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Old 01-05-2012, 06:02 PM   #1
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OATS recovery: how long until desk work?

Forgive me if one of the previous OATS discussion covered this issue. The older posts on this board have been incredibly helpful, but I wasn't able to find anything specific to this question.

How soon after OATS surgery did you feel well enough to sit up and work from home, either full time or part time? And how long did it take for you to be able to get around... if you didn't have to be the one driving?

I work for a very small company, and we're in the middle of a major reorganization, so being absent for an extended period of time would just not be an option. All of my job can be done sitting or lying down, and given the circumstances I'm reasonably confident that I could work from home for weeks or months. Also, I live in a large city, so getting to the office without driving should not be too difficult -- I don't commute by car now. Our city buses have accessible lifts, and my home is 1 block from a stop. I understand that pain may be a limiting factor more than mobility, at least at first, but I'm trying to get a handle on just how this will all play out.

My doctor hasn't yet told me I definitely need OATS, but it's clear from my diagnosis (stage 4 10mm medial anterior talus lesion) that the cortisone shot she gave me 10 days ago isn't going to be the fix. The doctor did say that if aircast immobilization didn't work (her next planned step after the injection) that she wouldn't even bother with drilling, as the lesion is too large and severe, and that a "bone graft" would be the next step. I'm presuming she was using that as shorthand for OATS; I will definitely be asking detailed questions at my next appointment!

Thanks much!

Last edited by AnitaSF; 01-05-2012 at 06:04 PM. Reason: added diagnosis info

 
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Old 01-05-2012, 08:00 PM   #2
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Re: OATS recovery: how long until desk work?

Anita,
It depends on a few factors. First the most important thing in the first few weeks of OATS you will need to ice and elevate. Now depending on how organized you are. It could be done fairly soon on a part time basis. The other huge factor will be what kids of medicine you will be on and how you function when on them. If you don't need alot of pain meds and can organize yourself to have everything you need accessable then I would say it can be done. Remember elevate is not just in a chair with your foot up, it is your foot higher than your head. It will really make a difference in the ammount of pain you have. There are some posts dealing with helpful pre surgery preparation. If you really prepare ahead it is helpful. I would say to give your work a longer time span than you think and then if you are able to start sooner it is a positive, rather than if you tell them and then are not able to.
Shorter answer 2 to 3 weeks. (based on my opinion after two OATS) If your pain is tollerable, you are very prepared, if you can lay down alot and if you can easily access things you need. Remember cooking and other normal life things will take alot longer at first. Its like life goes into slow motion.
Maybe someone else will reply too.
Good luck, Best wishes let us know how it goes.

 
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Old 01-06-2012, 04:44 AM   #3
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Re: OATS recovery: how long until desk work?

Let me first welcome you to the club..(unfortunately)... I am also glad your Dr is already talking OATS instead of the absolutely useless microfracturing procedure. I had about the same lesion as you when my journey began 7 years ago, I just last week had DeNovo NT, which is kind of a variation of OATS, newer, and less intrusive, and what you should be looking for if possible instead of OATS. It is very new, and not a lot of Drs are doing it yet. I got mine at Mass General. The difference, is that the cartilage comes from a juvenile organ donor instead of your knee, and it is prepared and attached in 1 surgery. With DeNovo they may or may not have to do the osteotomy. I didn't have to have that. I had 3 microfracturing surgeries, all just resulting in my lesion growing from 10mm to 25mm. Denovo also removes the risk of damage to your knee and also a second scope location.

Back to your initial question. I am at work now, and have been all week, it is a desk job I am doing. I had my surgery on Dec 29th, and returned to work on Jan 3rd. I would say you'd be out a week tops. Even though you'll be no weight bearing like me for 6 to 8 weeks. If you have good transportation, and a desk job, a week will be sufficient.

 
Old 01-06-2012, 05:51 AM   #4
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Re: OATS recovery: how long until desk work?

Another OATS'er here..

I had it done in 2008 and had the traditional plugs taken from my knee, osteotomy and I have to agree with Dizzi...two weeks minimum.

