cshires: I've just been an occasional lurker on this forum over the years until now. After reading your most recent post and noticing the similarities between our cases, I felt compelled to participate.
I will attempt to abbreviate the details of my treatments/surgeries to those that apply to your situation:
I was surgically treated for a ~13-mm x 8-mm osteochondral lesion, with an underlying ~4-mm bone cyst, on the anteromedial shoulder of my talus about 2.5 years ago. After arthroscopic debridement and microfracture, I received an allograft-particulate/BMAC bone graft and an overlying BioCartilage/BMAC cartilage graft. Side note: the bone cyst developed over just a 3-4 month period (since a previous MRI and surgery) and, after it formed, it caused new pain patterns that were joint-wide; these ranged from deep/sharp knife pain through the talus with certain weighted positions to capsular-impingement pain along the joint perimeter, including the posterior part of the joint.
Four months later I had an additional scope procedure to remove extensive scar tissue that had formed during the 6-week non-weight-bearing phase of my previous surgical recovery, which ended up limiting my dorsiflexion to just ~0-5 degrees. This provided ~10-15 degrees of post-op dorsiflexion.
After an additional 14 months, I had another surgery to address medial and posterior impingement by removing bone spurs, synovitis, and more scar tissue. At that time, I had full coverage of the BioCartilage graft tissue, however a full thickness fissure was identified along the anterior margin of the graft. The bone beneath the fissure was drilled twice with a K-wire, and the joint was injected with BMAC at the end of surgery. Despite the drilling, I was allowed to weight bear immediately following surgery, owing to the structurally supportive nature of the surrounding native and reparative cartilage tissue.
I had yet another surgery 6 months later to address recurring medial impingement and enhanced talar edema, both of which were likely caused by medial joint instability (the jury is still out on this). At that time, the previous cartilage fissure had completely filled in, however the BioCartilage reparative tissue had hypertrophied across the remainder of the graft surface. This was shaved back down to the level of the surrounding native cartilage surfaces. It's not clear whether the hypertrophied tissue was caused by normal growth or was induced by the K-wire drilling and/or BMAC. Apparently, it's not uncommon to have this type of overgrowth behavior with BioCartilage and DeNovo grafts. It's also not possible to determine what the respective contributions of the drilling and BMAC were on the the fissure repair. I did receive another BMAC injection after this surgery.
So I feel your pain, both physically and mentally. The last 5 years (including 8 ankle surgeries) have been the most exhaustive and discouraging of my life. For me, I have no choice but to fight this to the bitter end, since my core connection to this world is through self-powered motion. However, I would not judge you or anyone else for calling it at some point and moving on, for the fight over the long haul does not come without a steep personal and financial price.
Would be happy to provide any more details that you feel may help your situation. I am willing to do that either here online or offline.
