of my tibia. Sounds fun right? No, it’s as painful as it sounds.

Just head to YouTube to some graphic videos here is an animated version which is less gruesome, but if you want to see the real deal there are probably others on the side.

Here what I have been going through for the last year:

The first week after surgery hurts like hell, even with lots of bottles of oxy this, and oxy that, my shin throbbed to the point it was the only thing I could concentrate on.

For a good two weeks, I was pretty dependent on Hannah for most things, along with frequent help from my parents. By two weeks I had stopped pain meds but was still stuck in bed only moving when I had to go to an appointment or the bathroom.

If you found this article while contemplating this surgery feel free to ask any questions. Expect this to significantly impact 6 months of your life. I put a good effort into therapy and all of the doctors week marks of what I was supposed to be able to do things were underestimated by quite a bit. For example: I was supposed to be walking by 6 weeks, i was taking steps, I would hardly call it walking until the 2-month mark. Then back to full activity by 6 months, it’s been 12 and I am still limited, running is painful, basically not possible, even a few steps (which was part of the point of having this survey).

Other effects of the surgery:

You know how annoying it is not being able to kneel on my knee? Very! Not sure what about the surgery did this, but it is very sensitive to touch, even wearing pants that are tighter in the knee will aggravate it. Kneeling and putting weight on it produces a sharp pain, it is basically like hitting your funny bone, that kind of sharp, intense pain. So taking photos, or checking under the hotel bed is always a struggle.

It’s not a total loss because I still have done most things I wanted to do on this RTW trip so far, like hiking in Guatemala, surfing in Costa Rica, carrying around my 21kg backpack, walking on average 8-10 miles per day. It just slows me down, and I can’t do as much, I need more breaks, or I will suffer the next days. We ride public transport almost daily, and every bus ride reminds me that I had my knee ripped apart.

I chose today to post this article because I am still feeling the effects of climbing up to the ruins of Machu Picchu! Even with the help of a walking stick and a bunch of Ibuprofen!

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39 thoughts on “A year after having my knee sawed apart”

  1. So i found this, at 5 am, full of pain, 4 days after my Fulkerson osteotomy and MPFL reconstruction. I knew it was going to be a hard ride, but shit, this really hurts 🙁 my leg is so swollen, and the pain…. in not able to do any thing at my own, this is really no fun. I hope this turns out well, or else ill never be fixing the other kne.

  2. I’m really glad I found this, they basically want to do this to my knee because I’ve been experiencing subluxations since I was a kid, except back then no one knew what they were or at least no one claimed to. Long story short, I stepped wrong, felt a little pop, and my knee has been bugging me for almost a month. Went in and my knee is completely misaligned, they can’t just do a lateral release, they said they’d have to realign my leg and reseat my kneecap. I don’t really want surgery at all so I’m already on course to start physical therapy. The weird thing about mine is it doesn’t really hurt 99% of the time, even now, it just feels weird and like it wants to hyper-extend. So I am praying strengthening my leg muscles will help re-stabilize it for me

    • It’s an intense surgery with mixed outcomes. Personally, I would do everything I could beforehand and use the surgery as a last resort. Good luck and hope everything works out for you.

  3. I have pain in my knee during standing in anterior knee. I had TTO with Lateral release arthroscopically about 7 months ago, i dont have pain on going and up or down the stairs or during kneeling before or after surgery, I can’t stand still for over a minute or that uncomfortable sensation occurs. Now my doctor is trying prolotherapy, and saying may be doing lateral release with a scissor and MPFL will help
    Any comments will help, what should i do.

    • Lateral release wasn’t effective for me, but it sounds like you have a different situation. I had the lateral release before my tibia surgery. If the pain you are talking about is in the Tibia I don’t see how a lateral release would help that – the lateral release is more for alignment of the knee cap. I would get more/different medical opinion before they start cutting on you again. Good luck – hope you find something that works.

      • I am now 26 years old and had this surgery when I was 21. I had both the ACI and the AMZ as you did. I also had 2 surgeries on that same knee prior to the ACI and AMZ. I will agree with you that the first two weeks are awful, the shin pain was unbearable at times. By about 6 months in I was able to jog and run and at a year I was back into playing soccer. But I still have aches and pains in my knee and I cannot kneel down at all. Especially since I have had a surgery on my left knee as well (acl, mcl, pcl, and meniscus). Overall I am happy with they surgery because I now don’t have to fear that if I step the wrong way my knee cap will dislocate but the surgery is a brutal one at that. Glad to hear I’m not the only one that has had many issues

  4. I had mine done in 1997 at 31 years old. It went well but I fell 2 weeks after surgery and broke my tibia beneath the split right between the two screws (which are STILL in place). Thankfully it wasn’t a complete break. I never regained the ability to run or jog distances, but walking and other activity were fine. Now here I am 22 years later and experiencing the same pain that led to my original Fulkerson surgery. It’s called Patelarfemoral Arthritis. I’m seeing my trusted orthopedic doctor tomorrow to see what my options are at this stage. I’m hoping maybe some cortisone injections and therapy will help, but the realist in me knows I’m likely looking at a partial knee replacement at this point.

