Up until the beginning of 2011 I was fit and healthy 23-year-old guy, however, during pre-season training for the 2011 football season I had noticed some pain in my right knee. As this pain was never anything to give me any real concern I just continued on. The first game of the season came around and I was at the point where I had more strapping tape on than you would have thought possible. In the first minutes of the second quarter I landed awkwardly and had someone fall onto the outside of my leg. This tore the medial collateral ligament in my right knee.
A few weeks passed and I knew that there was more too it. I had pain all through my knee joint and could hardly walk. To be on the safe side I went and had an MRI, the results where horrendous. From the impact I had suffered multiple spiral fractures in the top of my tibia, severe nerve damage and worst of all they had discovered a section of dead bone in my femur.
Upon meeting with my surgeon he informed me that the death of the section of bone is not caused by an injury, it is most likely caused by a small clot cutting off the blood supply. As a result of this area of bone dying, all of the cartilage on top of it had completely perished as well, hence the pain in my knee that had been growing over time. By the appearance of my knee the surgeon guessed that it had probably been this way for 1-2 years.
The solution to my problem was to have a Matrix-induced Autologous Chondrocyte Implantation or MACI. This is a relatively new procedure. So in the beginning of June I went in for an arthroscopic procedure. I had the area of dead bone removed as well as a biopsy of healthy cartilage from the opposite condyle. The biopsy was sent to Sydney where it was grown on a matrix in a lab. Six weeks later, towards the end of July, I was back in hospital for a much bigger procedure. I my knee was opened with a 10-centimetre incision and the implant was secured using a biological glue. 3 days later I left hospital on crutches with an ankle to hip leg brace on.
The implant has the consistence of jelly up until the six-month mark when it has collected fibres and started to harden into mature cartilage. This means that it is extremely fragile and you need to be extremely careful with everything that you do.
I spent the next six weeks on crutches. I had to do 200 straight leg raises per day and as the weeks went by I was allowed to put more weight onto my leg and was given more degrees of movement on my brace. By the end of six weeks I was putting 50% weight onto my leg and had 85 degrees of movement as I crutched along. The muscle wastage was incredible; I had never seen anything like it. My right thigh was literally half the size of my left. I could easily put my hands around it. By this point in time I had dropped 12kg’s from 90kg’s down to 78kg’s. From week 7-12 I had to walk around with the brace on, I was seeing my physio twice a week and my only exercise was none resistant cycling and walking in the pool.
At 12 weeks I was back up to 81kg’s, the brace was off and I was swimming every week and upping my cycling to slight resistance and five times per week. I was performing squats as well as many exercises designed to build the stabilising muscles back up. At this point my knee already felt better than it had before the operation. The hardest part was remaining as careful as I had been and not pushing too hard too soon.
It has now been six months since I had the MACI procedure. I now weigh 85kg’s and still maintain low body fat percentage. From three to six months the story stays the same. No weight training, no running, just boring cycling and a bit of swimming. I was allowed to play golf after three months, which was great because I was finally allowed to play some kind of sport again. I have only just been allowed to go to the beach and walk on the soft sand as before the instability could have caused the implant to come out.
To get to where I am now I had to be thinking about my knee every waking minute. I have been paranoid and scared on many occasions but this has made me be careful. Once I get to the 10-month mark I will have a CT scan and then go and see the surgeon, he will hopefully give me the all clear to start running again (14 months after the football game). The return to sport is usually 12-18 months; I think mine will be around 14 months. My knee feels fantastic at the moment, I am slowly getting the muscle back into my thigh but at the moment it is still only 75% of the left thigh and strength is still down but I am definitely making progress.
It is definitely a long year but when there is no alternative it doesn’t seem so bad. I can see the light now and I already feel so much better than I did before the operation. I would recommend this to anyone in my situation in a heartbeat.
Matt Utley
Range of Motion Prac Student
