Hi there !
This is Nina from France. I am 26 and I currently live in Germany. I am 25 days post-op and I decided to post my post op thoughts here as the ressource on this forum has been so helpful to me so far. Therefore I hope my story could also be of relevance to some people.
But first, here is the story of my injury 
How it all began : February, 4th 2017I was skiing in France (for the 2nd time of my life) with my BF and a friend of mine. I do believe that the ski bindings were not that well adjusted, as I had fell a few times and the left ski was not released (the right one did release itself). But I did not pay attention to that ... And a few minutes later ... I fell at a higher speed, left ski did not release ... I am omitting here the excruciating pain at the time and the discussion with the very efficient (no irony here) rescuers.
At the first-aid station, various tests were carried out. The outcome was : no big deal, not so much swelling, ACL apparently fine, meniscus fine, just a light sprain of the MCL. I then went to the nearest GP to get a confirmation of the diagnostic as well as a prescription for a knee brace.
The GP confirmed the first diagnostic, prescribed me a knee brace for 2 weeks. She also told me that eventually, all this should be confirmed by an MRI.
2 weeks later, back homeI went to my own GP to see how things evolved. She mentioned the difficulty to examine the knee as it had got stiff in just 2 weeks. She therefore prescribed me PT sessions. And here is the big thing : I had signed a contract for a new job before my accident, beginning 1st of March in Germany. I decided to still do it, and so the last week of February was dedicated to PT and preparation for the big move. I also took off the knee brace at that time.
Just before leaving, I returned to my GP who mentioned it could be a meniscus tear as the flexion was limited to 90°. She knew I was leaving but I still asked for an MRI prescription so that it could be easier to convince the new doctor in Germany. I actually got 2 : one for an MRI, another for an X-ray.
What's next ? the story of my pre-op care in GermanyI started my new job as expected on March, 1st. I also knew that the priority #1 would be to get healthcare insurance as soon as possible. At that time, the knee was already pretty stiff, full extension was not possible and flexion was limited to 90°.
I was considering to even go to a GP without insurance to get an MRI prescription and pay by myself, but unfortunately you need an insurance number here to get a valid prescription
.
Confirmation of registration for health care insurance, despite all my efforts to expedite the process, came around the 3rd week of March. I rushed to the closest GP I could find. Old lady not really seeming to give a d*mn, does not even inspect my knee. I show her the French prescriptions stating "IRM" (Frenc for MRI) and "radio" (X-ray). She understands that IRM stands for MRI (MRT in German), states that X-ray is not necessary, writes the prescription and evens calls live the closest medical imaging center ("it's faster when the doctor makes the appointment" -> fair enough, the appointment is 5 days later ! 5 !!!!!!!)
So, 5 days later, 4th week of March : the holy MRIRegarding the MRI process, I have to say that I found extremely weird to have to ask to see a doctor (otherwise you don't see anyone and you go home without knowing your diagnosis -well you have the pictures. I mean seriously ?! At least in France you see a radiologist for 5 minutes without asking
).
So the radiologist calls me in and asks what happened. I explain briefly : ski accident, MCL light sprain diagnosed. She said well no, it's a
partial tear of the MCL. I ask about ACL and meniscus. She says
ACL is fine, and meniscus well there is a veeeeeery
small tear. She advises me to rest. I leave the imaging center with the pictures but NO written diagnostic.
A few days later, back to the GPThe GP has the letter from the radiologist and sums it up : meniscus tear, ACL sprain, hefty bone bruise, MCL partial tear. Tells me that she believes I need an operation for the meniscus tear, but that the rest is going to heal on its own (at least one good news !). She refers me to an orthopedist and says she will take care of the appointment.
While leaving, I ask her assistant to give me a copy of the radiologist's findings (Man, you have to ask for everything in this country
!)
The radiologist's findings more detailed than what the GP explained to me :Small oblique tear in the posterior horn of the meniscus, partial MCL tear, heavy bone bruise (medial femoral condyle), notable joint effusion and ACL sprain.