    Overall I was happy and satisfied with my original procedure. But I realize now that nothing is forever. Especially with chronic knee pain. Good luck everyone.

  5. Fulkerson Osteotomy in 1996. Ran 4 months post-op. Parts of my leg near the scar are still numb. I remember how horrible the pain was for the first year. I think that my surgery was successful. My patella was frequently dislocating. I did not regret having the surgery, because I could not walk a block without pain. The surgeon was a “sports medicine” specialist. I was discharged the day of surgery, but the pain and swelling were bad. I cannot kneel on that leg.

    • Glad to hear it worked for you, I knew there had to be someone out there that had a successful one. I too went to a sports medicine specialist, actually a team doctor for an NBA team who multiple other sports docs referred me to – but he destroyed my knee. I too can’t kneel, and the scar is numb mostly on the outside of the knee. However, I think the worst side effect is that it turned my tibia into another funny bone and a minor bump sends sharp pains.

      So you are 23 years out, how is it doing now? What made you seek out his article?

  6. Several doctors have suggested this surgery to me to fix my pain and disability from damaged knee cap cartilage. But these stories freak me out…the docs claim 80-90% success rate. But it seems true that it is difficult to find those success cases, based on my search online as well as IRL. I’m 38, so what’s the alternatives if you’re in pain all the time and cannot walk/run normally? Partial knee replacement?

    • Well, people probably don’t seek out articles like this if everything went fine, so maybe there are people who have had success – but I sure didn’t. All I can say is that I would have lived with my pain and skipped all 5 of the surgeries I had. If you are thinking about this one, I would get multiple opinions before considering this surgery.

        • I had a successful tibial tubercle osteotomy in 2009 when I was 29 yrs old. I was training for the national inline hockey team at the time and was 6 months out from the World Championships. My doctor, a sports medicine guy, said it was a long shot to be ready by then, but we could give it a shot with aggressive PT. I was skating 3 and half months after surgery and played in the World Championship 6 months later. 10 years later I still feel pretty good. I’m still playing hockey a few times a week and do high intensity interval training a few times a week. I can run short distances and do sprints (although I prefer not to run because I know it will aggravate it). It doesn’t feel great all the time, but I just listen to my body and give it rest when needed. I was also in tremendous pain for the first few weeks and PT was really, really difficult but I pushed through. I also have a screw in my patella because I was born with a bi-partite patella. So, with a total of 3 screws in my right knee, I’m still very active and feeling good and don’t regret my surgery one bit!

  7. I am 1 year post op as of 2/8/19. I had a tibial tubercle osteotomy and OATs procedure. My knee cap was realigned and damaged cartilage was repaired. Stairs are a huge nightmare for me. Going down is worse than going up. I still can’t run. I can sort of jog but it feels weird. I have permanent nerve damage/numbness on 1 side of my incision. I have like 90-95% range of motion. Cold weather and rain make the pain worse. I’m supposed to have surgery on my left knee too but I think I’ll pass and settle for arthritis. I’m 27 going on 77. My physical therapist said it’s possible I’ll never be 100%. It’s really sad and frustrating. In a way, it’s good to know I’m not alone in my suffering.

    • Sounds like the same exact story as me. I did this surgery to run again, but it made it hard to walk. I am now 5+ years out and it doesn’t get any better – in fact, it gets worse, a lot worse. Make sure to work to keep your lower body in balance. I found myself unknowing favoring my bad knee which has now lead to hip problems on my opposite side. 35 going on 85.

      • I had this done in December 11, 2018 and the pain wasn’t terrible, but at 2 1/2 months out my sim is killing me! Like it feels like it’s bruising and I don’t understand what’s causing this pain. Steps are terrible for my knee. I thought this surgery would help, but it’s made things worse. Does the shin pain every go away?

        • I am sure everyone is different, but after the initial recovery, my shin has not bothered me much. I can still feel a little bit of pain when it’s cold or a really put stress on it. However, it is still super sensitive to touch or hitting it – it has the same pain now as a “funny bone” sharp, intense, but short-lived pain for me.