If you have traditional OATS, please search back on old threads as there were about 5 of us going through it at the same time and are all doing well. No knee pain then or now, osteotomy wasn't a big issue and it is surgery so pain for most was worse during the first two weeks and Dizzi is correct, depending upon pain meds and how you are on them, you may be able to function sooner.

I had mine done at Hospital for Special Surgery in NYC.

Good luck, sorry you are joining the club

 
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Old 01-06-2012, 06:40 AM   #5
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Re: OATS recovery: how long until desk work?

Thank you all for your detailed replies, and the warm welcome.

JimJJr: thanks for the Denovo push. I agree this would be my top option if given my choice, but I know my insurance would not pay for it as it's still experimental for ankles. There is a Denovo trial going on at UC Davis (a few hours from my house, so a possibility but maybe when all is said and done not really workable for all the follow-up... And that's presuming I would qualify.)

Kimberp: thanks for directing me to the older threads. I've been poring over them for the last couple of days and they've been incredibly helpful.

Dizzizzi: thanks for the reminder about what the first few weeks will mean. I think my employer can tolerate a few weeks' absence, as we do manage to let people take vacations! (guess I am "going to" OATS this summer instead of London as we'd planned for our 10th anniversary). I was worried that people were describing months-long work breaks for OATS and I couldn't tell if that was because of their need to drive to work or some other factors.

I'm due for a follow up on the 17th and will report back then. Thanks again for your answers and support.

 
Old 01-06-2012, 07:50 AM   #6
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Re: OATS recovery: how long until desk work?

I was up and about about 2 weeks after OATS. BUT, it still was painful not to have a chair or something to rest your leg on at least level with the chair you are sitting on.

As for DeNovo and OATS. You can see a long thread I had on The "D" procedure I think it was titled.

I went to Myerson/Campbell's office in Baltimore to ask about it after my OATS failed. I was told there was not enough data on it and my insurance would not cover it. My dr. here in Chas. had wanted to do it, but had never done the procedure before and could not tell me how many "packets" I would need. At $5k a pop, that was pretty important paying out of pocket. The folks in Baltimore told me that I needed so much. perhaps 5 packets and my OCDs (yes, plural) were so widespread along with the post tramatic arthritis that it was not worth it. Plus, I don't think they could cover the tibia which also was going bad.
They lead me to distraction arthroplasty, which I had done. It failed as well.
I just had an ankle replacement done a month ago...at age 43.

I sometimes wonder if DeNOvo would have worked, but I trust that it works for smaller areas, once OCD, vs more than one. I think it depends on your situation.

As for OATS, I had/have no knee pain at all. My osteomtomy was okay. Microfracture did not work for me. One of my OCD's had it 4 times and just got bigger each time.

 
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Old 01-06-2012, 10:44 AM   #7
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Re: OATS recovery: how long until desk work?

Thanks for the detailed reply, K_Lana. Sorry that you ended up with the ankle replacement... yikes. I'm also in my early 40s, so I can imagine how daunting that must be. How is your recovery going?

I know my insurance also would not cover DeNovo; it will be enough of a struggle to get them to approve OATS, and it sounds like DeNovo approval for ankles is still years off.

 
Old 01-06-2012, 10:59 AM   #8
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Re: OATS recovery: how long until desk work?

My insurance denied OATS the first time. I had to appeal it, but they did cover it. OATS has lots more history to go back on to show success rate. I do know one person from my "D" procedure thread that had DeNovo and her insurance paid for it. I don't know how that was billed.

If you have on OCD and the rest of your ankle is good, then you may want to try OATS. Many have good success with it. It is a good long recovery, but no longer than when I had my Brostrom (ligament reconstruction) and microfracture the first time.

 
Old 01-06-2012, 11:01 AM   #9
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Re: OATS recovery: how long until desk work?

