All of my knee problems started when I decided it was a good idea for a thirteen year old girl to play on a boys' soccer team. An angry opponent esstentially tackled me while all of my weight was on my left knee and I was rotating to kick the ball with my right leg. I tore my ACL and tore my meniscus - not that the doctors figured that out right away (my physical therapist was the one who pretty much diagnosed me), but that's a story for another time.
After an ACL reconstruction (August 1999) and many months of physical therapy, I was finally able to return to playing soccer after a year off. At that point, I was in 9th grade. I made the varsity soccer team and had a good year that was uneventful in terms of my knee. Unfortunately, my 9th grade year was my only "good" year for my knee. After that point, I would play the spring girls' soccer season and follow it up with an arthroscopic knee surgery. Shortly after graduating high school, I had my fourth knee surgery before heading off to college (June 2004). The surgeries generally consisted of cleaning up articular cartilage (the cartilage layer on the femur bone) that was falling off, mending tears of my menisci, and tightening up my ACL graft.
At this point, I had seen two different surgeons. The first was Dr. F at OIP - he did my ACL reconstruction. When I started having problems again, I went to see Dr. H at AO - he came highly recommended. I loved Dr. H; he was very understanding, knowledgeable, and personable. He did everything he could to accomodate my schedule and my needs. He really cared about my progress and wanted to "fix" me. However, at the this point, Dr. H felt there was little more he could do for me - we had tried several arthoscopic procedures, Synvisc, Euflexa, and steroid shots. Dr. H wanted me to get a second opinion and suggested I see Dr. F (a different one!) at RI. Dr. H had given me three options at that point: 1) an abrasion chondroplasty (explained below), 2) a bone plug procedure (OATS procedure, using cadaver plugs), or 3) an autologous chondrocyte implantation or ACI (growing my own cartilage in a lab and implanting it). Dr. H could do the first or second options but wanted me to see Dr. F at RI about the third option. In short, Dr. F at RI saw me, did an exploratory arthroscopy (cleaned up a bit while he was in there), and determined I had too much damage for either the OATS procedure or the ACI.
At this point, I schedule my third surgery in under 12 months. We decided to do the abrasion chondroplasty with Dr. H in spring 2005. This surgery essentially consists of using a burr to "rough up" the bone surface and drilling small holes to produce bleeding; the procedure intends to produce a layer of scar tissue to serve as a substitute for the missing cartilage. The surgery was ineffective and I was out of options. We continued using Euflexa (I had developed an allergy to Synvisc from prolonged use) and steroids with little relief.
Then a terrible thing happened - Dr. H was going to retire! We had discussed knee replacement and he said he expected to do it before I was 40; slowly over time, the goal was changed to making it to age 30. Now, he was retiring and so were my hopes of a timely knee replacement. Before he left the practice at AO, he did a final arthroscopy on me (July 2009) to clean things up and hopefully buy me some more time.
In fall 2010, I went to another surgeon at AO, Dr. K, to discuss my options as my pain was increasing daily. He was less than helpful and essentially told me that he would not do a knee replacement before I was 40 and even at that point, he would tell me to wait longer, regardless of whether I was in chronic pain and stuck in a wheelchair. It was at that point that I began to doubt I'd ever find someone to help me...
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