          My surgery made everything much worse too. I was told it had a 93% success rate but have never found another person who’s knee it didn’t destroy. Even though that knee hurts work hard not to favor it or you will end up damaging other joints like I have. Keep up with therapies or it will just get worse.

  8. I had an ACI with Fulkersons (patella realignment) 4 years ago. I have regained my ability to walk again from this procedure. However, I have recently learned that this procedure has permanently atrophied parts of my quad. I am told this kind of atrophy is permanent and also makes a knee replacement very difficult. If I could go back in time, I would have gotten a partial knee replacement (at the age of 28). Yikes. I trusted my surgeon and his team. They sold this procedure so well. I believe he did want to help me, but he also has a business to run and a favorite and specialized procedure to use.

    • Sounds just like my surgery and my doctor… I don’t regret a lot of things in life – but this left me passing on activities like I am 60+ when I am 30.

  9. Oh boy! I’m 8 days post-op and wish I had googled “pain after Fulkerson Osteotomy” sooner. 5 days in hospital because they couldn’t control my pain, now I’m home and I’m sleeping on the sofa (as is my incredible man!) because even with a stair lift the idea of going upstairs makes me feel sick. Surgery was my last hope, I have Ehlers Danlos Syndrome and prior to surgery my patella (among other joints) was dislocating almost daily causing falls & ultimately put me in a wheelchair. I’m sorry to see so many of you have had such horrific experiences, I truly hope things improve for you but I am glad I found you.

    • Hi Claire. I also have EDS. I had a fulkerson osteotomy with a lateral release when I was 18. That was 16 years ago. I also had the surgery due to lateral dislocations. The surgery was hell and my knee never recovered completely. I still dislocate laterally and now I also dislocate my patella medially (towards the inside of my leg). My surgeon told me I would be able to run marathons 3 months post op. What an idiot. Every OS I have seen since has stated that I never should have had the surgery. That my patella and my knee both dislocate because of the EDS and lax ligaments. Changing the alignment of my leg just made everything worse. I hope you have a different outcome then I did. That surgery was the beginning of a major downward spiral for me. Putting so much weight on my other leg and also using crutches and eventually a cane for so long put so much stress on my other joints and now I am dislocating most joints frequently. It is possible that this is just progression of the EDS as I age but I truly believe that this surgery was the catalyst of it all.

      Since you have already had the surgery, the best advice I can give you know is to keep up with the physical therapy. Definitely try to find a PT who is familiar with EDS or at least willing to learn. Try to do static exercises (where the joint is in one position and not moving, like a squat. Work up to holding a squat for as long as you can. It took me almost a year to be able to hold a slightly bent squat position for more than 2 minutes or so.). Refrain from doing any repetitive bending exercises (not including non weight bearing bending while you work to get your ROM back). If you want to talk you can email me. Good Luck!!

  10. My God I am glad I found this webpage. This is the only surgery that will stop the constant clunking in my knee. I have had a serious dislocation and several subluxations over the past 40 years. I am a very fit athletic 58 year old woman who’s knee started making terrible sounds after salsa dancing too much. Finally the tracking just got too much out of alignment and this is apparently the only way they think I can recover. In the past Physical Therapy has worked well for me when I’ve had bouts of really bad instability. Given that I’m not having pain and I have no arthritis, I think I am going to hold off on the surgery even though I am clearly going to have to give up salsa and ballroom dancing for the 8 hours a week I was doing. I can’t even cycle now. I can’t row. and my gait is weird cuz I’m walking with a bit of a straight leg. It would seem like some lifestyle adjustments are a smaller sacrifice than the pain some of you guys have gone through. I’m going to give Physical Therapy another 6 months in the hope I can at least get some gentle cycling back into my life. The good thing is, I do a lot of freestyle swimming, so I can still get a good cardio workout in the pool. But God I miss all the things I used to be able to do. I am still grieving over that. Thanks for this post

    • Sorry to hear about your knees, Cheryl. The doctors claim a very high success rate with this surgery, but it significantly deteriorated my ability to do just about everything. I did this surgery to try and run again and now I have trouble walking for long periods of time. However, I wouldn’t want my experience to completely dissuade you from something that could help you, I would encourage you to talk to others and see if there isn’t someone out there that this surgery actually worked for, but still be critical of it. While I regret my surgery pretty much every day, I would do just about anything to run or be active again – but that’s also what got me into this mess. I hope you find ways to stay active.

  11. I had Fulkerson in 2013 and have had NOTHING but pain ever since. I have strange bruising and swelling at the bottom of my scar. Any kind of long weight bearing to my L leg is immensely painful. I am actually seeing Ortho tomorrow. I wished Id never had the surgery. I wished I knew then what I do now.

