Three months Post ACL - MCL Reconstruction

Okay, so here I am 3 months post-op and I just had my 3 month visit with my OS.  Things are moving along but I really thought my knee would be feeling a bit stronger by now.  However, according to the surgeon, things are moving along as planned - EXCEPT for my EXTENSION.  Okay so I have this JAS brace to help me with this along with physio and it's still a struggle.  I get excrutiating pain up and down my hamstring and calf muscles when I'm extended.  I'm at -7 for extension and he is concerned.  He says that I can manage with my flexion at 112 degrees and my new ligaments are doing well, but my lack of extension will cause me problems.  That's why I can't walk properly right now.  He said he could go in (AHHHHH!) and clean up scar tissue but he feels as though there is nothing stopping my extension.  Basically I have 6 weeks to get this leg straightened up and then perhaps he may do something.  When I brought up the issue with going back to work, he said we won't consider that for at least another 6 weeks.  He says I should notice progress in the next 6 weeks with regards to leg strengthening etc...    Anyhow,  this is surely the longest and hardest ordeal I've ever gone through.

Moving forward at a very slow pace!!

Wow, I can't believe how fast time is going by.  As long as some days are, I am already 9 weeks post-op and things are moving along well.  I think my greatest problem is the fact that I actually feel as though I can do more but after I do it I realize that I've done too much.  I need to remember to take things slow and not push myself too soon.  I saw the surgeon last week and he gave me the ok to put more weight down on my leg.  I was max. 50% weight bearing since 1 week post-op on surgeon's orders.  I am still to use my crutches to assist with the walking but he wants me to get the weight down and work on the natural walking motion.  I've also been given the ok to start muscle strengthening.  Other than that, my flexion is at 106 degrees but I have issues with extension.  He is putting me back into a JAS brace for the next month or so.  JAS brace is a "Joint Active Systems" brace which I also used after my skiing accident to get my flexion and extension.  It's quite an interesting contraption, check it out on the web!!

While at physio the other day I was doing an exercise and my knee kept on catching/clicking.  My physiotherapist said it was a kneecap tracking issue and should resolve itself when I regain some of the lost leg muscles.  The area where they took the patellar tendon graft is tender and easily gets swollen.  It is a very warm area on the knee that even the coldest ice doesn't cool down.  Time, icing and rest will help that!  I still have a large section of numbness (the size of my hand) on the left side of my incision. When I asked the surgeon and his resident, they explained that my MCL reconstruction required a lot of work in an area where the nerves cross over to the other side of the leg and the feeling may or may not return.  It may be 6 months or so before I know!  Talk about a wierd feeling.

As for my PCL, I guess its still hanging in there!!  He decided to do the ACL/MCL reconstruction in hopes that it provides enough stability.  HOPES??????  Anyhow, the posterior sag isn't too bad according to the surgeon but I think my shin has fallen far behind the tibia and looks rather ridiculous.  He'll keep and eye on this I'm sure.  Anyhow, I'll add some photos when I get my new JAS brace. 

The thought of doing anything other than my slow walk seems too far into the future it's crazy.  I've been like this for a year now and this seems to be the norm and everything else seems out of reach.  I had a dream the other night that I was running and I was as light as a feather on my feet - WOW what a feeling! 

www.jointactivesystems.com/         (JAS Brace information)
http://www.mysportphysio.com/      (My Physiotherapy Hangout)

Day 42 - Six Weeks post surgery!!!

It's been a while since my last post but I've actually been quite busy with physio and trying to get out to do some Christmas shopping - gotta love those scooters!!

Anyhow, about my knee... Physio is going very well.  I can actually do a rotation on the bike and that was a great acheivement.  I've reached 90 degrees in flexion which is what my surgeon was hoping for in 6-7 weeks.  I see him again on the 5th of January.  Swelling is going down and I'm fitting into my Don Joy hinged brace which is a great change from the zimmer brace.  The numbness and aching below the knee cap where I believe the patellar tendon was cut out is somewhat bothersome and I will be discussing it with the surgeon.  As for my quads and calf muscles - they are non-existant.  Once I get the okay from the surgeon, we will start leg strengthening excercises at physio.  Until the New Year, have a great holiday!!

Day 21 - Three Weeks Post Surgery



Incision and swelling at 3 weeks post-op




Well, I feel as though I'm getting stronger every day.  The incision is healing well, yet the numbness is still very bothersome.  I'm getting out with the help of others and realizing that Christmas is just around the corner.  I'm looking forward to everything that I'll be able to do once I'm off crutches and have the freedom of my hands. 
 



Nice knee Judy!!!



Physiotherapy is going well, my flexion is at around 70 degrees + or - a few degrees.  It's very hard work to get the knee bending but its coming along well.  I actually enjoy getting out to physio.  I think I may stop in at the school on Friday after my 10:00 appt. and have lunch with the staff.  I really miss the normal day to day routines of my old life.  It will be one year on Dec, 31st since my accident.  The best way to spoil myself is to get into the tub where the gravitational forces aren't pulling on my knee.  For anyone who has ever had knee surgery, you completely lose all muscle in quads and calf and your leg feels like a ton a bricks, taking two hands to lift it off the couch.  I will slowly need to build up that muscle in my leg again!  First goal is to reduce swelling and get ROM (range of motion ) to 90 degrees.