Early April I receive a call from my GP's assistant telling me that the appointment with the OS will be early May. So it is a month waiting time. Looking back at it, I now think that the GP should have prescribed me PT, so that my knee had not gone stiffer... Anyway ...
Early May Eventually !!!!! The
long-awaited OS appointment ! Unfortunately the knee has gotten so stiff that the guy does a few tests (MCL test, Lachman's for LCA) but quickly concludes that I should go to PT first (
). He takes a look at the MRI pictures and says that he thinks an operation will eventually be needed (meniscus stuff), but that PT first is mandatory as the knee could get even stiffer from the operation. Well, it sounds sound and realistic.
Late May Back to the OS after 2 weeks physiotherapy. Stiffness has improved a bit and ROM also a tiny little bit. He wants me to do a second MRI. It is now 4 months after the accident, I am not patient anymore, just sick and tired. I ask why a second MRI ? He says, well, to see if some things have gotten better. But he decides to take a look again at the pictures and at the radiologist's findings. He states that well the OP might be needed after all because of the meniscus tear (about 30%). Then he performs a few more tests related to the other injuries. Lachman's negative (I hate this test !!), MCL fine, and he gently hit the femur bone and asked me if it was painful, and concluded the bone bruise was over (is it ever so simple ?). Then he schedules the operation one week later. I am happy, at least something quick !
June, 1st - the so-long awaited operation, EVENTUALLY My appointment at the outpatient clinic is at 8.20am, so I am in with my BF at 8am. I am taken to the waiting room at app. 8.30. Worst feeling ever : I am feeling extremely anxious (this was my very first operation) and in the same room there is a small child crying as loud as he can. I am getting more and more anxious.
I am taken the OP room and that feels like a relief -man, this small child was driving me crazy!. I had opted for a spinal anesthesia (way too scared to go under) and everything goes pleasantly smooth (I had a lot of apprehension just thinking about the thought of being unable to feel my legs). The anesthetists asks if I want to sleep (no thanks !) and if I want to be able to see the operation on the TV (thanks but no thanks ! How about no ?!
).
Because I chose not to see the operation, the anesthetists keeps me posted in between 2 jokes (nice fellow !) : one can still see that something has happened to the knee, and
apparently the locking symptoms and other stuff were caused by loose bodies caught in the joint (rather than the meniscus tear which is
according to them extremely small). LCA is now completely fine, MCL is fine (can you see it arthroscopically
?). Both anesthetists and OS state that I was pretty lucky. Last but not least, although I am pretty sure that my perception of time during the operation was distorted, I felt it all went by extremely fast : something between 15 and 30 min.
Rest of the story in the recovery room is pretty insignificant : it took about 2 hours for the anesthetics to wear off, then I had little pain that was "easily" treated by 600mg ibuprofen, OS came in to tell basically that he did not trim the meniscus, just removed the loose bodies here and there. I am released by the anesthetists and free to go at about 12.30pm and back home with my beloved at 1pm. Nice and fast !
Week #1 "everything is as good as it can be after a surgery"Day 1 after the arthroscopy, back to the OS to remove the dressing, check the wound and other checks. Wound looks good, the knee is not so swollen thanks to the compression stockings, and the OS gives me the first prescription for PT. And on this prescription is staten something that at that time looked obscure to me but that many of you know : "
rupture of the plica infrapatellaris". I have to say that up to date I have not fully understood where this P. Infrapatellaris is. I am off work for 2.5 weeks for now and am allowed to bear weight as tolerated (and I do have crutches).
Most importantly the OS mentioned that while I was still under anesthetics after the surgery, he was able to fully extend and bend the knee. I did not say anything, although objecting in my head "Dude ! Sure I expect you to do this while I am under anesthetics ! What are you willing to prove me ?!"
The week-end passes by before I go to my first PT session (3x a week) and I feel surprisingly good. By that I mean that as long as I did not try complicated movements, I was fine and in no pain. I could walk a bit around the corner with my crutches.