My Dr. was a fellow at NYC Hospital for Spec Surg.. Now at MA General. 2 FINE Hospitals. My Insurance wouldn't cover the Denovo itself.. (About $4000) But MA General ate that cost because they want the data to show its a viable surgery, and its also MUCH cheaper than OATS, which is kind of funny that insurance wouldn't immediately embrace this. Its past clinical and is a fully approved by the FDA procedure, its just until there is enough long term data, the insurances don't want to touch it. (Kind of chicken and the egg thing... How do they get data unless they do it, but they won't do it, so they don't get data. That's where MA General stepped in. I was an ideal candidate.) My insurance would pay for the OR, the DR's and all, just not the Denovo product itself. I have been blogging here about my Denovo recovery, search Denovo recovery, and you'll see it.

Good luck

Jim


Quote:
Originally Posted by AnitaSF View Post
Thank you all for your detailed replies, and the warm welcome.

JimJJr: thanks for the Denovo push. I agree this would be my top option if given my choice, but I know my insurance would not pay for it as it's still experimental for ankles. There is a Denovo trial going on at UC Davis (a few hours from my house, so a possibility but maybe when all is said and done not really workable for all the follow-up... And that's presuming I would qualify.)

Kimberp: thanks for directing me to the older threads. I've been poring over them for the last couple of days and they've been incredibly helpful.

Dizzizzi: thanks for the reminder about what the first few weeks will mean. I think my employer can tolerate a few weeks' absence, as we do manage to let people take vacations! (guess I am "going to" OATS this summer instead of London as we'd planned for our 10th anniversary). I was worried that people were describing months-long work breaks for OATS and I couldn't tell if that was because of their need to drive to work or some other factors.

I'm due for a follow up on the 17th and will report back then. Thanks again for your answers and support.

 
Old 01-06-2012, 11:11 AM   #10
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Re: OATS recovery: how long until desk work?

K:

I'm sorry you're having so much trouble... One thing about 'D' v. Oats... I was told because my lesion is so big... (2.5 cm), Denovo was a BETTER choice because of the size of the plug from my knee that would be necessary.. I have an extremely large lesion.. I completely agree about the MFX. My lesion started just under 10mm and each MFX it grew until it reached 25mm (2.5 Cm, approx 1 inch) that MFX was no longer an option. (It wasn't for me anyway).

Good luck!

Jim


Quote:
Originally Posted by K_Lana View Post
I was up and about about 2 weeks after OATS. BUT, it still was painful not to have a chair or something to rest your leg on at least level with the chair you are sitting on.

As for DeNovo and OATS. You can see a long thread I had on The "D" procedure I think it was titled.

I went to Myerson/Campbell's office in Baltimore to ask about it after my OATS failed. I was told there was not enough data on it and my insurance would not cover it. My dr. here in Chas. had wanted to do it, but had never done the procedure before and could not tell me how many "packets" I would need. At $5k a pop, that was pretty important paying out of pocket. The folks in Baltimore told me that I needed so much. perhaps 5 packets and my OCDs (yes, plural) were so widespread along with the post tramatic arthritis that it was not worth it. Plus, I don't think they could cover the tibia which also was going bad.
They lead me to distraction arthroplasty, which I had done. It failed as well.
I just had an ankle replacement done a month ago...at age 43.

I sometimes wonder if DeNOvo would have worked, but I trust that it works for smaller areas, once OCD, vs more than one. I think it depends on your situation.

As for OATS, I had/have no knee pain at all. My osteomtomy was okay. Microfracture did not work for me. One of my OCD's had it 4 times and just got bigger each time.

 
Old 01-06-2012, 02:11 PM   #11
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Re: OATS recovery: how long until desk work?

Jim I've booked a second opinion appt with your doc at MGH Danvers. It's a couple months out though, but no biggie. If I don't need an invasive repair immediately, I probably will down the road as the microfracture just doesn't seem to hold up.

Honestly, I don't know if the pain below and sometimes behind the medial malleolus is from the OCD or posterior tibial tendon, but it's been off and on for the last 10 months. I can usually feel it as the weight shifts to the ball of my foot vs. standing straight up on my heel.

My other issue is just chronic synovitis and scar tissue impingement on the anterior side of the ankle. I haven't had a cortizone shot in 6 months (in the joint) and that usually calms down the synovitis and scar tissue.

Bob

12mm X 6mm OCD posterior medial talus microfracture repair July 2009
Scar tissue and synovitis debridement Sep 2010

 
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