Dr. Justin scheduled me for surgery in 2 weeks, 1/30. My meeting with him was OK. He described my injury as a oblique root tear along with other parts of the meniscus. He noted some wear already on surfaces and couldn't be certain the level of repair he could accomplish 'til he got in there'. I wouldn't say he was brazenly optimistic, nor roundly pessimistic. Perhaps a bit aloof. I do like him, trust him, I like what I've seen from his staff, his prompt scheduling, and his willingness to work with my insurance company to reduce my out of pocket expenses. He did push the BMAC stem cell treatment which I declined (because I don't think it really works that well and is expensive) and like last time, opted for PRP only. He also mentioned the MISHA knee device, an internal prosthetic, but I'm pretty opposed to that at this point since it is so new, only FDA approved 4/23. It would be last resort before a knee replacement.
The logistical issues involved with doing this in LA, in the W. Hollywood area, are formidable. I know it will not be at all like it was in Vail at Steadman. It's basically check in, surgery, and adios. No PT meetings, just bye-bye. Followup via zoom. His post op protocol is far less conservative than LaPrade's. I'll be flying in Wed, surgery Thurs, home on Friday. At least I won't need to drive. One of the worst parts is finding someone to check me out. They will not release me alone to an Uber. Roya found someone through her caregiver network that I could hire for $150 to check me out and drive me to the hotel, will be worth it, LA during rush hour. Good, so I don't have to drive in LA. I'll checking out of the hotel to the airport shuttle only about 15 hrs after I return to my hotel after surgery. I'll be glad to get home.
I remember the trip to Vail, this same time of year, 6 yrs ago, it was truly epic
Not to spend your money, but I'd perhaps keep thinking about BMAC, which demonstrates better outcomes than PRP (see FEB 2024 Nature article, for example). Most other SC therapies, e.g., fat cells, are not efficacious and frankly a waste of money but BMAC works, especially with respect to addressing inflammation. Good luck with the procedure.
ReplyDeleteThe efficacy is tiny if any. Cost is high. This article explains:
Deletehttps://drrobertlaprademd.com/stem-cell-therapy/
BMAC I don't think is covered under insurance and would increase the cost of surgery by as much as 50%. PRP may be slightly less effective, but it costs $500 vs $3600 for BMAC.
DeleteThere are multiple meta analysis that conclude BMAC is only slightly more effective than PRP or placebo.
ReplyDeleteI read that it is really important to not be weight bearing for 6 weeks. Will you be on crutches that entire time? What is the early rehab, no resistance cycling, passive motion, etc?
ReplyDeleteJustin says "50% weight bearing" for 6 weeks but I'm welcome to more conservative. Last time I was non weight bearing for 5 -6 weeks. Yes crutches. He also says slow straight running at 4 mo, too soon. I'm going to be conservative. It's difficult higher risk repair than the previous and I'm 6 yrs older. https://meniscustears.com/root-repair-protocol/
DeleteI'm going to follow LaPrade's rehab protocol. Worked before. Seems more conservative. No weight for 6 weeks, can swim at 7 or 8 weeks. https://drrobertlaprademd.com/wp-content/uploads/2022/10/JMonson_Post-Op_Meniscus_Root_Repair_2022-10.pdf
DeleteThat’s a really good document. Meniscus health is probably another reason to right size your bicycle cranks.
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