First PT session however
was painful
. She had me contract my not any longer-existing quadriceps which felt so painful deep inside the knee (pretty much like a knife stab). Left the PT sore but happy to have done something. Rest of the week at the PT was dedicated to regain the extension. The way it works here in Germany is that the PT sees you for 15-20min and gives you homework. The homework for me at this point are exercises meant to stretch the hamstrings and calf muscles -mostly forward bends. I like these exercises very much because I can do them without putting much strain on my knee
.
Week #2 "well it's just two weeks, right ?"Week #2 looks pretty similar to week#1 in terms of PT exercices, plus quadriceps contraction and a tiny bit of flexion (ouch so painful !!!!!). Knee feels sore and stiff in the morning. Next appointment at the OS's (mine is on holidays so it's another doctor this time) to check the wound, renew the PT prescription and assess my ability to go back to work. Wound looks good, the steri-strips came off by themselves, PT is renewed. BUT as the extension is not fully regained here, I still should not drive and therefore cannot go back to work. Looking back at it, I do admit it was a decision for the best, it would have been too early for me to go back to work. I ask whether the pain in the morning + when bending is normal. "Yeah yeah it's just 2 weeks, no problem
".
Week #3 "um, is it ever getting any better ?"Highlight of week#3 is a saying by a PT (not my regular one) : "well you know, you should be doing those exercises for 4-5 hours a day !"
Huh excuse me
So this week, the knee feels unhappy and
so sore. It is getting so complicated to do even 5 min of gentle bending back and forth. The PT's saying makes me laugh in my own pain. How can she expect me to do 5 hours a day, I mean really. I try to keep up with icing-> exercising > resting, and again. Compression stockings are now off. Visits at the PT are getting depressing : extension is quite ok but bending has not shown any improvement and is stuck at 90°. PT states that usually after meniscus trim, at 3 weeks the knee feels better (thanks for giving me hope !).
I am getting very sad and doubtful : it is now 3 weeks and I have seen so little if not any improvement. Most importantly, the PT exercises seem to only trigger pain but do not improve my ROM. I decide to try something : 800mg ibuprofen about an hour before the PT appointment. Unfortunately, it does not help at all.
New appointment at the OS (he's back). I tell him that PT is concerned about my progress, that I am in a lot of pain (knife stab when I bend my leg). He repeats what he told me 2/3 weeks ago : he really does not think that the meniscus tear is a problem, and he (at last!) could extend it and bend it while my legs were under anesthetics. This time I do object (!) that I do not know what conclusion he can draw as I could certainly not feel any pain. He says yes sure, but that way he can determine that nothing mechanical obstructs the knee. He says the pain is most likely due to the fact that everything has gotten so stiff inside the knee. Therefore he wants to go on with PT and thinks a good 8 weeks will be needed. I ask if something can be done for the pain however, so that I could at least do those bloody PT exercises with less pain. I also tell him that I tried ibuprofen but it didn't help. He says some people do not react so well to ibuprofen so he has me on diclofenac instead (hefty dose : 2x75mg/day) + the German equivalent for paracetamol (metamizol, 3x500mg/day).
Now here are my thoughts regarding what the OS said : I do understand that the pre-op stiffness does not help but what I do not understand is how it can trigger such a massive pain (when I bend it at least). So I am thinking to now let 2-3 weeks pass and if no improvement is to be seen, then I might go for a second opinion.
Since then, the anti-inflammatories have helped a little bit. It is now slightly more comfortable to bend the knee past 90° (I would say 80° is feasible). In the mornings, I wake up lacking app. 5° extension, but I regain them with a few exercises afterwards (I am wondering if it will stay like this forever
). I try not to take the NSAID (diclofenac) twice a day as yesterday my stomach felt pretty upset (even though I always take it after a meal)
Tomorrow I am going back to work, and I am going on with the PT. This story is to be continued ! Thanks for reading me !