    • Mostly the same here, different pain, but life-altering pain and regret of ever having the surgery. The doctor claimed 93% success rate, he was a team doctor for one of the best teams in the US, yet I have never found a person who was actually happy with the surgery, let alone somebody where it did ruin their life.

  12. I as well have had this surgery (Left knee November 2015). I had the screws taken out in May 2017, hoping to relieve me from my pain(interior pain, as well as the top of my shin). Removing the screws did absolutely nothing for me. I still get a shooting pain from the inside of my leg, that goes down to my foot. The top part of my shin is also ALWAYS in pain. I sometimes feel as if my Ortho screwed the bone in too low, and now my tendon is extremely tight. The pain starts getting bad after standing for approximately an hour, and just gets worse and worse. Also, sitting with my knee bents at 90 degrees, I can only handle about 10 minutes of that, then I have to extend my leg to get any relief. Like yourself, I cannot get down on my knee. I never knew how to describe the pain, but the way you explained it “like hitting your funny bone”, is dead on. It’s hard being 33, and not being able to run again. I even try to job and it feels as if something is going to snap in my knee. Mind you, this was my second surgery, I’ve had quite a bit of work done to me. I was messed up before my first surgery, but I feel as if the surgeries messed me up a whole lot more.

    • My Ortho basically destroyed my knee. I don’t have the issue with the bone/screws you described, but the tension of my tendon was never right and just caused a pressure point in a different spot of my knee. It’s been 5 years almost and it still sucks. In a lot of ways seems to be getting worse. I had this surgery to try to be able to run again, and now I struggle to walk as far as I want, and I couldn’t run even if I was running for my life. I am not sure there’s much we can do about it now, but anyone reading this considering the surgery, just know that it can have serious negative impacts that the docs don’t really talk about. Hope you find some relief from your pain.

  13. About 4 weeks ago I had fulkerson osteotomy and MPFL reconstruction surgery on my left knee. I understand the pain, bone surgery is not fun! But so far I have had a pretty good and speedy recovery. I had surgery on Dec 16, stayed in the hospital until the 19 due to immense pain. I wasn’t able to walk or even move without bursting into tears. The first two weeks after surgery were the hardest days of my life. I was completely helpless and dependent on my dad. But he pushed me, I pushed myself and I went back to school on Jan 4. From that point on I have had an uphill recovery. Without a doubt I still experience pain and uncomfortableness, but much less frequent and not as extreme. I have made much progress in these last few weeks, days even. I went from kicking my physical therapist a couple days ago when he bent my knee to 45 degrees to easily hitting 50-52 on my own. I hate that Adam, you have had a rough experience!! But Lori, I can tell you that my results so far have been outstanding!!

    • Glad it worked out for you! Hopefully it continues to get better and you get back to doing what you love. I pushed myself a lot too going to well over 200+ physical therapy appointments before and after the surgeries, but not luck, I think they just put me back together wrong.

  14. I’m having fulkerson osteomy April 14th. .I have had both knees scoped. . Pain Has Returned Big Time. Constant pain. Hurts to walk, sit, drive. Climb stairs. This surgery is my option, other than living in constant pain. . Now I’m wondering if I should do it.. has anyone had a good result?? Any advice would be appreciated. ..thanks

  15. I had the exact surgeries. ACI stands for autologous chrondrocite implntation. They actually take a cell sample from your healthy cartilage and send that to Cambridge to be grown into millions of cells. I am 3+ years out of surgery and am currently 28. I am grateful I had this surgery now. I don’t have the goal of running but I am pain free in most environments. I do experience the same discomfort kneeling, but have accepted that as life. I still have another knee to kneel on.

  16. I got this surgery over a year ago. It is more aggravating than before. Your story is just like mine. I still have a weird numbness and jolts of pain that feels like an itch that can’t be scratched. I can’t stand still for over a minute or that uncomfortable sensation occurs. What, if anything, are you doing /have done to help?

    • My surgery was a little over two years now and it’s still sensitive, but mine hurts more when I put any weight or kneel down on it (which I do al the time taking photos). It feels like you just hit your funny bone really hard. A small bump stops me in my tracks, wincing in pain. I did months and months of therapy after, but without much success. I wish I had some ideas for you, but I don’t. All I know is when I am old and someone asks me if I have any regrets, I will say this surgery. It destroyed my knee.

  17. This sounds awful! David had knee surgery around 10 years ago- Meniscus was scoped out and he had an ACL reconstruction. Soccer injury that took 3 surgeries to fix. He still has some issues with it, running is ok but he can’t ski or snowboard anymore and he has lots of numbness in that area from nerve damage, so kneeling is really hard for him. Hang in there!!

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