First Day of Physio

I went to Physio today and it was great to get out of the house and talk to people other than my immediate family.  My physiotherapist took a great deal of time to talk about my surgery and how I'm feeling.  He said we'll take things slow to start and that made me quite happy because I'm very nervous with this "new" knee.  I did some semi-circles on the stationary bike, did the electrode thing, ultrasound, went over some exercises that I could do and measured my ROM.  Before the stationary bike I measured 50 degrees and then after, he measure me at 62 degrees.  I'll be going to physio 3 days a week for the first month and then we'll assess later. 

I'm Back! - 11 Days post-op from ACL, MCL Reconstruction!!

So, the past 11 days have been quite challenging both physically and emotionally.  On November 8th, 2010, I had ACL, MCL reconstruction using hamstring and patellar tendon from the injured knee.  The PCL was left alone since his goal was to take a 3 ligament injury and turn it into a 1 ligament injury.  The plan for surgery was to use an allograft (achilles tendon) but that changed.  I also woke up from surgery 4 hours later to 40 staples forming a beautiful L on my knee. Well, I slept for the first 3-4 days batttling the side effects of the pain killers and anesthesia (mild nausia and dizziness)  .  By about day 5 I decided to start spending more time on the couch with my CPM machine continuously bending my knee!  The pain during the first week was not all that bad other than the rush of pain in the shin and calf when changing elevations.  The doctor explained that it was the blood that was lying beneath the surface of the skin as a result of the bone drilling/plugs during surgery- very common!

Now into week two, the pain is very manageable but it has now become knife jabbing pain in the kneecap!  It's not as bad as the calf and shin from week one, but it can be bothersome.  Yesterday I saw the surgeon again and the staples were removed from the incision.  Icing the knee feels great and I'm using my cryocuff all the time - it is a lifesaver!!  One thing that is very bothersome is the numbness below the knee and around the incision, however I know it will slowly get better.  I'm heading to the physiotherapist on Monday with a program to work on range of motion to 90 degrees over the next 6 weeks.  I'm also partial weight bearing to maximum 50% during this time as well.  Looking forward to my physiotherapist's cold ice and great conversations.   I told my children that they could decorate my crutches for the holiday season and they were thrilled.  Although I feel as though I have gone though all of this already (post injury), this time it's different - I've started on the road to recovery!!!!

Getting Things in Order

Yesterday was a busy day with phonecalls and arranging things so I'm ready to go up to Ottawa Sunday night.  Dervin's office called to confirm surgery for Monday and the Hospital called to arrange my overnight accomodations!  I also made my phonecall to my old surgeon to tell him to take me off the waiting list - yipee.  So I have my Cryocuff, Ice is made, Zimmer Brace, Crutches, CPM machine rental, Physiotherapy Appts Booked and travel arrangements to get me back home.  This is oficially my last post until I'm home. 

Surgery Date

Okay, so last night I got a message from my OS office letting me know that they had November 8th, a week from Monday, available for surgery.  So ... what can I say other than I'll let everyone know how it went once I regain my composure from the anesthesia and when the pain is under control. Until then .......

Moving Forward



An MRI image - but not mine!



So, I had my latest visit with my new OS and I was very impressed!  He actually put my MRI on the screen and went through it with me as well as the resident who was working with him.  The word "mush" came into play when he was showing me where my ligaments used to be!!!!  Since I am in a "chronic" state (greater than 4 weeks from accident) his goal is to take this three ligament injury ( AKA knee dislocation) and turn it into a one ligament injury.  He is doing ACL, MCL reconstruction, fixing the meniscus and cleaning up the scar tissue in the very near future.  Since he can't harvest enough tissue from my leg to do two reconstructions, I will be having an allograft (achilles donor tendon) to reconstruct my MCL and an autograft (my own tissue) for my ACL.  There was the option of taking a graft from my good leg but I passed on that one.  Let's leave the good leg alone please!!!

He is concerned about the PCL but at this point feels as though surgery will not get my PCL any better than it is right now.  PCL reconstruction has average outcomes and the newly reconstructed ligaments tend to stretch out.  It is a very difficult surgery drilling into the back area of the knee. It is something that he will monitor and if it's required, it may be done down the road.

I've gone into the hospital for my pre-op visit and all the paperwork is done.  His secretary told me to be on call and ready because I may find out the night before my surgery.  Sooo ... everything is in order and I'm ready to go!  I'll be staying overnight in the hospital to monitor pain etc...  I will let everyone know when the big day is ... I'm thinking in the next few weeks because initailly he was hoping for TODAY but it wasn't approved!  Here we go!

Nervous Feeling

Today is October 19th, 2010, almost 10 months from my skiing accident.  I'm seeing my new surgeon tomorrow and I'm a bit nervous.  I know that he will do surgery, but which surgery and when?  I'm so accustomed to leaving my appointments with very few answers.  However, tomorrow I feel that it will all be set in stone as to what he feels I need done.  Ah Well, I'm in good hands!